Having a Baby in Spain
Giving birth or having a baby in Spain can be quite a worrying time and with the ages of many people who choose to come and live in Spain getting younger, it stands to reason that many couples will expand their families here too.
What can at first seem a bit daunting is in reality a very straightforward process.
You don’t need to be fluent in Spanish as the terminology used is the same as in the UK. On the one hand, there is the private option for childbirth, which means paying for all the check-ups, scans and ultimate hospital time and birth. The majority of private hospitals are found in Malaga although there are a couple in Marbella and one in Estepona.
Most healthcare options have an allowance for pregnancy, but quite often you must have held the policy for at least a year before becoming pregnant.
The other option is on the Spanish health care system (provided you have a social security number). This really is a very good, competent and ultimately safe way to have your baby, and one I’ll go into more detail on below.
Having a Baby in Spain – The First Steps
The conception bit I’ll leave to you!! But once you think you are pregnant, go to your local GP who will congratulate you and refer you to your local Centro de Salud which is where all your appointments will be (except for the scans). They will not give you another pregnancy test as they trust your competence and judgement.
At this point ask for a prescription for folic acid if you are not already taking any. Take one tablet a day throughout your pregnancy. This has been scientifically proven to help reduce the risk of spina-bifida. Later on the doctor may prescribe you iron tablets too.
At the initial appointment you will have your general details taken. You will be weighed and asked when your last period was. They can then estimate your due date. They will then give you your Documento de Salud de la Embarazada booklet. This is your pregnancy health book and should be kept with you at all times and taken to all your appointments for the doctors to fill in the relevant details. It also has information on your rights as a pregnant woman.
Having a Baby in Spain – Appointments
Your first appointments at the health centre will be for blood tests. They routinely screen your blood and urine for everything, even HIV. It normally requires an early start (8.00am appointments) and you will be there with the world and his Spanish wife, as they do blood tests for EVERYTHING over here!
Having said that, they do manage to go down the list fairly quickly. Don’t worry if you are late because they will re-call any names at the end of the session.
You will then be required to pick up the results about 10 days later. The nurse may telephone you beforehand if say you have anything like a urine infection that needs treating sooner. These results should be kept with you for your next appointment. It’s quite a good idea to get a little wallet file so you can keep all the papers together.
At your first appointment they will mention about folic acid and the risk of toxoplasmosis. This is a serious infection cased by mainly animal faeces and poor health and safety when handling raw meats.
You will be advised to thoroughly cook the meats you eat, and here in Spain you have to particularly careful and avoid such things as unpasturised milk, soft cheeses, home-made mayonnaise (although shop bought is fine! Yippee!!), pates, cured meats (i.e. Serrano ham) and shell fish.
Within a couple of weeks from your initial visit to the health centre you will be contacted by the hospital (in most cases the Hospital Costa del Sol in Marbella) for your first scan. This is such an exciting moment!
Having a Baby in Spain – The Scans
As the hospital is like a rabbit warren here’s a quick explanation as to where you need to go. If you are standing looking at the main entrance of the hospital, you will have the Accident and Emergency department to the left of the building and on the right hand side there is a smaller secondary entrance. Go through this secondary entrance (facing the sea) and you will see a reception desk in front of you, bear diagonally right so the reception area is behind you.
You will be standing at the end of a fairly long corridor with waiting areas to the right and consultation rooms to the left. Go right to the very end and there are two paediatric/gynaecological rooms signposted on the left hand side. Sit in the waiting area to the right and at a point in time a nurse will come out and take your name.
This is unfortunately where the Spanish "manana" attitude kicks in. Regardless of what time your appointment is they don’t do things quickly here. On more than one occasion we were kept waiting for 2 hours! It is incredibly frustrating, but unfortunately that’s the way it is. It is also wise to remember that this is where Spain differs from the UK. You will only be allowed to have one other person in with you. So going mob handed with partners and mothers doesn’t serve any purpose at all.
The scanning technology nowadays is phenomenal. They will be able to determine pretty much exactly the due date for your baby. The doctor will also tell you what sex the baby is early on. You must tell them beforehand if you have chosen not to know, and keep reminding them at your subsequent visits as they do have a habit of blurting it out!
Once the doctor has made his/her necessary checks she will then turn the screen to show you everything, and then give you a couple of photos to treasure. There are translators available at the hospital, but to be honest with you the terminology is so similar I didn’t have any problem understanding what was going on at any stage.
One of the things we did was go to a private gynaecologist in between the hospital visits as you get a video of the scans as well as photographs. Private centres also tend to have the latest 3-D technology now too. It is possible to do this and it doesn’t affect your treatment through the state system. The cost of this will be around the €80-€100 mark per visit.
After the scan you will be given a small business card-size card with a telephone number and your Numero de Historia Hospital on. This is your reference number and it is up to you to telephone, quote this number and get your next appointment (It’s worth making a note of this number in your maternity booklet just in case you lose it!).
They do speak Spanish only on this number so you’ll have to tune your ears in to what time and date you’re told, or have a Spanish speaking friend with you if you cannot understand much Spanish.
You will have an appointment here about every 4 or 5 weeks. You will have a scan on every visit, which is remarkable as in the UK I think you routinely only get 2 scans throughout your pregnancy. Towards the end of your pregnancy you may just be fitted to the monitor that listens and records baby’s heartbeat.
Having a Baby in Spain – Getting Closer
You will also be given a couple of forms to fill in. The first is if you think you may want an epidural. (Detailing allergies any history of disease etc) However natural a birth you think you may want it’s wise to fill this in anyway. You never know. The second one is giving your consent for your baby to be given the Hepatitis B vaccine when born. They recommend it over here because of the high level of immigrants living on the coast.
Both forms need to be handed in when you check in to the hospital once your labour starts
Your ante-natal appointment at the health centre will be about the same, every 4 or 5 weeks. Don’t be surprised if you feel you’ve not seen anyone in weeks then suddenly get two or three appointments together! At these appointments they will weigh you test your blood pressure and then using a Doppler instrument, you will be able to hear your baby’s heartbeat.
Sounds surprisingly similar to a galloping horse!
Again depending on what degree of Spanish you speak and understand you can go into greater or lesser detail as to things that you feel/need in your pregnancy. I was quite happy with the treatment I received and understood at all times what was being talked about.
At week 32 your health centre will refer you for your Educacion Maternal. This again is not obligatory. I went when I was pregnant with my son 3 years ago and a lot of the time felt like I was in a fish market with a lot of squabbling women! They all seemed to know each other and gabbled away in decibels over the poor chap who was trying to teach us relaxation exercises!
Suffice to say I didn’t bother going when pregnant with my daughter last year!
Having a Baby in Spain – Midwives (Private)
There are private mid-wives over here in Spain who are British and will be with you every step of the way if you wish. You can employ them just for private anti-natal classes, just for being there at the birth or throughout if you wish. Different ‘packages’ are available from different mid-wives. There is more information at the end of this article on useful contact numbers.
Please bear in mind, if you do employ a mid-wife to assist at your birth in the Hospital Costa del Sol, you will have to fore-go letting your partner/husband be present as again you are only allowed one other person in the delivery room with you.
Having a Baby in Spain – Tests
Throughout your ante-natal appointments you will be monitored and there are other blood samples taken at about 28/30weeks and again at about 34 weeks. These are routine tests for things like toxoplasmosis, indirect Coombs test (auto-antibodies working against your own red blood cells) and the O’Sullivan test which tests for gestational diabetes. These are all tests done on pregnant women throughout the modern world.
With the O’Sullivans, you will be required to go to your health centre for an early blood test. You will then be given a glucose drink (tastes like thick, flat lucozade) and get told to wait in the waiting area for an hour. (Take a book!) A blood sample will be taken again and this determines your sugar levels. If you feel nauseous or faint at any time, it is important to attract the attention of the nurse immediately.
Having a Baby in Spain – Maternity Leave
If you are working you will, towards the middle/end of your pregnancy, choose to go on ‘Baja’. This is when your GP will sign you off work. You are allowed 16 weeks paid maternity leave here in Spain so to opt to go on Baja only means you’re not well enough to work, and you will then start your maternity leave the day your baby is born.
Many GP’s are happy to sign you off on your say so often quite early on in the pregnancy. You are better discussing this with your employer however as it may affect your maternity pay due to the cut-off point being when the calculations are made.
You will have to get the baja every week until the baby is born. (My GP was fantastic and let me have 3 or 4 weeks all in one go so as not to have to keep going back).
Once the baby is born you will need to return to your GP to receive the ‘alta’ (signing you off sick-pay) and get from them the maternity paper. This you will need to hand over to your employer. They will give you back a form, filled out by them that you need to take to the Social Security office so your maternity payments can start.
Having a Baby in Spain – The Big Day
As the big day approaches your mind starts to turn to the procedures involved at the hospital. One thing you don’t have any choice in here in Spain is the type of birth. It is very much a case of "on your back, feet in stirrups and push, push, push".
However I did notice that even in the two and a half years between my children things were changing. With both labours I had my own TENS machine with me. (Transcutaneous Electric Nerve Stimulation) which provided me with some relief in the early stages of labour. There is also no gas and air used to aid pain relief when in hospital. Never having used it I didn’t know what I was missing. Some of the private mid-wives are licensed to have it if you are going to control your labour at home. However, they will not be allowed to bring and use their equipment in the hospital.
At no time throughout either birth did I feel stressed or not in control. The hospital is very modern and the nurses and mid-wives very calm and reassuring.
Remember to have your bag packed a few weeks prior to your due date and to take your ante-natal booklet along with you. You don’t need to pack very much as the hospital really does supply most things for you! They will of course have your scanning records on file. When the big day happens, make your way to the admissions area of the Accident and Emergency reception on the right hand side of the hospital building.
From here you will be taken up to the maternity area and probably asked to wait whilst they sort a room out for you. You will then be called through and depending on how imminent the birth is, given an examination. Your partner/husband will have to stay in the waiting area. There is a telephone on the wall in here and they will call for him when you are ready in your room.
During your hospital stay you will be allocated a room that you only have to share with one other person. (You might be mega lucky and not have anyone!). You have a joint toilet/shower too which is great as only the two of you use it.
Having a Baby in Spain – Labour
Your labour will be monitored while you are in this room and at a point you will be taken along to the delivery area. Your partner/husband will have to wait in the waiting room again and will be telephoned when he can join you.
In the delivery area there are a number of outer rooms where you will be closely monitored by the mid-wife allocated to you as you reach the second stage of labour.
This is where you will receive the epidural (Mmmmm epidural!!!) if you request one.
Having a Baby in Spain – Delivery Suite
At the right time you will then be transferred to the delivery suit. Your partner/husband will have to don the surgical greens. Shoe’s, overall and hat! Quite a sight!
The delivery suite is clean, new and very modern and the team of doctors and nurses here are fantastic and you should soon be holding your precious little bundle of joy whichever way it comes out!
Having a Baby in Spain – They Think It's All Over
Once all the relevant checks have been made on the baby and you have been made comfortable they do wheel you to an outer room where for a couple of hours they will pass by and monitor you.
After this you will be taken up to your room and left to coo at your baby! The normal stay here is overnight, you will be checked and your temperature will be taken to make sure there is no infection of any sort. You will be given nappies to use although you should take your own creams along and you won’t be prompted on when to change the nappy either.
You also get given a fresh supply of towels and a new nightie on a daily basis. It really is best to use theirs! Same goes for baby, he or she will be dressed in a vest and swaddled in blankets supplied by the hospital and taken off for a bath on a daily basis.
There are nurses available to help you if you feel you are having any problems breastfeeding or anything, never feel you are alone.
Having a Baby in Spain – It Is Now!!!
Once you’ve been given the nod that it’s your day to go home, you and your baby will ultimately be checked by the senior paediatrician and then released. This is when you get to dress your baby in whatever you’ve chosen as his going home outfit!
Once you have received an envelope containing all the documents you need to register the birth you are free to go. Just make sure you have had the release paper stamped by someone at the main reception downstairs. (It’s the yellow paper). It’s very important not to lose any of these documents. Keep all these together and with you at all times when you are going about the process of registering your child.
Having a Baby in Spain – Registering Your Child
One of the first things you have to do is get the heel prick test done. In your envelope of papers you will have a form that is needed. If you’re not sure which one, just take them all along. This test needs to be done within 7 days and it’s necessary to go to your Centro de Salud. You have to register the child there, but obviously won’t have a social security number yet…it’s not a worry.
You then have 30 days to register your child at your Civil Registry.
The first time you go your partner/husband will have to be there too as you both need to sign documents. Get there as early as you can and expect to have to queue. You will also need to arm yourself with photocopies of lots of your documents (I always had a few copies of everything then they could take what they needed) and remember to have the originals with you too. These are:
- Passports
- Residencia
- ‘Long’ Birth Certificates (i.e. the one that details your parents occupations)
- Wedding Certificate (if married)
All the details will be entered into big books which you then check and sign. One of you will have to return a week later and pick up the copy that needs to be stamped by the head honcho. This is your child’s birth certificate.
It is an extremely laborious task and something you could really do without a couple of weeks after giving birth, but once it’s done it’s done.
Getting your child’s social security number is another chore! You need to go along to your local Social Security Office. Again go with a couple of copies and the originals of all of the above and expect to queue some more. You don’t really need to speak much Spanish as they seem to be fairly used to dealing with us foreigners! You will be given your child’s social security number on headed paper. This is sufficient to register the child with your GP until the card comes through the post.
As I mentioned above, you will receive a document from your employer that you will need to take to the Social Security office to start your maternity pay. It goes without saying that you will also need to take the usual copies of documents and originals along!
The different municipalities up and down the coast have their own Civil Registry Offices and Social Security Offices. It’s best to find out in advance (even before the baby is born) where your particular one is as this will save you a lot of stress once you have your baby with you.
Having a Baby in Spain – Your Baby's Passport
To obtain a British Passport for your child is a fairly straightforward. Print off the internet form C-1 from the website www.passport.gov.uk website and it will detail the paperwork you have to send via registered post to the Embassy in Madrid.
You used to be able to do this through the British Consulate Office in Malaga, but you now have to post it. If you’d prefer not to post original documents, you can still go to the Consulate Office where they will stamp and verify they have seen the originals.
Having a Baby in Spain – Important and useful numbers.
Hospital Costa del Sol Marbella – 952 862 748
British Consulate Office, c/ Mauricio Moro Pareto 2-2, Malaga – 952 352 300
British Embassy Madrid – 913 190 200
Having a Baby in Spain – Mid-wives
Here are some numbers for mid-wives who can help you in any ante-natal or post-natal support and many offer private preparation for birth for both mothers and fathers. There are many other private clinics you can contact for help in your pregnancy look at your local press for other details.
Sara Tennant RM., RN. Based in the San Pedro Alcantara area. 952 787 571 or 627 781 865
Dr. Berral. British trained consultant gynaecologist. Base in Marbella. 952 864 088 or 687 956 511
