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Old 29.05.2020, 10:43
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Choosing hospital for high-risk pregnancy [Zh]

Hi,

I am at 32 weeks now and considered high risk due to age and uterus shape.

Seems like University of Zurich is a good choice as they are equipped well in case of complications.

I have basic insurance.
I understand that I can choose the doctor (say head of department) if I pay the difference for semi-private insurance (7.800 CHF which is only the deposit actually, so the price can go up).

I will most probably have c-section.
My question is, if I go with basic insurance and don't choose a doctor, what is the risk of having an inexperienced doctor for the operation?
Would the hospital see that the situation is high risk and assign a doctor who is experienced with risky situations?

Or should I just pay semi-private and not be surprised if I receive a bill of 30k later?
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Old 29.05.2020, 11:00
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Re: Choosing hospital for high-risk pregnancy [Zh]

We knew upfront that due to the size/weight of the baby it be a C-section anyway and we've been to Frauenklinik Triemli.

Don't worry to much about inexperienced doctors, both hospitals are perfectly equipped and have excellent people for whatever might happen and will provide a team that is more than capable of handling the delivery. And choosing the doctor only works if the kid allows you to have a nicely planned delivery, my OH's water broke at 11 in the evening, and the kid was born at 03:56 at night.
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Old 29.05.2020, 11:16
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Re: Choosing hospital for high-risk pregnancy [Zh]

You would be better off talking this over with your gynecologists' than getting subjective opinions here. The Hirslanden group of hospitals has great facilities even in their public wards, our two sons were born there and service and facilities were excellent.
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Old 29.05.2020, 23:35
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Re: Choosing hospital for high-risk pregnancy [Zh]

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You would be better off talking this over with your gynecologists' than getting subjective opinions here. The Hirslanden group of hospitals has great facilities even in their public wards, our two sons were born there and service and facilities were excellent.
They're not exactly equipped for high risk pregnancy due to age though. I assume you're over 42, as that's the highest risk group. You might end up separated from your infant.
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Old 30.05.2020, 00:17
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Re: Choosing hospital for high-risk pregnancy [Zh]

Similar advice to above - find out what happens if you are well but baby is unwell. My colleague had a premmie in Zurich, but I don't know which hospital... and she went home after a week, but her baby stayed at the hospital ...she could not drive due to c-section, needed a taxi service twice a day to get to the hospital to deliver her milk and spend time with her baby... it was really really hard... but she did it and baby came home quite quickly and was tiny but generally very well and she was able to breastfeed successfully in the longer term... but it was quite a fight!


Generally really complex cases, mother or baby, will go to a specific hospital - I would say to check with your doctor, and talk through likely scenarios if mother or baby are very unwell...
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Old 30.05.2020, 01:12
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Re: Choosing hospital for high-risk pregnancy [Zh]

Shouldn’t you already be registered at a hospital that has a working relationship with your gynecologist?

Are you planning to just show up when you are ready for delivery?
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Old 30.05.2020, 08:45
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Re: Choosing hospital for high-risk pregnancy [Zh]

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Shouldn’t you already be registered at a hospital that has a working relationship with your gynecologist?

Are you planning to just show up when you are ready for delivery?
Sorry about that. I re-read your post and you are at 32 and not 36 weeks.

If you expect there might be complications, having someone that knows exactly how to stitch your shape could make for a more comfortable experience. After delivery, you don’t want someone down there that is trying to figure out how to fit everything back together.
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Old 30.05.2020, 16:24
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I would call the hospitals and ask for information (i.e. whether you can pay the difference). The thing is that if you have something of particularly high risk I understand you should be redirected to a specialist for that. Before when I did not have private insurance I needed to have an orthopaedic surgery that is highly specialised - I was operated by the head doctor despite being on general insurance.

Except Uni Spital and Triemli maybe Limmattal could also be an option (even though I do not have any experience with the hospital I doubt it would have much more to offer than the first two).

I have recently read entire threads on Englishforum regarding giving birth and remember someone saying Dr Michael Rabner was an advising doctor for someone's high-risk pregnancy but I do not have any experience myself.

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Sorry about that. I re-read your post and you are at 32 and not 36 weeks.

If you expect there might be complications, having someone that knows exactly how to stitch your shape could make for a more comfortable experience. After delivery, you don’t want someone down there that is trying to figure out how to fit everything back together.
Maybe one could put up this more nicely, but yes I do agree. I have heard of horrid experiences of terrible stitching in some hospitals in ZH unfortunately... Luckily that is not a life-death matter and not a high-likelihood issue but may have significant effects on your well-being.

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And choosing the doctor only works if the kid allows you to have a nicely planned delivery, my OH's water broke at 11 in the evening, and the kid was born at 03:56 at night.
This is not true, with semi-private or private insurance you can choose your doctor. And in case they are not available (e.g. on holidays, have a parallel delivery though unlikely) they will have appointed an alternative. Note that most of them show-up only after you are 10cm dilated or before if there's a problem.

Some hospitals have pre-fixed amount to pay for the upgrade. 4am delivery is a very standard thing.

Last edited by 3Wishes; 31.05.2020 at 23:41. Reason: merging consecutive replies
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Old 31.05.2020, 02:17
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Re: Choosing hospital for high-risk pregnancy [Zh]

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Maybe one could put up this more nicely, but yes I do agree. I have heard of horrid experiences of terrible stitching in some hospitals in ZH unfortunately... Luckily that is not a life-death matter and not a high-likelihood issue but may have significant effects on your well-being.
It's not terrible stitching, it's the "husband" stitch that basically tightens women and makes sex so painful it ends the marriage.

Your best bet is to do perineal massage and using an epi-no starting now and avoid an episiotomy so you don't need to be stitched. Highly recommended.
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Old 31.05.2020, 11:02
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Re: Choosing hospital for high-risk pregnancy [Zh]

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It's not terrible stitching, it's the "husband" stitch that basically tightens women and makes sex so painful it ends the marriage.

Your best bet is to do perineal massage and using an epi-no starting now and avoid an episiotomy so you don't need to be stitched. Highly recommended.


btw, epi no is from week 36+
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Old 31.05.2020, 15:12
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Re: Choosing hospital for high-risk pregnancy [Zh]

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They're not exactly equipped for high risk pregnancy due to age though. I assume you're over 42, as that's the highest risk group. You might end up separated from your infant.
Agree to that plus don't have baby ICU if needed. I have loved giving birth there but I and baby were low risk. Would not go for high risk.
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Old 31.05.2020, 23:02
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Re: Choosing hospital for high-risk pregnancy [Zh]

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Your best bet is to do perineal massage and using an epi-no starting now and avoid an episiotomy so you don't need to be stitched. Highly recommended.
Save yourself the money and the hassle as the EpiNO doesn't work, really. Perineal massage isn't all that useful either: it reduces your risk of getting stitches by 10% and an episiotomy by 15% but not the general incidence of tearing. As these are relative risks, this means that if 20/100 women need stitching, of those practicing perinatal massage only 18/100 will. Looking at those numbers I decided I have better things to do in the last weeks of my pregnancy
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Old 31.05.2020, 23:28
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Re: Choosing hospital for high-risk pregnancy [Zh]

I was an older mother (37) with gestational diabetes and a couple of other risk factors which I have now forgotten. I have private medical insurance, but opted for Unispital as I didn't want to be separated from my baby if ICU care was required. I gave birth to two babies there, the second of which did require a few precautionary hours in ICU.

I can't say I was really bothered about having my own doctor there. He couldn't anyway attend Unispital and wouldn't have turned up if I had chosen the Hirslanden, which he recommended, as he was on holiday for both of my births. I was lucky and had two natural deliveries without much drama and was off home again within a day or two. I was happy with the choice I made and believe it was the best choice for my sons. I should add this was more than 20 years ago.

I think you would get good care there and probably don't need to upgrade your insurance, but obviously this depends on your risk factors. In any event, I wish you and your baby all the best.
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Old 01.06.2020, 10:03
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Re: Choosing hospital for high-risk pregnancy [Zh]

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Save yourself the money and the hassle as the EpiNO doesn't work, really. Perineal massage isn't all that useful either: it reduces your risk of getting stitches by 10% and an episiotomy by 15% but not the general incidence of tearing. As these are relative risks, this means that if 20/100 women need stitching, of those practicing perinatal massage only 18/100 will. Looking at those numbers I decided I have better things to do in the last weeks of my pregnancy
I guess it's the selection bias. None of the women that I spoke to about the epino ended up tearing. All the women that didn't have one and didn't do massage tore, and needed stitches. I'm pretty glad I was spared this ordeal. Sounded unpleasant.
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Old 01.06.2020, 14:38
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Re: Choosing hospital for high-risk pregnancy [Zh]

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I guess it's the selection bias. None of the women that I spoke to about the epino ended up tearing. All the women that didn't have one and didn't do massage tore, and needed stitches. I'm pretty glad I was spared this ordeal. Sounded unpleasant.
I have read a lot about this and am undecided, not sure what to think... Many people using it did not tear, some say it is easier than the massage which I can imaging to be so. On the other hand I did come across reviews where people did tear despite using epi-no... but maybe it would have been worse without or maybe not, very difficult to say... There are also lots of people who did not use either and did not tear at all...

Maybe having extra collagen and c-vitamin can help (difficult to say, but if trying epi-no would also go for supplements that make skin more elastic - though one should be careful with c vit dosage during pregnancy)

An additional thing is the perineal massage and/or hot compress during the delivery itself. But some studies say it helps only for 3+ tears and the position of doing it is so that may increase the risk of tears...

One of the risk factors for tearing is a too quick delivery - water can slow down to an extent so having some time in-water may help but that's a separate story with lots of dimensions...
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Old 01.06.2020, 19:31
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Re: Choosing hospital for high-risk pregnancy [Zh]

My both pregnancies were of higher risk due to a breech position and my uterus shape and they both ended with C-section. I intentionally chose UniSpital and have never regretted my decision.
In both cases I had only a basic insurance and didn't know the doctors who would perform the procedure but they knew me and my case. Were fully professional and did great job!
The second daughter had to spend some days at the neonatal ward and I could visit her as soon as I could move (well, the nurse brought me on a wheelchair for the very first visit, then I was slowly moving myself).
Long story short: UniSpital is the place that one wants to be in case of complications as they do have very good professionals.

PM me if you have any additional questions.
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Old 01.06.2020, 19:40
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Re: Choosing hospital for high-risk pregnancy [Zh]

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I have read a lot about this and am undecided, not sure what to think... Many people using it did not tear, some say it is easier than the massage which I can imaging to be so. On the other hand I did come across reviews where people did tear despite using epi-no... but maybe it would have been worse without or maybe not, very difficult to say... There are also lots of people who did not use either and did not tear at all...

Maybe having extra collagen and c-vitamin can help (difficult to say, but if trying epi-no would also go for supplements that make skin more elastic - though one should be careful with c vit dosage during pregnancy)

An additional thing is the perineal massage and/or hot compress during the delivery itself. But some studies say it helps only for 3+ tears and the position of doing it is so that may increase the risk of tears...

One of the risk factors for tearing is a too quick delivery - water can slow down to an extent so having some time in-water may help but that's a separate story with lots of dimensions...
I tore and had an episiotomy on both of my births. I can't honestly say I felt a thing either at the time or afterwards. I suffered no repercussions and it didn't impact on my positive birth experiences. I understand it would no doubt be better if it could be avoided, but it's not as bad, in my experience, as you might think.
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Old 01.06.2020, 22:53
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Re: Choosing hospital for high-risk pregnancy [Zh]

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I tore and had an episiotomy on both of my births. I can't honestly say I felt a thing either at the time or afterwards. I suffered no repercussions and it didn't impact on my positive birth experiences. I understand it would no doubt be better if it could be avoided, but it's not as bad, in my experience, as you might think.
Thanks for sharing. For many people it does not have too much consequences.

But actually it depends a lot on:

1. what level tear it was (there are 4 levels with worst ones including severe muscle damage and 1 is peripheral skin damage).
2. how was the stitching done

I know people who could not sit for half a year and that's not the worst case scenario...
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Old 02.06.2020, 01:23
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Re: Choosing hospital for high-risk pregnancy [Zh]

One of my close friends said she was struggling with a second degree tear for weeks. And a colleague barely noticed a 3rd degree tear despite having to use frozen sanitary pads for a month.

I'm a bit horrified that anyone would have to use frozen sanitary pads for a month, or how anyone would find frozen pads barely noticeable.

More women should have c-sections, episiotomies sound barbaric.
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Old 02.06.2020, 02:01
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Re: Choosing hospital for high-risk pregnancy [Zh]

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More women should have c-sections, episiotomies sound barbaric.
luckily they are not as mainstream as they used to be but still lots to be done
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