Key points at a glance
- Under the KVG, midwives are service providers in their own right and bill basic health insurance without a doctor’s prescription (Art. 35 para. 2 let. d KVG).
- In a normal pregnancy, the midwife may carry out seven check-ups (Art. 16 KLV).
- After the birth, basic health insurance covers 10 home visits, or 16 for first-time mothers, multiple births, premature births or caesarean sections, in each case within the first 56 days.
- Antenatal preparation with a midwife is covered with CHF 150, breastfeeding advice with three sessions (Art. 14 and 15 KLV).
- The insurer charges no co-payment on midwife services in the case of maternity (Art. 64 para. 7 KVG).
What is a midwife?
A midwife is a health professional who cares for women during pregnancy, at the birth and in the postnatal period. In Switzerland, she needs a cantonal licence to practise under the Health Professions Act. Midwives work in hospitals, in birth centres or independently, in which case they also come to your home.
Midwives have a special position in health insurance. The Federal Health Insurance Act (KVG) lists them as service providers in their own right, alongside doctors, pharmacies and hospitals. Unlike physiotherapists, for example, they do not need a doctor’s prescription for most services. What they may do at the expense of basic health insurance is set out exhaustively in the Health Care Benefits Ordinance (KLV).
Midwife services are among the special maternity benefits. The insurer charges no deductible and no retention fee on them. This applies regardless of which deductible you have chosen and which insurer you are with.
Supplementary insurance can pay for further services around the birth, such as household help or additional classes. This depends on the contract, not on the KVG.
How it works
The midwife bills your insurer directly or sends the invoice to you, depending on the arrangement. The services follow the course of events:
| Phase | What the midwife does at the expense of basic health insurance |
|---|---|
| Pregnancy | 7 check-ups in a normal pregnancy, necessary laboratory analyses, referral for an ultrasound scan by a doctor, cardiotocography if indicated |
| Preparation | Antenatal class or counselling session on the birth, the postnatal period and breastfeeding: contribution of CHF 150 |
| Birth | Obstetric care at home, in a birth centre or in hospital |
| Postnatal period | Home visits in the first 56 days: a maximum of 10, or a maximum of 16 for first-time mothers, multiple births, premature births or caesarean sections; up to 5 second visits in the first 10 days |
| Breastfeeding | 3 breastfeeding advice sessions |
| Postnatal check-up | one examination between the 6th and 10th week after the birth |
| After a miscarriage | from the 13th to the end of the 23rd week, a maximum of 10 home visits |
The midwife points out to you that a medical examination is advisable in the first trimester. The ultrasound scan itself is carried out by a doctor with the relevant postgraduate training. In a high-risk pregnancy without manifest pathology, the midwife works together with the doctor; if there is manifest pathology, she works on a doctor’s order.
If you need more home visits than provided for, for example because breastfeeding is not going well, the doctor issues an order. Basic health insurance then also pays for visits beyond the maximum number or after the 56 days. According to the Federal Office of Public Health (FOPH), these visits also count as maternity benefits without co-payment.
Legal basis
Art. 35 para. 2 let. d KVG includes midwives among the service providers of basic health insurance. Art. 29 para. 2 KVG lists check-ups by midwives (let. a), obstetric care by midwives (let. b) and breastfeeding advice (let. c) as special maternity benefits. Art. 64 para. 7 let. a KVG excludes co-payment on these.
Which midwives may bill is governed by Art. 45 of the Health Insurance Ordinance (KVV): a cantonal licence to practise, two years of practical work under the supervision of an approved midwife and proof of meeting the quality requirements. Art. 45a KVV applies to midwives’ organisations. The scope of services is set out in Art. 16 KLV, with references to Art. 13 (check-ups), Art. 14 (CHF 150 for antenatal preparation) and Art. 15 KLV (three breastfeeding advice sessions).
Cost containment package 2, which Parliament adopted on 21.03.2025, extends midwives’ powers: they are to be able to administer certain medicines, prescribe analyses and aids, and also care for mother and child after the birth in the event of illness. The federal government is still drafting the implementing provisions; until they apply, the scope under Art. 16 KLV remains decisive.
Example: the postnatal period after a first birth
Elena, 29, has her first child in hospital and goes home after three nights. She has a CHF 2,500 deductible. Her midwife cares for her after the birth.
| Service | Entitlement under the KLV | Elena uses | Co-payment |
|---|---|---|---|
| Antenatal class | Contribution of CHF 150 | Class with the midwife | CHF 0, rest of the class fee herself |
| Home visits in 56 days | maximum of 16 (first-time mother) | 12 visits | CHF 0 |
| Second visits in the first 10 days | maximum of 5 | 2 second visits | CHF 0 |
| Breastfeeding advice | 3 sessions | 3 sessions | CHF 0 |
| Postnatal check-up in weeks 6–10 | 1 examination | with the midwife | CHF 0 |
What this means for you
Look for a midwife for the postnatal period early in your pregnancy. Independent midwives are in high demand in some regions. Ask whether she is approved under the KVV; if so, she can bill your insurer.
Check your insurance model. In a GP, HMO or telemedicine model, special rules apply to access to specialists. If you break them, the insurer can reduce benefits. You will find your insurer’s contact details in its profile under health insurers.
Check your statements: no deductible may appear on midwife services. If you are planning a birth next year, compare the premiums for yourself and later for your child in the premium calculator. Registering your baby is explained in the entry on registration before birth, and details on breastfeeding advice are on a separate page.
Common mistakes
- Looking for a midwife too late. If you only start looking after the birth, in some regions you will not find anyone for the first days at home.
- Overlooking the maximum number of visits. Beyond 10 or 16 visits, basic health insurance only pays with a doctor’s order.
- Assuming the class fee is fully insured. Basic health insurance only pays CHF 150 towards antenatal preparation.
- Accepting a deductible on the statement. Midwife services in the case of maternity are exempt from co-payment.
- Ignoring the model rules. In the GP or HMO model, failing to inform the insurer can lead to reductions.
Frequently asked questions
Does the health insurer pay for the midwife?
Yes. Basic health insurance pays for check-ups, obstetric care, antenatal preparation with CHF 150, three breastfeeding advice sessions and the home visits after the birth. The midwife must be approved under the KVV. No co-payment is charged.
How many home visits by the midwife does the health insurer cover?
In the first 56 days after the birth, a maximum of 10; after a premature birth, a multiple birth, for first-time mothers and after a caesarean section, a maximum of 16. In the first 10 days, up to 5 second visits on the same day are added. Further visits require a doctor’s order.
Do I need a referral from a doctor to see a midwife?
No. Midwives are independent service providers. In a high-risk pregnancy without manifest pathology, the midwife works together with the doctor; with manifest pathology, she works on a doctor’s order.
Do I have to report the midwife in the GP or HMO model?
That is set out in the conditions of your model. The rules for direct access to a gynaecologist and a midwife differ from model to model. Read the model conditions or ask your insurer before you submit the first midwife invoice.
Related terms
- PregnancyDuring pregnancy, basic health insurance pays special benefits on top of the normal benefits for illness: seven check-ups, two ultrasound scans, CHF 150 towards antenatal classes, the birth and three breastfeeding consultations. No deductible applies to these benefits. From the 13th week until eight weeks after the birth, you are exempt from any co-payment.
- ChildbirthBasic health insurance covers the costs of childbirth, in hospital, in a birth centre or at home. For maternity benefits, you pay no deductible and no retention fee, and the same applies to treatment from the 13th week of pregnancy until 8 weeks after the birth. You must register your baby with a health insurer within 3 months.
- Breastfeeding counsellingBreastfeeding counselling is professional support with breastfeeding from a midwife or a specially trained nurse. Basic health insurance pays for three sessions as a specific maternity benefit. No deductible and no retention fee apply to them, whatever deductible you have chosen. On top of this, it covers the midwife’s home visits in the postnatal period.
- MaternityIn basic health insurance, maternity covers all benefits relating to pregnancy, childbirth and the postnatal period: check-ups, the birth, the midwife, breastfeeding advice and CHF 150 for antenatal classes. You pay no deductible and no retention fee on these benefits. From the 13th week of pregnancy until eight weeks after the birth, there is also no co-payment for illness.
- Antenatal preparationAntenatal preparation covers classes and counselling sessions that prepare you for the birth, the postnatal period and breastfeeding. Basic health insurance pays a contribution of CHF 150 towards a class or a counselling session with a midwife. No deductible or retention fee applies; anything the class costs beyond that, you pay yourself or a supplementary insurance pays.
Sources
- Health Care Benefits Ordinance (KLV), Art. 16Art. 16 KLVfedlex.admin.ch
- Federal Health Insurance Act (KVG), Art. 29 and 35Art. 29 KVGfedlex.admin.ch
- Federal Health Insurance Act (KVG), Art. 64 para. 7Art. 64 para. 7 KVGfedlex.admin.ch
- Health Insurance Ordinance (KVV), Art. 45, current version (German; the English version on fedlex dates from 2021 and predates the approval rules in force since 2022)Art. 45 KVVfedlex.admin.ch
- Health Care Benefits Ordinance (KLV), Art. 13–15Art. 13–15 KLVfedlex.admin.ch
- FOPH: Health insurance, maternity benefits (German, no English version)bag.admin.ch
- FOPH: Amendment of the KVG, cost containment measures – package 2 (German)bag.admin.ch