Having a Baby in Spain by Charlotte Humphries (A recently new mummy in Spain!):
However long you’ve lived abroad, it’s the momentous occasions which remind you that you’re living in a foreign country and that some things are just not the same as at home, wherever home may be. Having a baby is just one of those times!
Before and during the birth:
Private vs. State Healthcare
It’s important to get checked up as soon as you suspect you are pregnant and so first you need to decide if you’ll be going down the public or private healthcare route. It may not be as simple as making a personal choice when having a baby in Spain. Some private healthcare plans require you to have had insurance cover for a certain period of time before falling pregnant. On the other hand, some expats may not qualify for public healthcare under the social security system.
If you are not entitled to either state or private healthcare, you may have to “pay as you go” with a private doctor or gynecologist, or make a one off payment to an insurance company to cover your care during pregnancy and birth. If, on the other hand, you qualify for private and public healthcare, you may choose to visit both doctors in the early stages so that you can make an informed decision as to which system (and doctor) suits you best. Many choose to have their check ups with a private doctor and then give birth in a public hospital – often regarded to be the best place to have your baby if there is any risk of complications.
A private doctor will expect to see you monthly. He will give you either an internal or an external scan at each visit and arrange all the required and routine blood tests on your behalf. The state doctors may also see you regularly but will not perform as many scans (generally only from 12 weeks and all external). However, they also have midwives at their disposal who are very approachable and on hand to provide you with a huge range of advice (and some freebie samples!)
Some future parents need the reassurance provided by an antenatal course prior to the baby’s arrival. Many of the public health centres run short courses in Spanish where midwives will take you through what to expect. Unfortunately most seem to be run during the day making it tricky for those who work.
If language is a problem or if the classes clash with your availability outside work, there are private options. On the Costa del Sol the most popular is run by two Irish midwives www.irishmidwife.com. The course is spread over four weekly evening sessions of about three hours. Both of the midwives have children themselves and extensive experience of working in the public and private hospitals in Marbella and Malaga and so are ideally placed to answer any questions you may have on which hospital to choose and what to expect. In the course they cover hospital policies, labour, exercise, breastfeeding, paperwork and much more.
The Hospital Birth
Home births are very rare in Spain and most babies are born in the hospital. Your first port of call if you go into labour is to check in at the URGENCIAS department. You should have with you your passport and social security card (if applicable) as well as everything you will need for you and the baby during your stay, and your birth plan (in Spanish). You can download a birth plan template HERE which may help you to complete yours.
Certainly in Marbella’s Costa del Sol hospital there is some provision for those aiming for a water birth but very few of the midwives are trained in this specialism and so it is available only to a few mothers to be on a first come, first served basis. You should include in your birth plan any preferences you have for pain relief (although they won’t hold you to it should you change your mind half way through!) There is no gas and air in Spanish hospitals (except in some private hospitals) but pethidine and epidurals are readily available.
The public hospital in Malaga also provides excellent care although it is regarded as more old fashioned in its approach to childbirth which some expat mums to be may find off putting.
While in the private hospitals you will be accommodated in a private room where your partner can sleep on a sofa bed near you, expect to have to share a room in the public hospital with one other new mum. In the Spanish health system, your family are expected to provide you with the support you need in the hospital – helping you to wash, use the bathroom, eat, etc. Of course, if no-one is available then the staff will help but the new baby’s father will be encouraged to stay overnight (or another family member) despite the fact that they will probably only have a rather uncomfortable chair to sleep on! It’s good practice for when the baby keeps them awake in the months to come!
The Spanish healthcare system has been accused of being too pro caesarian section, especially if you have had one previously. Spanish babies are, as a rule, smaller than northern European babies so you may find that you are encouraged down the surgery route if your baby is expected to be over 4 kg. In other European countries, fathers are allowed to be present in the operating theatre. This is not the case in Spain. Assuming the baby is healthy and there are no problems, after a c-section delivery the baby will be held near to the mother for a few moments skin to skin, before being whisked away to the father patiently waiting outside. The mother will then be taken down to the recovery ward for around two hours. During this time, baby will be washed up, weighed, dressed, thoroughly checked over by the pediatrician and given his or her initial injections.
Once mother and baby are reunited, the nursing staff will briskly assist with breastfeeding positions each time they check up on you both. The public hospital wards are busy, noisy places with lots of comings and goings – be prepared to be checked over regularly throughout the night whether or not you and your baby are getting some well deserved sleep! Door slamming is not unusual!
The public hospitals provide maternity towels, nappies, baby clothes, baby blankets, washcloths and hospital nightgowns (although you may be more comfortable in your own clothes post delivery). If you are struggling to breastfeed, need top up feeds or have decided to formula feed your baby then the hospital will provide ready made up bottles for you to feed your baby (although you will be encouraged to breastfeed if possible). The auxiliary staff are normally very helpful and won’t need much encouragement to take the baby off for a bath whenever required (my husband went along with the baby and learned how to bathe her, massage her and swaddle her very efficiently!)
When the hospital staff decide you and your baby are ready to leave the hospital they will discharge you separately. The baby will be checked over and signed off by the pediatrician; the new mother will be examined by the gynecologist before being given the all clear. The mother is issued with a “baja”, or discharge, plus any prescriptions needed for her immediate future care.
A number of documents are issued for the new baby including paperwork detailing any vaccinations already given and a baby book in which future healthcare appointments/vaccinations should be recorded.
The baby will also be issued with a very important yellow form which is vital for baby’s within eight days after birth. It’s called a Cuestionario para la Declaración de Nacimiento en el Registro Civil – check the information on this form as it must be 100% correct and duly signed by the midwife or doctor who delivered your baby. The hospital will also issue a certificate to confirm that the baby’s birth has not been registered by the hospital.
Talking of names, my husband was asked what the baby’s name would be while I was having my caesarean section. Thankfully we’d more or less agreed the name beforehand as it was recorded at this time! I’m sure we could have changed it if necessary but I suggest you either know 100% or tell them you are not ready to provide a name in order to avoid future documentary complications!
In many European countries midwives or health visitors will visit the new mum and baby at home regularly after the birth. This is not the case in Spain where most new parents rely on support from their families. Midwives are available at local health centres if you need help and you will be encouraged to meet with a pediatrician, whether private or public, early on in order to check on baby’s progress.
On the Costa del Sol there are private English speaking midwives who are available to visit you at home (for a fee) to answer any questions you have, check on the health of new baby and mum, help with breastfeeding and general baby care queries. In addition, many run baby groups where you can meet up with other mums to trade advice, woes, achievements and concerns.
There are several formalities to complete before you can settle into your new life as parents. The most important in terms of time limits is to register the baby. It is mandatory if your baby was born in Spain, whatever your nationality. If you have signed on the Padron where you live, you can register the baby in your local Registro Civil. If you are not on the Padron then you will need to register the baby in the town where he or she was born. Click here for more information on registering your baby in Spain: https://familylifeinspain.com/how-to-register-a-birth-in-spain/. Remember to ask for a full birth certificate (Certificación Literal) if you intend to apply for a non-Spanish passport for your baby.
Obviously the passport application procedure is different for each country but for the UK, you now need to apply online and then send the required supporting documentation to Belfast. This includes baby’s original long birth certificate plus a translated, certified and apostiled copy, parents birth certificates and, in some cases, a grandparents birth certificate. Most towns have a business centre with staff who can check the supporting documentation for you as well as taking baby passport photographs which fulfill the strict criteria.
Once you have been issued with a Libro de Familia by the Registro Civil, you can proceed with the other formalities. For us it was important to register her with Social Security so that we didn’t have to pay to have her vaccinated privately. As long as one parent is paying social security, the baby is entitled to cover (although by law a child cannot be refused public healthcare treatment in Spain). The procedure involved a few trips between the medical centre and social security office with various pieces of paper issued by each, and a lot of patience. Devote a morning to the job in order to get it all out of the way in one go and make sure you take your passports, NIE / residencia certificates and copies! We were also asked for proof that we had applied for the baby’s passport.
If you are claiming maternity and paternity pay, you’ll need to visit your doctor in the local health centre to be signed off and issued with the appropriate paperwork which also needs to be submitted to the social security office along with their form Prestación Maternidad-Paternidad por Nacimiento, Adopción o Acogimiento.
This is not as urgent as some of the other formalities but it’s useful to get everything done together. For more information on how to apply for your baby’s NIE, click here: https://familylifeinspain.com/spanish-paperwork-nie-residency-spain/
Registering your Child’s Birth in the UK
If you intend to return to the UK, you may find it helpful to register the baby’s birth there and so have access to a British birth certificate if required. The application is similar to a passport application and requires similar supporting documents. You can find out more information here: https://www.gov.uk/register-a-birth