TeamBirth Switzerland

What is TeamBirth?

TeamBirth is an evidence-based and internationally evaluated communication model designed to promote shared decision-making in maternity care. Developed by Ariadne Labs under the leadership of Amber Weiseth from the Harvard T.H. Chan School of Public Health, the model aims to provide patient-centred and transparent birth care.

The central element of the TeamBirth model are the so-called «huddles». Huddles are brief, clearly structured team meetings between the birthing person, their birth companions, midwives, doctors and nursing professionals. These team meetings take place during outpatient antenatal care, throughout the entire course of labour, and in the postpartum setting. During the huddles, options for action are presented transparently, decisions are discussed jointly, and care steps are coordinated and planned collaboratively.

TeamBirth Switzerland

Reproductive health in Switzerland faces fundamental challenges. Caesarean section and induction rates are significantly above WHO recommendations and are amongst the highest in Europe. Whilst caesarean section rates have stagnated for years, inductions continue to rise. This development points to structural deficits in shared decision-making and interprofessional collaboration around the course of labour.

At the same time, more than a quarter of birthing people in Switzerland report a lack of co-determination, insufficient transparency, and experiences of informal or structural violence during childbirth. Restricted autonomy and a lack of participation are demonstrably associated with increased risks of postpartum psychological complications such as depression or anxiety. They also impair breastfeeding and bonding processes as well as the long-term wellbeing of the entire family — with significant consequences for public health and the cost of care.

Maternity care is therefore far more than a medical issue. It touches on fundamental societal questions: Are all people receiving equally good care? Can birthing people trust the system? Do they understand what is happening to them and why? Good care around birth must therefore consider the whole person — physically, psychologically, and socially. It must take seriously and actively incorporate the needs, values, and resources of birthing people and their birth companions.

This is the starting point for our pilot study at the Stadtspital Zürich Triemli: With this study, we aim to structurally embed this integrative perspective in research, teaching, and practice.

Objectives

The aim of our project is to adapt the TeamBirth model to the Swiss context and to pilot it in practice for the first time. We are investigating whether and how well the approach can be implemented in everyday clinical settings (feasibility), how it is received by healthcare professionals, birthing people, and their companions (acceptability), and what initial effects it demonstrates (effectiveness).

At the heart of the project is a structured approach that improves communication between all parties involved and actively engages birthing people in decisions during labour (shared decision-making).

The study pursues the following secondary objectives:

1. To investigate whether the implementation of the TeamBirth model is associated with changes in patient-reported experiences and outcomes (PREMs and PROMs) of birthing people and their partners.
2. To investigate whether changes in clinical care practice are evident in connection with the intervention, particularly with regard to intervention rates as well as maternal and neonatal outcomes.
3. To identify contextual factors, barriers, and facilitating conditions that influence the adaptation and implementation of structured decision-making in Swiss maternity care.
4. To derive recommendations for the sustainable implementation and possible scaling of the TeamBirth model in the Swiss context.

Methods und procedure

The study encompasses the context-sensitive adaptation, pilot implementation, and evaluation of the TeamBirth model at the Stadtspital Zürich Triemli, where approximately 2’900 births take place annually (2’932 in 2025).

During a preparatory phase, we will adapt the model to the local context and develop a training concept (e-learning and simulation-based training) for healthcare professionals.

Implementation will subsequently take place in everyday clinical practice and will include structured team communication (e.g. huddles) as well as the use of visual communication tools to support shared decision-making during labour.

Furthermore, we will conduct data collection during the implementation phase which encompasses patient-reported experiences and outcomes (PREMs/PROMs) from birthing people and their companions, surveys of healthcare professionals and the collection of routine clinical data. In addition, we will capture implementation-related aspects (e.g. acceptability, barriers, and facilitating factors). We will also use data from the pre-implementation phase (standard care) for comparison.

Prior activities

In September 2024, Amber Weiseth delivered the online lecture «Process innovation for clinical safety, effective communication, and dignity in childbirth».

Building on this, two one-day workshops entitled «TeamBirth-Workshops: Gemeinsame Entscheidungsfindung in der Geburtshilfe» were held in Winterthur in February 2025 under Amber Weiseth's leadership. Together with her team, she introduced midwives and interprofessional birth teams to the innovative approaches of TeamBirth. The workshops established the foundation for a growing TeamBirth community and methodological expertise in Switzerland. The Stadtspital Zürich Triemli was recruited as the first pilot hospital, and further institutions in the Zurich/Winterthur region expressed strong interest in implementation.

TeamBirth Switzerland network

TeamBirth Switzerland sees itself as part of a growing learning and development partnership for respectful and participatory maternity care.

We aim to collaborate nationally and internationally with practice partners from a range of healthcare systems and models of health care, with the goal of learning from one another and advancing maternity care together.

An important first partnership links us with Malin Edqvist, lecturer and midwife at the Karolinska Institutet in Stockholm, who leads the Swedish TeamBirth study.

Project organisation

Project lead

• Prof. Jessica Pehlke-Milde, Head of the Institute of Midwifery and Reproductive Health, ZHAW School of Health Sciences
• Dr. Karin Brendel, Co-Head of the Bachelor's degree programme in Midwifery, ZHAW School of Health Sciences, Institute of Midwifery and Reproductive Health

Project team ZHAW

• Dr. sc. med. Vanessa Leutenegger, Lecturer, ZHAW School of Health Sciences, Institute of Midwifery and Reproductive Health
• Larissa Zeller, Research Associate, ZHAW School of Health Sciences, Institute of Midwifery and Reproductive Health
• Piroska Zsindely, Research Associate, ZHAW School of Health Sciences, Institute of Midwifery and Reproductive Health

Project team Stadtspital Zürich Triemli

• Dr. med. Gabriella Stocker, Principal Project Lead, Consultant Physician ad personam
• Nathalie Colling, Principal Project Lead, Head of Nursing, Maternity Services
• Tamara Bonc, Principal Project Lead, Advanced Midwife Practitioner, Maternity Services
• Dr. med. Natalia Conde, Core Team Member, Senior Physician, Maternity Services
• Dr. med. Nadja Bosshard, Core Team Member, Senior Physician, Maternity Services

Project duration

• 24 months

Funding

• Part-funded through the ZHAW Community Health Call programme structure (supporting the development of the training concept)