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The degree of medical contact with pregnant women is reasonably high in Spain, with more antenatal tests and intervention during childbirth than would happen in the UK. The standard of care is highly regarded, both public and private. In the larger cities, such as Barcelona and Madrid, maternity facilities are very comprehensive, ranging from large hospitals to smaller clinics. Larger facilities are usually run under the social security system, while smaller providers are via health insurance.
The traditional option of birth in a hospital is by far the most common, although in some areas home births are becoming available.
Once you think you may be pregnant you are advised to see a doctor as soon as possible, so that the pregnancy can be confirmed, you can be examined and routine blood tests and ultrasound scans arranged. Many clinics have a community midwife who will arrange antenatal appointments; generally once a month with progress recorded in the consultation document, or 'mothers’ passport'.
Your next port of call will be the local hospital for a scan. A number of tests will be conducted including for diabetes, toxoplasmosis and HIV. You will also have monthly blood and urine tests. In most cases the midwife will schedule you for a scan once month up until the 32nd week of pregnancy, at which point the frequency of appointments will increase to once every two weeks. As the birth draws nearer there will also be a test for streptococcus B, which is compulsory in state hospitals. Should you be receiving treatment from a private hospital, then the test will only be carried out upon request.
Maternity care is not included in the EU EHIC card that covers public healthcare so make sure your health insurance or social security has been sorted out. Being registered for social security will also entitle you to the standard maternity leave of 16 weeks. In order to qualify you must have been paying contributions for a set period of time (zero for mothers under 21; 90 days for mothers aged between 21 – 26; or 180 days for mothers over 26).
When you go to the hospital to give birth you should go to the emergency ward (urgencias) of the local hospital. English is not always widely spoken so it is sensible to have someone with you who can speak Spanish, to ask questions on your behalf and communicate your preferences concerning medical treatment. Spanish hospitals will have standard operating procedures that they don’t necessarily run past patients, so it is important to have someone to explain what is happening and to speak up for you.
Similar to Germany, hospitals in Spain do not allow gas or air, although epidurals and pethidine are available.
Home births in Spain, meanwhile, are rare and not covered by the state health system.
Immediately following the birth, the baby's health will be thoroughly assessed based on the Apgar score, which rates the baby's condition with particular focus on heart rate, breathing and reflexes. An overall score of between 0 and 10 will be given, with 10 being the highest. Any concerns about the score will be addressed by the doctor or midwife. A score of 7 or higher usually indicates that the baby is in good health, but a lower score doesn't necessarily mean there will be any long-term health problems for the new-born.
Some common duties performed by nurses in other countries, such as supporting new mothers with personal care and feeding, are not done by nurses in Spain. Therefore you may wish to arrange help at the hospital from partners, friends or family. You can have one visitor with you throughout your time in hospital, including at night.
Most mothers leave the maternity hospital within five days, in which time at least two checks on the newborn will have been completed. A final examination will include a scan and you will be given an infant record book to track the child’s condition and health appointments until the age of 18. The baby will also have a blood test at one week to determine if there are any genetic defects.
When you are being discharged the hospital will give you a yellow form to register the birth. You must register your baby at the local Civil Registry Office (Registro Civil) within eight days of the birth. If there is a valid reason a delay of up to 30 days is allowed however. In addition to the documentation provided by the hospital, you must also bring any national insurance documents belonging to the parents as well as a marriage certificate, which must be translated into Spanish. If the baby is born outside of marriage, then both parents must attend the registry office.
It is generally advisable to bring your passports, in case they are required to verify your identity.
Maternity and paternity leave
Support for mothers after the birth is slightly limited in Spain, principally because women have relied on strong family networks and there has been less of a need than in other countries.
Statutory maternity leave in Spain is just 16 weeks, rising to 18 weeks for twins and 20 weeks for triplets. Most women go back to work immediately after the 16 weeks, which means mother and baby groups are less common. However, the standard option for daycare is the nursery (guarderia), which often take children from a few months old and upward. Fathers receive 15 days paternity leave.
Expatica / Updated by Bupa International
For private care, Bupa International is a leading international expatriate health insurer with customers in over 190 countries.
Photo credit: Meagan (pregnancy).
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