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You are here: Home Health & Fitness Healthcare Giving birth in Spain: Is it all horror stories?
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04/01/2012Giving birth in Spain: Is it all horror stories?

Giving birth in Spain: Is it all horror stories? There are countless horror stories about giving birth in Spain, as evidenced from many of your comments on the Expatica forum. But how much of it is true?

If pregnancy were a book, they would cut the last two chapters," says Meryl Streep's character Rachel Samstat in the film Heartburn.

Of course, childbirth can't be edited conveniently, but women rightly expect a central role in writing that story. In Spain, though, many discover childbirth choices are limited.

"I asked my gynaecologist about a water birth," says Dominique White, a British-Argentine mother who had a son at a state hospital in Madrid a year ago.

"She said it wasn't possible. 'We don't like to expose the baby to any unnecessary risk.'"

It is not just water births that are out of the question. The standard hospital delivery procedure is highly regulated, with doctors and midwives generally inflexible over delivery positions and pain relief.

Briton Sonya Dowsett considered going private, but found private obstetricians were not open to the kind of birthing positions recommended in top medical journals like The Lancet.

Giving birth"I asked if I could adapt the birth position," she says.

"I had found one that worked well for me when I had my first son in England. It was a completely ordinary position, but you would have thought that I had asked the doctor if he could come into the woods with me and light joss-sticks from his reaction."

Disappointed, Dowsett opted for a state hospital near her home in Madrid where she had an upsetting delivery.

"I was put on my back with my legs in stirrups," says Dowsett.

When she didn't want to forcibly push because she didn't want to tear, the female doctor on duty told her: "With the volume of deliveries that we have here, we haven't got time to wait until you're ready to push."

"The doctor was so horribly unsympathetic and unprepared to allow any leeway, like just letting me not have my legs in stirrups. It really shocked and upset me."

But not everyone has had a traumatic experience. Gemma Sims, who is half British and half Spanish, gave birth to a daughter in another state hospital in Madrid where she found the staff supportive.

Sims felt confident about giving birth here after learning of the country's low rate of infant and neonatal mortality. According to Eurostat figures, in 2011, infant mortality in Spain was 0.33 percent of births, compared to the UK's 0.46.

"There are a lot of horror stories about birth in Spain, but they're not horror stories about deaths," says Sills.

"I think too much choice can be dangerous if someone pigheadedly wants a type of birth which creates a difficulty where one didn't exist. I knew that my birth was not going to be very progressive, but I was happy to go along with what the professionals were telling me. I felt confident if there was a problem they could fix it."

Sills would, however, have liked to have used gas and air - which is not available in most Spanish hospitals - and to have been allowed more mobility during labour.

In Dowsett's case, medical staff removed her TENS machine, a pain relief device which is regularly used in many countries. They said it interfered with an internal monitor.

"At one point, when I shouted and cried a bit, they told me not to make so much noise. I heard one nurse say to another: 'This is what happens when they don't have an epidural'. "

"Here women are told they must be off their rockers not to want one," says Rachel Macleod, a British midwife who has worked in Spain for 13 years. Macleod is the head of midwifery at the maternity unit at Acuario (www.acuario.org), a private clinic in Beniarbeig near Alicante.

Pregnant womanMacleod believes it is the only Spanish maternity ward to offer a natural birth - with gas and air available and facilities such as birthing pools - while also providing full medical backup to handle complications.

"It is all defensive medicine with the idea being this is dangerous; let's get this baby out as fast as we can," she says.

"Natural birth is about being patient and waiting. Here almost everyone is induced. Almost everyone is given episiotomies and the drug oxytocin. A drip is stuck into her with glucose. The worst thing is a woman being on her back without being able to move which is the worst position to have a baby in."

Macleod adds: "What happens usually is a cascade of interventions - one leading to another. An epidural slows down contractions, so then oxytocin is given.

"The woman can't eat and drink or move and is in an environment in which she's scared. Her adrenalin goes through the roof and that leads to foetal distress and then it's off to theatre for a Caesarean."

According to the 2010 OECD Health Data, the Caesarean rate in Spain at 26 percent in 2006, the EU average was at 23.1 percent in 2008.

Spain's routine use of episiotomies and lack of choice of birthing position are among a number of aspects of Spanish procedure which go against WHO guidelines.

The evidence causes many non-Spanish women who want a natural birth to consider returning to their home countries to give birth or to consider Acuario.

One mother, who did not wish to be named, found an alternative solution after one less-than-satisfactory Spanish hospital birth. She found there was a small body of midwives who do homebirths.

A birth in her own home proved a reasonable way to have a proper say in the birth process for this fourth-time mother. However, she says it is by no means an ideal solution for many expectant mothers.

"Really I would have liked to have been able to choose a natural birth with full medical backing," she says.

Sarah Morris / Expatica


8 reactions to this article

Beverley N. Mulvanerty posted: 2008-11-30 10:58:25

Hi There, I noticed from this article that the person who seemed to have the best treatment while giving birth was half British, half Spanish. It seems to me that with Social Security/medics in general there is a resentment towards foreigners utilising their country's systems. They seem to forget that we are working here, contributing our dues to the Social Security system too and are therefore entitled.

My birthing experience was just as awful. The main thing being that I could not communicate fully with the staff (doctors were always nicer than nurses I might add). They treated me like an animal. No respect, ordering me about like I was a five year old; my husband wasnt allowed by my side in the birthing room until the last minute - as our daughter appeared. Just after she made her entry into the world, the door flew open and a half-witted male orderly walked in to return a gurney - my legs were in stirrups and he offered me a jolly buenas tardes, through my knees. The worst thing of all was the following morning after my daughter's birth, a nurse came to take her away for some reason or another. I was speaking on my mobile and she simply grabbed my baby's cot and started making off with her. I grabbed the end of the cot and asked her where she was going with my child. She hadnt said a word. She pulled at the cot and told me she was going to bath my baby. I hung on to the cot and told her never ever to walk in and attempt to walk away with my child without saying anything again. I told her that in England there have been baby snatchings in hospitals where snatchers have been dressed as orderlies, doctors etc. Also it is common courtesy to say something. I was told later on, by a kinder English speaking, trainee nurse that the other nurse had been in floods of tears and had complained that she had never been spoken to like that. Too bad I said. They need to learn some manners around here. After that I was labelled the difficult British woman in room whatever it was. Good luck to anyone who opts for National Health medical treatment. Especially if foreign. Natalie

Ana posted: 2011-11-24 23:42:30

I had read all the horror stories about giving birth in Spain and was quite stressed out about not being allowed the natural birth I wanted... I researched all the local hospitals and found one that had good reviews, and even though it was over an hour away I didn't mind. When my waters broke at 35 weeks we panicked and went straight to our nearest public hospital (Jerez de la Frontera). They decided to keep me in and the contractions started about an hour later. When I told them I wouldn't be signing the epidural consent forms they looked at me like I was clearly unwell in the head. In the dilation room I was (luckily) assigned a really friendly young midwife who listened to my requests and was extremely supportive. She brought me a pilates ball and showed me the movements that alleviated the pain and helped relax the pelvis, kept refilling a hot water bottle for my back, and showed my husband the best way to massage me. I was allowed to eat and move around, was not forced to have an oxytocin drip, not shaved/given an enema/episiotomy and was asked what position I would like to give birth in. The midwife prepared the birthing stool and explained the pros and cons but at the last minute I chose to give birth lying down as I was so exhausted I was falling asleep between contractions. Baby Sam was born weighing 5 1/2 pounds and within 30 mins I was up and about again feeling fine. I cannot fault the treatment I received in the delivery suite. Like Natalie, my (tiny, premature) baby was shuttled off for his first bath and to my horror was literally hosed down with a rough sponge under a tap, patted down and shoved into his pj's. I had to strip him off, dry him properly and put on another pair of pj's back in my room. And me thinking 'what a special moment, his first bath'...!! But overall I was pleasantly surprised at the treatment we both received. Ana

Peter Aldred posted: 2011-12-15 16:01:25

Ethos Endymion Bright Eyes descenso de Ojos para Cataratas. Son unas gotas de los ojos que disuelve cataratas naturalmente y sin la necesidad de cirugia para las cataratas - desarrollada originalmente para la gente, pero funciona al igual para las mascotas y otro typos de animales domésticos. Nuestro producto aparecio en el programa de Richard

Stephanie posted: 2012-01-17 17:14:07

To be honest I am completely disgusted by Beverely's comments about the Spanish health care system and this article in general. I am 100% British and have never been treated with any disrespect by nurses or doctors but then guess what? I actually bothered to learn Spanish when I moved to spain. I completely understand the reactions of most of the Spanish towards 99% of the british living here. How do we react in the UK to foreigners who don't speak our language? With contempt, that's how. So don't expect different treatment when you move to another country and can't be bothered to learn the language. The nurse who came to take your baby probably didn't say anything because she thought it wa pointless.

Also I don't know which hospital you were in but the hospital in my area (Huercal Overa, Almeria) has the BEST maternity and neo natal unit in Spain and is in the top 10 in Europe. My little one is due in April and on my first hospital visit I was given loads of information regarding the options available to me. Including different positions for birth, different pain relief methods and the list goes on. I was RECOMENDED the TENS unit and RECOMENDED movement and walking during labor. And after seeing the maternity ward and later watching Channel 4 program 'One born every minute' I am glad I am having my baby in Spain as most of the women on this program were lying down the whole time and were not encouraged to move at all. Very archaic.

All of the expats here who do nothing but whine about this and whine about that really get on my nerves. I have NEVER had any problems here, because I can comunicate with the local people. And basically if you think life in Spain is so awful perhaps you should go back to the UK.

Juliette posted: 2012-01-20 18:03:36

I gave birth two months ago in a public hospital in Seville and I never felt, as an English woman whose Spanish is adequate but limited, that I was treated any better or worse than a Spanish woman would have been.

Of course there were cultural differences and on occasion the staff would come across as cold or unsympathetic where I would expect English people to be more tactful, but there are two things to say about this; first, that there were just as many occasions where they were more warm and affectionate than English people would likely be, and second, that a surprising number of my English friends have had awful experiences with cold, unsympathetic or even aggressive nurses and midwives in the UK, so it's an individual thing rather than a national one IMO.

As for the birth experience, I had also read the horror stories and decided that in order to avoid disappointment, I would just not make plans for the birth, and accept that there would be no gas and air, no water births, etc. I was dreading the birth but in the end, after an unpleasant 22 hours of contractions at home, the hospital part was almost embarrassingly good. I went in, they (in true Spanish fashion) told me I should have waited a bit more but admitted me anyway, they gave me an epidural (with various people coming in and out while I sat there with everything hanging out) and left me to it until it was time to push, when they left me a bit longer and then took me in the delivery room, put me in stirrups and told me when to push.

Daughter was born shortly afterwards without any pain at all, they stitched a small internal tear and that was that. Absolutely fine. I probably could have done with a bit more attention during the labour, but I couldn't fault their efficiency and skill and for me that is the most reassuring thing of all; I always feel that I am in competent, experienced hands within the Spanish medical system, no matter what else might be unfamiliar, confusing or frustrating.

O. R. posted: 2012-02-01 17:08:43

A one alone...

http://www.youtube.com/watch?v=nykCCYzbB5w

.

Kris posted: 2012-02-06 15:06:33

When I was pregnant, I heard all kinds of horror stories about having a baby in Spain, and I was really scared. I am a nurse from the USA and I didn't know what to expect here. My experience turned out to be really good. I had my daughter in Huercal-Overa, and my care was excellent. I had to have an epidural because I had a cesarean (she was breech). Although I do speak Spanish, because i was nervous, it was helpful that one of the nurses in the delivery room spoke English. The only thing I didn't like was that my husband wasn't allowed to come in to the delivery room. Otherwise, my pre- and post-natal care was very impressive, and I couldn't have asked for anything more.

Lucy posted: 2012-03-07 11:32:10

I had my son two years ago in the public hospital in Jerez de la Frontera, and couldn't fault the treatment I received. I ended up having a C section and stayed in for 5 days. Was very well looked after (and yes I imagine it helps enormously if you speak Spanish, which I do), so much so that I'm having my next baby, due in April, there too.

8 reactions to this article

Beverley N. Mulvanerty posted: 2008-11-30 10:58:25

Hi There, I noticed from this article that the person who seemed to have the best treatment while giving birth was half British, half Spanish. It seems to me that with Social Security/medics in general there is a resentment towards foreigners utilising their country's systems. They seem to forget that we are working here, contributing our dues to the Social Security system too and are therefore entitled.

My birthing experience was just as awful. The main thing being that I could not communicate fully with the staff (doctors were always nicer than nurses I might add). They treated me like an animal. No respect, ordering me about like I was a five year old; my husband wasnt allowed by my side in the birthing room until the last minute - as our daughter appeared. Just after she made her entry into the world, the door flew open and a half-witted male orderly walked in to return a gurney - my legs were in stirrups and he offered me a jolly buenas tardes, through my knees. The worst thing of all was the following morning after my daughter's birth, a nurse came to take her away for some reason or another. I was speaking on my mobile and she simply grabbed my baby's cot and started making off with her. I grabbed the end of the cot and asked her where she was going with my child. She hadnt said a word. She pulled at the cot and told me she was going to bath my baby. I hung on to the cot and told her never ever to walk in and attempt to walk away with my child without saying anything again. I told her that in England there have been baby snatchings in hospitals where snatchers have been dressed as orderlies, doctors etc. Also it is common courtesy to say something. I was told later on, by a kinder English speaking, trainee nurse that the other nurse had been in floods of tears and had complained that she had never been spoken to like that. Too bad I said. They need to learn some manners around here. After that I was labelled the difficult British woman in room whatever it was. Good luck to anyone who opts for National Health medical treatment. Especially if foreign. Natalie

Ana posted: 2011-11-24 23:42:30

I had read all the horror stories about giving birth in Spain and was quite stressed out about not being allowed the natural birth I wanted... I researched all the local hospitals and found one that had good reviews, and even though it was over an hour away I didn't mind. When my waters broke at 35 weeks we panicked and went straight to our nearest public hospital (Jerez de la Frontera). They decided to keep me in and the contractions started about an hour later. When I told them I wouldn't be signing the epidural consent forms they looked at me like I was clearly unwell in the head. In the dilation room I was (luckily) assigned a really friendly young midwife who listened to my requests and was extremely supportive. She brought me a pilates ball and showed me the movements that alleviated the pain and helped relax the pelvis, kept refilling a hot water bottle for my back, and showed my husband the best way to massage me. I was allowed to eat and move around, was not forced to have an oxytocin drip, not shaved/given an enema/episiotomy and was asked what position I would like to give birth in. The midwife prepared the birthing stool and explained the pros and cons but at the last minute I chose to give birth lying down as I was so exhausted I was falling asleep between contractions. Baby Sam was born weighing 5 1/2 pounds and within 30 mins I was up and about again feeling fine. I cannot fault the treatment I received in the delivery suite. Like Natalie, my (tiny, premature) baby was shuttled off for his first bath and to my horror was literally hosed down with a rough sponge under a tap, patted down and shoved into his pj's. I had to strip him off, dry him properly and put on another pair of pj's back in my room. And me thinking 'what a special moment, his first bath'...!! But overall I was pleasantly surprised at the treatment we both received. Ana

Peter Aldred posted: 2011-12-15 16:01:25

Ethos Endymion Bright Eyes descenso de Ojos para Cataratas. Son unas gotas de los ojos que disuelve cataratas naturalmente y sin la necesidad de cirugia para las cataratas - desarrollada originalmente para la gente, pero funciona al igual para las mascotas y otro typos de animales domésticos. Nuestro producto aparecio en el programa de Richard

Stephanie posted: 2012-01-17 17:14:07

To be honest I am completely disgusted by Beverely's comments about the Spanish health care system and this article in general. I am 100% British and have never been treated with any disrespect by nurses or doctors but then guess what? I actually bothered to learn Spanish when I moved to spain. I completely understand the reactions of most of the Spanish towards 99% of the british living here. How do we react in the UK to foreigners who don't speak our language? With contempt, that's how. So don't expect different treatment when you move to another country and can't be bothered to learn the language. The nurse who came to take your baby probably didn't say anything because she thought it wa pointless.

Also I don't know which hospital you were in but the hospital in my area (Huercal Overa, Almeria) has the BEST maternity and neo natal unit in Spain and is in the top 10 in Europe. My little one is due in April and on my first hospital visit I was given loads of information regarding the options available to me. Including different positions for birth, different pain relief methods and the list goes on. I was RECOMENDED the TENS unit and RECOMENDED movement and walking during labor. And after seeing the maternity ward and later watching Channel 4 program 'One born every minute' I am glad I am having my baby in Spain as most of the women on this program were lying down the whole time and were not encouraged to move at all. Very archaic.

All of the expats here who do nothing but whine about this and whine about that really get on my nerves. I have NEVER had any problems here, because I can comunicate with the local people. And basically if you think life in Spain is so awful perhaps you should go back to the UK.

Juliette posted: 2012-01-20 18:03:36

I gave birth two months ago in a public hospital in Seville and I never felt, as an English woman whose Spanish is adequate but limited, that I was treated any better or worse than a Spanish woman would have been.

Of course there were cultural differences and on occasion the staff would come across as cold or unsympathetic where I would expect English people to be more tactful, but there are two things to say about this; first, that there were just as many occasions where they were more warm and affectionate than English people would likely be, and second, that a surprising number of my English friends have had awful experiences with cold, unsympathetic or even aggressive nurses and midwives in the UK, so it's an individual thing rather than a national one IMO.

As for the birth experience, I had also read the horror stories and decided that in order to avoid disappointment, I would just not make plans for the birth, and accept that there would be no gas and air, no water births, etc. I was dreading the birth but in the end, after an unpleasant 22 hours of contractions at home, the hospital part was almost embarrassingly good. I went in, they (in true Spanish fashion) told me I should have waited a bit more but admitted me anyway, they gave me an epidural (with various people coming in and out while I sat there with everything hanging out) and left me to it until it was time to push, when they left me a bit longer and then took me in the delivery room, put me in stirrups and told me when to push.

Daughter was born shortly afterwards without any pain at all, they stitched a small internal tear and that was that. Absolutely fine. I probably could have done with a bit more attention during the labour, but I couldn't fault their efficiency and skill and for me that is the most reassuring thing of all; I always feel that I am in competent, experienced hands within the Spanish medical system, no matter what else might be unfamiliar, confusing or frustrating.

O. R. posted: 2012-02-01 17:08:43

A one alone...

http://www.youtube.com/watch?v=nykCCYzbB5w

.

Kris posted: 2012-02-06 15:06:33

When I was pregnant, I heard all kinds of horror stories about having a baby in Spain, and I was really scared. I am a nurse from the USA and I didn't know what to expect here. My experience turned out to be really good. I had my daughter in Huercal-Overa, and my care was excellent. I had to have an epidural because I had a cesarean (she was breech). Although I do speak Spanish, because i was nervous, it was helpful that one of the nurses in the delivery room spoke English. The only thing I didn't like was that my husband wasn't allowed to come in to the delivery room. Otherwise, my pre- and post-natal care was very impressive, and I couldn't have asked for anything more.

Lucy posted: 2012-03-07 11:32:10

I had my son two years ago in the public hospital in Jerez de la Frontera, and couldn't fault the treatment I received. I ended up having a C section and stayed in for 5 days. Was very well looked after (and yes I imagine it helps enormously if you speak Spanish, which I do), so much so that I'm having my next baby, due in April, there too.

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