• Pregnancy is a great time of excitement and joy but it is also a time of uncertainty when you are living in a foreign country.
  • The maternity care system in Spain is entirely different to the U.K and other E.U. countries.
  • The main differences are the over-medicalization of the whole process including numerous ultrasound scans and trips to the Hospital for monitoring of your baby in the final weeks of pregnancy.
  • Of course the language barrier is the biggest hurdle and communication can easily break down.
  • Pregnant women and their families need to have clear information and to have any concerns understood.
  • As always, women should seek care as early as possible in pregnancy, and there are a few options to choose from.
Centro de Salud – this is the most frequently used choice – the equivalent to a health centre. Here you should sign up with a doctor and be referred to the matrona (midwife) for your first appointment. The dating scan before week 12 will be carried out here, along with all of your blood tests.

You will be given a libro de embarazada (pregnancy booklet) to keep all your information in. Delivery will take place at your local public Hospital. You do need entitlement to access care at the Centro de Salud; either a social security card or you can use a European Health card (this last option is only a temporary solution).
Private Maternity Hospitals – these can be accessed with or without insurance cover ie: Sanitas, Mapfre, Bupa international. This option is expensive, particularly without insurance cover. A delivery in a private Hospital can cost around 5,000 euros and if your birth is by caesarean 8,000euros. If you are planning a pregnancy it is a good idea to plan insurance well ahead, at least 10 months before the conception.

Women choose to give birth in a private Hospital can enjoy the benefits of entonox (gas and air) and the l uxury of a family room after the birth. However, if complications arise you or your baby may be transferred out to the nearest public Hospital for specialist care. Most of the private Hospitals are located in Málaga, Granada and Marbella, though you can access local pregnancy clinics for care.
Independent Midwives- like myself, are pretty thin on the ground and are limited to the amount of births they can take on. The advantages of having a private midwife are numerous and a relationship of trust is built up which is imperative to the womans confidence throughout the pregnancy and birth. The woman has much more control in decision making and her care is planned in accordance to her needs. Mainly the births take place at home and families feel reassured that they know the midwife well who will help them through the birth process.

The cost of an Independent midwife will vary ranging from 1,500-3,500 euros Marbella area) The midwife will also carry out all postnatal visits including breastfeeding support until the baby is 28 days old. Women report very high satisfaction rates with this type of service. I am happy to travel inland, within the provinces of Malaga and Granada, providing the destination is one hour from my home in Nerja.

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