During birth

There are 3 phases of birth: opening phase, expulsion phase and postpartum phase. The opening phase can be further divided into a latency phase, active phase and transition phase.

At the beginning of the latency phase, contractions come at intervals of 5 to 20 minutes and last between 60-90 seconds. These opening contractions are most comparable to period pain or mild back pain. In the latency phase, you can do anything that doesn’t stress you out too much, e.g. take a warm bath, take a walk outside in the fresh air, read, etc. The latency phase can last several hours.

In the active phase, there is increased labor activity. The intervals between contractions become shorter and the cervix opens. This is where the breathing and relaxation exercises learned in the childbirth preparation course come into play. The transition phase from 8cm to full cervical opening is experienced by most women as the most intense and painful phase.

In the expulsion phase, the pushing contractions push the baby through the birth canal and you are finally allowed to push along. This phase usually lasts 1-3 hours for the first child. In each subsequent pregnancy, this time is shortened.

In the postpartum phase, the placenta is detached from the uterus, which is manifested by renewed contractions. To assist in this process, synthetic oxytocin is often administered to cause the uterus to contract again and minimize bleeding. Light pushing leads to placental delivery. This is checked for completeness by the midwife and the doctor using the 4-eyes principle. No residue should be left behind, otherwise there is a risk of increased bleeding.

There is no blanket answer to this question. On the one hand, it depends on the stage of birth, as well as your personal preferences.

In the opening stage, upright positions, such as standing or walking, can help to initiate labor or promote delivery. Over time, such positions can become strenuous, so sitting wide-legged on an exercise ball can also be an alternative. Likewise, a warm bath can be found soothing, antispasmodic and relaxing. There are women who feel so comfortable in it that a water birth can be attempted.

In the expulsion phase, alternating between different positions such as kneeling, quadruped or knee-elbow position helps, likewise sitting in bed or lying on your side can be a birthing position where you can also relax between contractions. If a suction cup needs to be inserted, this is done in a semi-sitting position.

Your midwife will try out different birthing positions with you, allowing you to help decide what suits you best.

The midwife can support you according to your wishes. Relief can bring heat, a relaxing bath, as well as aromatic oils and homeopathy. Anticonvulsants or nitrous oxide may also be used. An experienced anesthesia team is on call around the clock for peridural anesthesia or remifentanil PCA (“happy button”).

Harmless preterm labor (practice contractions) are usually painless, last about 25 seconds, and get weaker when you rest or take a warm bath. Contractions should not occur more frequently than three times per hour or ten times per day.

Contractions that last between 20 and 60 seconds, occur every five to seven minutes for an hour, and become increasingly painful may be a sign of true labor. In this case, you should contact us immediately.
But even if you are worried about whether your contractions are harmless preterm labor or “real” labor, we are always available to check on you.

If you are concerned, please contact us for a check-up appointment in the outpatient clinic (during the day +41 44 255 51 03) or in the delivery room (at night or on weekends +41 44 255 53 15).

Routine performance of an episiotomy leads to unnecessary perineal injuries and therefore we refrain from doing it. In principle, perineal incisions are only used very restrictively at the USZ.

However, there are situations when there is a fear of a higher degree of perineal rupture (in case of narrow vaginal entrance, tight tissue, large head) or damage to the child. This is the case, for example, when the drop in fetal heart sounds necessitates rapid termination of labor, whether by suction cup or forceps delivery. An episiotomy may also need to be made for births from breech presentation or spontaneous twin births.

Our checklist will help you prepare for your hospital stay. We recommend that you pack your suitcase a few days before the expected date of birth. With it, you will be ready immediately when your child announces himself.

To register the birth of your child, the Civil Registry Office of the City of Zurich (www.stadt-zuerich.ch/zivilstandsamt , Tel. +41 44 412 31 50, E-Mail: infozsa@zuerich.ch) needs several documents of the parents. These must be handed in to the patient office upon admission to the University Hospital. Depending on the origin and marital status of the parents, different documents are required.