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Perched on the edge of the exam table at my doctor’s office in a Chicago suburb, I was shivering under my thin gown.
“Do you have any questions about the delivery?” My OB-GYN stepped back and readjusted her glasses.
I paused. My questions were not about the mechanics of delivery, since I had already given birth once before in Switzerland — but more about the way birth was handled in a place that still felt foreign to me after almost a decade away — my own country.
I wanted to ask why the US has the highest maternal death rates in the developed world. I wanted to ask if the birth would cost more than $3,000 — the price for delivery, and a five-night stay in a Swiss hospital, which is fully covered by Swiss insurance. I wanted to ask why we are the only developed nation in the world without paid family leave.
Instead, I asked something simpler. Something that had a yes or no answer.
“Does the hospital have birthing stools?”
My doctor’s wrinkles deepened.
“What’s a birthing stool?”
Arrival at the delivery ward in the US vs Switzerland
So no, the suburban Chicago hospital had no birthing stool. When I arrived, fully dilated and ready to deliver, they also had no record of me (or perhaps more importantly, of my insurance) despite the fact that I had already been there for my two allotted ultrasounds.
As I stood there, wincing in pain while they messed with their computer, I learned my first lesson at the American hospital: You can’t push unless they can confirm you can pay.
This “welcome” was in sharp contrast to my arrival at the Swiss hospital, where nurses met me at the door with a wheelchair and whisked me away to a birthing room, with no bureaucracy to hold my labor back.
When I was finally deemed worthy of a room at the American hospital, I was shown to a bed. I did not want to be on a bed. I knew from birthing my first child that lying on a bed was the most uncomfortable position of all.
I knew because the Swiss and German midwives who had attended the birth of my first child had prompted me to try almost every position and option they knew of to find what would make me the most comfortable. Yet when I continued to request an alternative situation at the US hospital, the nurse gave me an oxygen mask instead, perhaps to keep me quiet.
I felt lucky not to be a first-time mom in America
The other major difference was the overall level of care, both in the hospital and outside it. In Switzerland, the standard of care is a five-day hospital stay for a vaginal birth and a 10-day hospital stay for a C-section. Despite having a private insurer-based system like the US, the Swiss system is tightly regulated by a government that acknowledges that there’s a basic level of care that all people deserve.
This includes the belief that a woman and her newborn need close monitoring across an extended period of time to ensure positive health outcomes for all.
Contrast this to the US, where I was discharged after less than 40 hours, with no follow-up care included other than a six-week, postpartum check-up at my OB-GYN’s office. If I had been a first-time mother in the US, I couldn’t have been taught to breastfeed right at the hospital, as a mother’s milk doesn’t come in for three or five days after birth.
During my five-day hospital stay in Switzerland, in addition to constantly monitoring my baby and my health, I was taught to breastfeed, diaper, and bathe my baby. I was asked if I’d like to go outside for a walk in the woods. I was also given a candlelight dinner with my husband within the hospital.
The level of care was outstanding, even with my basic Swiss health insurance (premium $274 a month) and even at a public hospital.
Then, after five days, I was only allowed to be discharged knowing I’d be under the continued care of a midwife, who came to my own home to check on me and the baby for another 10 days over the next month. All are covered completely by my Swiss insurance, with no surprise billing included.
At the time, I had taken this level of care for granted. I had no idea how it compared to what new mothers experience in the US. But now I know: No time to heal or learn to breastfeed in a hospital, hardly any follow-up care for the newborn or herself, no legally mandated paid leave, and stress-inducing, opaque costs surrounding delivery and beyond.
My US, non-medicated birth cost my insurer over $9,000 — more than three times the Swiss price for much less care — but I was “lucky.” The average US birth costs insurers $18,865, with out-of-pocket payments for women enrolled in large group plans totaling $2,854, according to the Peterson-KFF Health System Tracker. It’s a staggering price to pay by world standards.
The system in the US felt broken
Five years later, I haven’t been able to shed the feeling that something is wrong with the care in my own country. That we all deserve better. Especially considering we are paying so much more for so much less.
My experience is only mine, but statistics also show that there are problems behind the state of care in America. In June, the Commonwealth Fund reported that more women in the US are dying of pregnancy-related complications than in any other developed country. In 2022, the rate for infant mortality in the US also increased, per Centers for Disease Control and Prevention.
I was left feeling that healthcare doesn’t have to be like this — I know from experience that in other wealthy countries, it isn’t.
Chantal Panozzo is writing a book about what she wishes she’d known about American life before giving up her Swiss residency permit.
Got a personal essay about culture shock or relocating a family that you want to share? Get in touch with the editor: [email protected].
