Attention: The enclosed listings and general information
provided are for informational purposes only. Our company is not
responsible neither for the quality of the service nor the fees
charged by the professionals or companies that appear in this
document.
Pregnancy
Once the pregnancy has been confirmed by a test from the
pharmacy, you go to the Centre de Salut/Ambulatori or to your
gynaecologist, where the test will be repeated with urine
analysis (or ultrasound scan). You will be given the Carnet de
l’embarassada, a document for the mother-to-be which records age,
blood group, allergies, any hereditary diseases, serious
illnesses in the past etc, and which charts the progress of your
pregnancy (test results etc). You should carry this document
with you at all times. (Private doctors also issue something
similar). In addition you will be given the booklet with advice
from midwives “Los consejos de tu matrona”.
Antenatal check-ups:
In the early months you go for a check-up every 4 weeks. At
the end of the pregnancy, (from week 38) in the public system,
you go every two weeks to the hospital where you will give birth.
Private doctors may make weekly appointments in the last few
weeks.
These check-ups will normally be carried out by the midwife: she
will check your weight/weight gain, urine, blood-pressure,
varicose veins, the uterus, position and heart-rate of the
foetus. Each trimester a full blood test is carried out in the
lab within the health centre. Go with the paper the midwife has
given you and you will be given an appointment. Note that in
Spain blood tests are always done first thing in the morning on
an empty stomach (en ayunas).
With the first blood test the mother’s blood group and the
rhesus factor are established. Tests are also made for specific
diseases such as German measles and toxoplasmosis.
Each trimester you also have an ultra-sound scan (ecografia).
Many health centres (and private doctors) do not have their own
equipment and you have to go to a designated centre. Some
private doctors do scans more frequently but you may have to pay
extra as health insurance policies normally allow for 3, as in
the public system.
The photos taken during the scan are made to establish
measurements etc, not to give you beautiful pictures of baby in
utero. The captions will be in Catalan in the public system but
with private insurance you may get 3-D pictures and longer
explanations in Spanish.
In Spain between week 13 and week 15 Triple Screening is carried
out as a matter of routine on all pregnant women, irrespective
of age. However if you have objections to the test you can opt
out. The same is true for the blood-sugar test which in some
countries is carried out only on high-risk patients.
Amniocentesis is offered to women above a certain age (usually
35) with Seguridad Social. It is not covered as a matter of
course by private insurers. Ask yours for exact details of cover
where appropriate.
All costs of ante-natal care are covered by Seguridad Social. A
private doctor charges around 50 euros per visit though this is
normally covered by the mutua (private health insurance). Note
that private health insurance schemes demand that you hold the
policy for a certain amount of time before you become pregnant
in order to have the costs covered.
Birth-Preparation Courses/Ante-natal
Gymnastics
The Centres de Salut /Ambulatoris offer antenatal courses
with gymnastics (Gimnasio Prenatal): these are run by the
midwives. The course is often in 2 parts: first the gymnastics
and then information about the delivery, questions about
epidural, episiotomy etc. The partner can accompany the woman
for the discussion part but not for the gymnastics. These
courses are normally held in Catalan only.
In Barcelona the following Centres de Salut
offer preparatory courses:
CAP: Numancia 23,
Ph. 93.322.70.61
CAP: Sant Antoni Mª Claret 19-21, Ph. 93.258.47.04
CAP: Manso 19, Ph. 93.423.71.73
CAP: Avda Drassanes 17-21, Ph. 93.329.44.95
CAP: Avda Meridiana 28, Ph. 93.311.00.53
Private hospitals and some gyms offer
preparatory courses (at a charge).
One hospital is the “Dexeus” Passeig Bonanova, 67 – 69, 08017
Barcelona, Ph. 93 227 4747
Various gyms, public and private also offer
courses. Prices vary. Ask around for recommendations. Here are a
few examples: Gimnasio Iradier, Iradier 18, Ph.(mobile) 678 435
377, Coordinadora: Paloma CrisPhlys
Vincles, Passeig Sant Joan, 140, pral, 1ª, Ph.
93 207 7388, Coordinadora: Marta Cequiel
Piscines Bernat Picornell, Av. de l'Estadi,
30-40. Te. 93 423 4041. Ask about: Programma Pre-part, Aquatic
gym classes,
Lenoarmi, Metodo de Educación Integral, C/Dr.
Roux 19, Ph. 93 203 82 24
9 Meses (Sant Cugat), C/Valldoreix 73, Phefon
93 589 53 48/ 93 674 66 39, Coordinadora Lali Barrero
Swimming courses for expectant mothers
Held at various pools including UBAE in Gracia (Ph.93 459 44 30)
and Piscines Bernat Picornell on Montjuic (Ph.93 423 4041) .
Yoga for expectant mothers
Ask in your local district; look out for notices in schools,
parvularis etc or in Barcelona Metropolitan magazine.
Yoga teachers who advertise will sometimes organise courses for
pregnancy, if there is a demand. “Sitges Verd” also offers one
such course: Ph. 93 811 06 37.
Midwives (Comadronas)
In Spain midwives play a more secondary role in the delivery
than in other countries and there is no care/contact once you
are home. That is, unless you ask specially of a midwife who
works privaPhy, and you will have to pay yourselves as it not
covered by private health insurance either (the cost is around
60€ per visit). In the public health system you cannot choose
the midwife. You will be seen by the midwife on duty at the
health centre and similarly at the hospital. The Seguridad
Social covers attendance by the midwife during pregnancy, the
antenatal courses incl. gymnastics, the delivery and a stay of
2-3 days in hospital (5 days in the case of caesarean).
The private health insurance schemes offer similar cover in
relation to antenatal visits and delivery/hospital stay; however
preparatory courses are not normally included.
Some midwives do work independently or in a small group.They
offer home births, water births (not possible in any hospital in
Barcelona). They provide antenatal care (same control as in a
health centre), delivery and postnatal care plus a final visit
40 days after the birth. Charges per visit are 36€ plus approx.1200€
for the birth. Before you decide on an independent midwife you
must be very clear how you can contact her, whether she can
drive and has a car, and with which hospital(s) she works.
Midwives group in Barcelona:
Centro Titania: Ph. 93 426 65 59
In Barcelona the obstetrician may recommend a
midwife e.g. Viamedic Sara Tornel, Via Augusta, 128, 1, 6 Ph.93
200 1308
A recommendation in Sitges is Anna: Ph.: 977
26 89 22 or (mobile) 666 63 44 75 who also does ante- and
post-natal preparation (30-40€ per visit), baby massage, baby
yoga, help with breastfeeding etc.
Hospitals
If you are having a baby with the Seguridad Social you will
be assigned a hospital by your doctor: you do not have a say. If
you have a private health insurance there may be a number of
private hospitals covered by it. However your gynaecologist
probably works in only one or at most two, so again your choice
is in fact limited. If you want to have the baby in a particular
hospital, check that it is included in your insurer’s list. If
you have to pay it yourself, be aware that the cost of a normal
delivery can be anything from 700 to 3500€! “Rooming In” is
offered in some places. In private hospitals there is usually a
bed (sofa) for your partner. (In general, Spanish hospitals work
on the assumption that a family member will be spending the
night, which relieves the nurses of some of the pressure of
keeping an eye on the patients!).
Packing for the hospital
Whether you are giving birth in a public or a private
hospital you should pack clothes for yourself and for the baby.
For you:
4 nightdresses preferably with buttoned front, dressing-gown/housecoat,
slippers, disposable pants (available e.g. from Prenatal),
sanitary towels, maternity bras
For the baby: at least 4 bodies, 4 babygros, plus dummy/pacifier.
In public hospitals you must bring nappies/diapers; in the case
of a private hospital, ask about the latter. Spanish mothers
will also have packed baby-cologne, and, if it’s a girl,
earrings as these are inserted by the midwife before the baby
leaves hospital
The delivery (El parto) or, ”Birth plan,
what’s that” ? Giving birth in Spain is still a high-tech
affair, taking place in tiled rooms like operating theatres.
Birth plans, birthing suites and water births are unheard of,
birthing – stools (sillas de parto) the exception. Although it
varies with individual doctors, the norm (94% according to the
World Health Organisation) is still for the woman to lie on her
back with her legs in stirrups. Women are definiPhy not expected
to have opinions of their own! In recent years things have
improved somewhat and the umbilical cord is now not cut
immediaPhy and the baby is also normally put to the mother’s
breast. Ask in advance what the practice is so as not to have
surprises/disappointments later. Natural childbirth and
alternative methods of pain relief such as acupuncture and
homeopathy are not used by Spanish doctors on the whole. The
standard practice is to give an epidural anaesthetic and there
is a high rate of delivery with forceps and caesarean section. (Spain
has been criticised by the World Health Organisation on this
point). Data for hospital deliveries 2001:
Private Public:
Epidural 97 % 93 %:
Episiotomy 55 - 90 % 60 - 90 %:
Oxytoxin 20 - 80 % 68 - 80 %:
Caesarean Section 19 - 35 % 13 - 19 %:
(Caesareans are particularly popular on Fridays, so the doctors
are free at the weekend!)
Natural childbirth in hospital An
American gynaecologist working at Clinica Teknon offers natural
childbirth in hospital: Dr Leila Catherine Onbargi . Ph. 93 393
31 61 An other gentler option is the Maternity Hospital in
Barcelona (near Hotel Princesa Sofia). El Hospital Casa
Maternitat offers physiological care, nutritional care and
advice and support for breastfeeding. They have an average of 5
births a day without oxytoxin or epidural; these are used only
in an extreme emergency. Birthing stools are available and
rooming-in is offered.
Address:
Hospital Casa Maternitat
Sabino Arana, 1
08028 Barcelona
Ph: 93 227 5600
You can also contact the association “Nacer
en Casa” (home birth).
The organisation was set up in 1988 in Spain. Professional birth-helpers
work for this organisation. Contact in Barcelona: Pepi Dominguez
on Ph.: 93 384 41 03.
They will also provide information on preparing for the birth,
the delivery itself, breast-feeding and advice on handling new-born
babies.
Ph.: 950 36 03 25. or see website:
www.nacerencasa.org
The “Colegio Oficial de Enfermería y
Matronas, Ph.: 91 552 66 04, can give you info on natural
childbirth and places where it is put into practice.
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