You think you are pregnant? There's good news: The Spanish Public Health System is one of the best in the world!
- You’ve recently moved to Mallorca and just discovered you are pregnant?
- Rest assured - Spain has one of the best Public Health Systems of the world!
- We at Affordable Mallorca tell you everything you need to know to navigate the Spanish Health System:
- How to find a midwife,
- Where to do your blood tests and scans,
- How to find the hospital of your choice …
- How to get everything ready to deliver your precious baby safely into this world.
When I discovered I was pregnant after our first year of living in Mallorca I was, I suppose, quite a normal mix of excitement and anxiety. However, I also felt completely overwhelmed by the fact that we were in a ‘foreign’ country and so felt like I had even less of an idea of what to expect than if I was in my home country.
We couldn’t afford private health insurance, and besides which in order to be covered for pregnancy and birth on insurance you need to be a member for at least six months before you become pregnant. I had heard the Spanish public health system was one of the best in the world so I knew I was in good hands, but at the same time I felt a little in the dark as I found it difficult to find online many experiences written in English of what to expect in Spain let alone in Mallorca. So, here’s my account of my experience of pregnancy and birth in Mallorca.
I Think I’m Pregnant - What Now? #
Get a National Health Card
I read that you should see a doctor first when you find out you’re pregnant so I made an appointment with a GP at my local PAC (the local health care centres) in Andratx. At this point I didn’t have my Tarjeta de Salud (national health card). See How to Get your NIE and Residency - The complete guide to moving to Mallorca for more details about a national health card. So, I was just using my European Health Cover Insurance (EHIC) card that all members of the EU countries are entitled to. It’s fine to use this but after many appointments the ladies on the front desk were begging me to get my Tarjeta de Salud so that they didn’t have to make photocopies of my documents every time I came for an appointment. I was not yet an official resident but had been working on and off and paying my social security when I did. So this entitled me to full-blown access to the public health system.
See a Doctor for Referral to the Midwife at Ýour Local PAC
I had just done a home pregnancy test that said I was pregnant and I thought the doctor would do a test to confirm this but I was wrong. The doctor’s visit seemed a bit unnecessary to me as all he did was refer me to the midwife without a single test or examination. Whether you can skip straight to the midwife or you have to do this cursory doctor visit I’m not sure.
So, we then went to see the midwife at our local PAC in Andratx, and she was completely lovely. She didn’t speak much English but my Spanish was good enough to get through and my husband understood more than he could say. I remember this first appointment taking ages as she went through questions and questions about my health and previous vaccinations, family history and symptoms I had been experiencing.
An Emotional Moment: The First Scan #
I was very surprised when at the end of the appointment she scheduled me in for a scan the following week. I didn’t think any scans would happen until twelve weeks but we had one a week later at the PAC in Santa Ponsa at what they guessed was week seven. It was there that we saw the lentil that was growing inside me for the first time and heard its tiny heart beating. Emotional and surreal times for sure!
First and Second Trimester: Test Subject #
An Astonishing Number of Appointments …
If you think that then the next appointment you might have is just the next scan at twelve weeks you would be very wrong. I have nothing to compare it to really, but having spoken to my pregnant friends in other countries it seems that the whole process is quite medicalised in Spain with appointment after appointment for blood test after blood test Even for my standard, low-risk status pregnancy, every month all the way through the pregnancy there was at least one midwife appointment and some kind of test or scan and in the first trimester it seemed like it was almost every week.
The Blood Tests
Tests include iron levels, glucose levels, Rh blood type, HIV and various other STD tests. There’s also a diabetes test you have to take in the second trimester that involves a blood test either side of drinking a super-sweet lemon drink. I had the dTpa vaccine (it is of course optional) in the third trimester which gives the unborn baby immunity against whooping cough in the early months when they are too young for the vaccine themselves.
The Scans #
- Scans-wise I had the first one which was at 7 weeks,
- A 12 week dating scan where they can also do the test for risk of Downs Syndrome which is optional and I didn’t have,
- A 20 week one where we could find out the sex (which we did - I don’t know how people have the patience not to!),
- One at 30 weeks and one at 38 weeks where they get much more of an accurate idea of the weight of the baby (if the baby hasn’t come by then of course).
A couple of times at my midwife appointment she also had an ultrasound and would scan me just for fun! It was nice to have so much ‘contact’ with the baby inside! Every scan after the 7 week one was done at Son Espases Hospital apart from the 38-week scan which I had at Inca Hospital. I will explain why that is the case.
Change of Hospital and Birth Choices #
Giving Birth at Home
When we got toward the 30 week mark we started thinking about birthing options and what we wanted. It turns out in Spain home births aren’t covered by the public health so you have to pay a midwife privately if you want to do a home birth. And there are more and more midwives who do this on the island now. This wasn’t what we wanted for a few reasons the main one being that we felt we lived too far away from the hospital to feel comfortable about a home birth.
Giving Birth in Hospital
Our midwife, who was very much into the more natural side of things, encouraged us to consider switching our hospital from Son Espases to Inca. The reason for this is that the labour and maternity unit at Inca was, at the time (i.e. in 2016), very much the leading one on the island. They had the facilities for water births as well as gas and air. And the midwifery team there were very much about as few interventions as possible. I had been reading a book about hypnobirthing and felt that I wanted myself and my husband to be given as much privacy and time as possible and the idea of the water birth really appealed to me as did the gas and air as I was pretty sure I didn’t want to have an epidural.
We had heard that Son Espases, as it is a teaching hospital is busy and has students observing and can be quite medicalised. However, I have friends who have given birth in Son Espases and said they couldn’t fault it at all and loved it. So we considered it but in the end agreed Inca seemed like the option that suited us personally the most and that we didn’t mind the extra-long drive to the hospital in Inca from Andratx (about 45mins in good traffic).
I just had to fill a form out to change hospital stating the reason and then it was all fine. We went to Inca for our last scan where the doctor made a joke about the baby being a boy when we already had found out she was a girl…. It was a good prank and it helped break the ice!
The Birth #
The Baby Takes its Time
Time ticked on. My due date came and went. I was given an appointment to go into the hospital a week after my due date to discuss inducement which I really didn’t want. So the night before this appointment I insisted on an extra-long walk with the dog, stomping my way up the hill and down the hill in the dog park all evening until I physically couldn’t stomp any longer. The next morning, an hour before we were due to leave for the hospital appointment my contractions started. Talk about working to a deadline!
Whiling Away the Time
We went to the hospital in Inca anyway and they agreed my labour had already started but with a still a long way to go. They told me to go home and to come back when the contractions were closer and unbearable. I remember being at home, playing Battlefield online on the PlayStation, shooting enemies and then having a contraction and having to pass the controller to my husband for 20 seconds or so and then it passing and me taking back the controller and carrying on. It makes me laugh to think how those people I was playing against could never have imagined that I was a woman in labour!
The contractions progressed and I used a TENS machine to help me. It made me feel like I was doing something and had some sort of a control over the contractions when they came. Placebo or not I didn’t care, it seemed to work. We returned to the hospital when the contractions got to an intensity level I figured was pretty unbearable and given that we had a long drive to the hospital again we made our way there.
You go to the emergency reception and it’s pretty clear to everyone when you walk in what’s happening. People smiled at me and said encouraging things like ‘enhorabuena’ (congratulations) ‘buen suerte’ (good luck) and ‘ánimo!’ (general encouragement and courage). We went through the maternity unit and they wanted to put me on the monitor and made me drink an apple juice to try and wake the baby up with a sugar rush. There were other women coming and going in various stages of labour.
I had been doing so well but I did lose it mentally at the point where they put me on the monitor because they asked me to take my TENS unit off. I felt like I’d lost my control and my thing to do when the contractions came and the anxiety and fear started to take over. I remember thinking I must be very near the end stage because the pain was so intense, I was crying although somehow still managing to translate all my woe for I remember whining “no es juuuuusto” (“it’s not fair!”) to the amusement of the staff.
Focusing on My Breath
I realised I needed to get a grip. My husband helped me focus on my breath and I was able to get to a decent level of calm and the pain was much more manageable. My labour then progressed very quickly. Before I knew it they were saying if I wanted an epidural then it has to be now. To which I said yes at the time but between me saying yes and the anaesthetist still making their way up to me, I changed my mind and said I’ll just have some gas and air instead. For some reason the water birth idea went out the window, not because it wasn’t offered to me but because I just felt everything was happening way too fast and I couldn’t fathom the idea of getting into a nice warm bath in all of the craziness that is labour. The best laid plans!
Finding my Groove
But I really found my groove with it all and accepted the anxiety and didn’t try to fight it, which of course has the opposite effect and makes the anxiety dissipate for it can only feed on fear. By the time I was in the Transition stage which is by all accounts the most painful, I remember asking “This is the hardest part right? Because if this is the most painful then I can definitely deal with it.” I’d found my flow and the gas and air was great like the TENS machine for giving you the feeling of having something to do when the contractions came.
Calm and Compassion
The midwife was amazing. She was so nice and so cool and so calm and compassionate. She gave us as much space as we needed leaving us in the room by ourselves but as soon as we felt we needed anybody we only had to call and they came in straight away.
Here She Is!
When our daughter was born, they placed her straight on my chest. They left it a minute or two before cutting the umbilical cord and did not give me an injection to hurry along the delivery of the placenta but allowed it to come naturally. I didn’t even know it was happening to be honest. I was so dazzled and enamored by the arrival of my daughter I couldn’t have cared less what else was happening in the room at that moment. However, looking back this was really amazing, because all these points were on my birth plan, but I’d never even handed over my birth plan to them! In all the chaos of everything and the speed of the labour I just seemed to forget all about it. But the team at Inca were incredible and did everything I’d wished for without even knowing that’s what I’d wanted, so I knew I was right to have chosen Inca as my hospital for the birth.
The After-Care #
The Tiniest of Fingerprints
They left my daughter on my chest for an hour to let us all bond before coming back in the room to sort out some paperwork which included taking a fingerprint from this little newborn which was hilarious because it really was just a tiny little splodge with no recognizable print in it at all! But it was lovely. And they wished us well and said goodbye as a porter took us downstairs into a room that would be our home for the next two nights.
Five Star Service
The aftercare and room was incredible. Technically it was a twin room but we had it to ourselves as did everyone else from what I could gather. It seemed like nobody had to share a room. Although my husband was not allowed to sleep in the empty bed or indeed even sit on it in case it was needed so we squashed up into my single bed! Our room opened out onto a garden courtyard which was really pretty and it was honestly like staying in a hotel.
Just Ring a Little Bell
Whenever we had problems with the baby, like we didn’t know why she was crying and crying, we could just ring a little bell like room service and a nurse would come in and help us. I was taught how to breastfeed which I’m so grateful for and taught little tricks like tickling her feet to get her to feed which seemed to work like magic in those first few days! We were shown how to give her a bath and how to change her nappy. It was so valuable, and although I would have thought I’d like to have been able to go home straight away those first couple of days in the hospital really were very useful to us because we were honestly so clueless about everything.
A Very Positive Experience #
In conclusion I cannot fault my experience of the Spanish public health system. Although I found the endless tests and appointments throughout pregnancy a bit tiresome and frustrating at times, the actual birth and after-care was enjoyable and very caring. I felt safe and assured at all times even with the language barrier and nobody made me feel bad at the times when I was struggling with understanding anything. I have no other experience like this to compare it to, but I would not hesitate even slightly to recommend anyone to go through their pregnancy and birth on the Spanish public health system and especially at Inca Commercial Hospital in Mallorca. Oh and by the way, any men out there who claim that kidney stones are as painful as giving birth - it’s nonsense! Birth wins by a long, long way!!
DISCLAIMER: My daughter was born at the end of October 2016. All information contained in this article is based on personal experience and opinion and may change due to changing laws and regulations and/or based on where in Spain you are.
By Holly Jazz
20 February, 2020