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Readers reveal: What it’s really like to give birth in Spain

Even if you’ve given birth before, having a baby in a new country with a different language and practices can be daunting, as there are so many unknowns. Here readers recall their experiences of giving birth in Spain.

Giving birth in Spain
There are limited options for home births in Spain, mostly because there is no insurance for delivery at home. Photo: Jimmy Conover/Unsplash

Going private or public?

Many foreigners in Spain have private health insurance, meaning they can choose whether they want to give birth in private hospitals or in public ones. The general consensus among our readers who have given birth in Spain, was that it didn’t matter if you go private or public, as people had both positive and negative experiences with both.

Women didn’t think that by going private you necessarily had better facilities or were given better attention, so it all depends on the actual hospital itself. Several said they had chosen to go public because they had read that rates of caesarean sections were higher in private hospitals in Spain.

Generally, most mothers we spoke to had a positive birthing experience in Spain and felt that the doctors and midwives were very attentive wherever they went. 

Casandra Benalcázar, who had children in both public and private hospitals said: “[In the public hospital] it was actually a great experience. The encouragement was never done in a bad manner and they were always super respectful. In the private hospital, they wanted to do everything I didn’t want and didn’t respect my birth plan”.

Anja Alvárez Petrovic from Croatia agreed when she told us: “I had two babies here and as soon as I arrived in Spain, I learned that public hospitals are better for births than private ones”.

Maya Haim Cicos on the other hand had only had good things to say about the private hospital she gave birth at and not such a glowing review for the public one. “I gave birth twice at Quiron Hospital (in Barcelona) and the treatment, nurses and all the experiences were amazing. They treated me with the utmost care. Due to complications, I had to be transferred the same day to a public hospital and the maternity ward was horrible to say the least”.

Carol M. Arciniegas-Mendoza disagreed with this saying: “We gave birth in a private hospital twice and I expected better. From the moment our baby was born, it was a bad experience…. I was super disappointed with how the hospitals here treat mums after being discharged”.

Our advice is to do as much research as you can on the specific hospital you choose and its practices, so you know what to expect.

Pain management

Epidurals seem to be the pain management of choice in Spain. Epidurals are used in 98 percent of births, which gives you some idea of just how common they are here. Gas and air, which is widely used as pain management when giving birth in the UK, is not widely available. You may only find it at certain hospitals, but it’s not something you should expect to have access to.

Many women also told us that in Spain they increase the epidural when the time comes to start pushing, which seems in direct contrast to their experiences giving birth in other countries where they turn it down.  

Limited options for home births

There are limited options for home births in Spain, mostly because there is no insurance for delivery at home. If you do want to give birth at home and have a low-risk pregnancy, this is something you’ll have to organise and often pay for yourself too.

Anna Korenromp told us that in the Netherlands, “home births are a big thing, as well as doing it completely naturally”, but that here she did not have that option.

If you really want a home birth in Spain though, it is possible. Nina Krause told us: “I gave birth in Málaga and it was a home birth with midwives (all paid from my pocket). The experience was amazing, and if I have another child, I would wish exactly the same”.

What’s it like to give birth in Spain? Photo: Sharon McCutcheon / Unsplash

Alternative birth plans

Many hospitals in Spain are more traditional when it comes to birth plans, offering limited options for things such as water births, pilates balls, and walk-in birthing showers. However, if these are things that are important to you and you want to do things a little alternatively, then you will find hospitals in Spain that offer them, you may just have to do more research and looking around first.

Is there anything I should be aware of?

Yes, you should be particularly aware of something called the Kristeller manoeuvre, which is not uncommon in Spain, but is actually banned in some other countries such as the UK. The manoeuvre is when the doctor or midwife forcefully presses down on the mother’s womb in a series of strong, sharp movements to create fundal pressure and help deliver the baby during the second stage of labour. It was found to be used in approximately 26 percent of births in Spain. 

READ ALSO: Parents’ reveal: These are the best and worst things about having children in Spain

The World Health Organisation doesn’t recommend the technique because of the potential for broken bones, organ damage, and other complications.

Lindsay Forrest told us: “I specified I didn’t want it used before my birth, but was convinced by my doctor while in the midst of pushing that it was necessary”.

Jasmine Sic also had the manoeuvre performed during the birth of her child in Spain. “I was begging them to stop pressing because it was super painful and was make me throw up, but they wouldn’t stop. The doctor also said it was necessary”.

If you do not want this manoeuvre practiced when you give birth, make sure the doctors know. Tell them verbally and also put it in writing in your birth plan.

Paperwork 

Like many things in Spain, the birthing experience is also hampered down by bureaucracy and paperwork. Many mothers reached out to us to say that the paperwork was one of the most frustrating things about giving birth in Spain and unlike in other countries, you’re expected to do it all yourself. 

Patricia Adjovi told us: “I was mostly surprised that you have to do all the paperwork yourself, and I didn’t find it easy at all. In Denmark, where I’m from, the midwife does all the paperwork when the baby is born, so you can focus on taking care of your newborn instead of running around to 100 different offices to get the birth certificate”.

Shayna Black agreed when she told us: “Our first outing with the baby (before we were ready) was forced on us by an archaic bureaucratic system. I could barely walk and it was a really hot day. So stressful!”

Member comments

  1. I gave birth in the Ourense public hospital in 2014. I had a natural birth just the way I wanted my baby to be born, with no epidural – it was a fantastic experience. However, to a large extent this was because I had prepared myself physically and emotionally, was clear about how I wanted to give birth and was confident enough in myself to insist on help when I needed it. Culturally and individually I was not afraid of the birth process or of the pain of childbirth as many of the local mothers-to-be in the hospital at the same time as me. I was lucky in that I simply and naturally trusted my body and the natural birth process. Most of the other women were very afraid of the pain and were quite ignorant about the actual natural birth process and what happens in a woman´s body and mind during birth – they didn´t see birth as an experience, more as a trial to be endured. I recommend going on a tour of a Spanish hospital before giving birth. I did, and so was familiar with the resources for natural birth including portable monitors (I had a dread of being strapped to a normal monitor which I´d have to lug around with me and not be able to move around during labour). So when I was admitted I knew what to ask for and I always felt I was in control of my own labour – and the hospital staff respected my preferences during labour and were great. HOWEVER. In 2014, at least, the public health system in Ourense was definitely still geared up to channel women to a) to have an epidural b) bottle feed newborns. The (male) hospital anaesthetist with whom I had a routine pre-birth consultation, was arrogant, consciously encouraged me to opt for an epidural, presented it as “normal”, and when I expressed my doubts, told me that having an epidural was like “taking an aspirin for a headache” which I was shocked – obviously it´s nothing like taking an aspirin and has potential consequences that mothers to be should know about. He did not answer my questions about the greater probability of having a caesarian section or forceps birth as a result of having an epidural, nor that birth might take longer if I opted for an epidural, but was defensive and irritated by my questions. I was fuming afterwards – knowing that many younger women would not feel able to challenge a “professional” and just go with it, as opposed to making an informed choice. The reason why so many more Spanish than UK mothers have epidurals is obviously cultural and reinforced by the hospital system.
    My newborn was initially reluctant to latch on to breast feed and instead of receiving adequate and understanding support by the hospital staff I was constantly pressured to accept bottle milk. However, I had inside knowledge of how the hospital worked thanks to the midwife who gave me pre-natal classes. She told me specifically that if I had breast feeding issues I could ask to see breast feeding specialists on another floor of the hospital. I´m just lucky I was sufficiently confident to ask for this help, and insist, when I met with resistence from the ward nurses who were defensive and didn´t want me to consult staff on another floor. As a result I was able to access more sympathetic help from specialist staff, who gave me tips, told me my breasts were fine and gave me confidence! And thanks to their support and my own persistence, my daughter started breast feeding no problem and I was able to give her the best start in life!

  2. PS – I should also say that the pre-natal care, the routine checkups etc leading up to birth were all great. Spain still has a great NHS, despite cuts.

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HEALTH

What is Spain’s trouble-ridden Dependency Law?

The landmark legislation introduced in 2006 was supposed to widen the safety net for dependent people, but a person on the waiting list for services offered by Spain's Dependency Law died every 13 minutes in 2023.

What is Spain's trouble-ridden Dependency Law?

What is Spain’s Ley de Dependencia?

Spain’s Dependency Law (Ley de Dependencia) was passed in 2006 under the Zapatero government.

It was essentially put together in order to try and construct a social, psychological and financial framework of support for dependent people. In the words of the law itself, the aim was to: “to regulate the basic conditions that guarantee equality in the exercise of the subjective right of citizenship to the promotion of personal autonomy and care for dependent persons.”

To do this, it created the System for Autonomy and Care for Dependency (SAAD), and the benefits and services offered were put in place to give dependent people not only more support but dignity.

READ ALSO: What’s life in Spain like for people with physical disabilities?

However, the law (and system) has been dogged by backlogs and delays ever since. In 2021 the Spanish government injected hundreds of millions into the system to try and improve performance, but recent reports in the Spanish media suggest that things have barely improved — as of December 31st 2023 there were 296,431 people still on the waiting list.

How does the Dependency Law work?

The support available depends on the level of dependency, something which is examined by a medical expert and then graded on a scale. In theory, the dependency level can be changed depending on how the recipient’s needs develop over time.

The law outlines the Basic Activities of Daily Living (ABVD) that the SAAD is designed to assist with: “the most basic tasks… which allow them to function with a minimum of autonomy and independence, such as: personal care, basic domestic activities, essential mobility, recognising people and objects, finding their way around, understanding and carrying out simple orders or tasks.”

The three degrees of dependency are as follows:

  • Moderate dependency (1st degree) – someone who needs help once a day to complete basic activities.
  • Severe dependency (2nd degree) – someone who needs help 2/3 times a day to complete basic activities.
  • Great dependency (3rd degree): someone who needs ongoing, permanent assistance to manage their basic needs and activities.

What are the different types of dependency?

Dependencies can be wide-ranging and often have crossovers. The law defines dependency as “the permanent state of people who, for reasons of age, illness or disability, and linked to the lack or loss of physical, mental, intellectual or sensory autonomy, require the care of another person or persons or substantial help to carry out basic activities of daily living or, in the case of persons with intellectual disabilities or mental illness, other support for their personal autonomy.”

So the four main dependency categories are physical, mental, sensory, and mixed.

  • Physical – disability or mobility issues due to age, injury or illness, that makes someone dependent on another for physical support.
  • Mental – when a mental condition (such as dementia, for example) means a person is no longer capable of making decisions or problem solving and rely on someone else to do it for them.
  • Sensory – a loss of a sense, such as blindness, makes someone dependent on another for help.
  • Mixed – someone who suffers from two or more types of dependency

What does the law offer to dependent people?

Essentially care, whether in the home or at a residency centre, or financial assistance for people caring for loved ones.

The degree of dependency is tied to the care coverage:

1st degree: 10-20 hours/month
2nd degree: 21-45 hours/month
3rd degree: 46-70 hours/month

The average amount of home help is 33.8 hours per month, which rises to 57.9 hours for 3rd degree dependencies.

The financial benefit received by those who care for a dependent relative at home is €240.17 — €369.6 in the case of 3rd degree decencies.

The average amount of state benefit linked to a residential place for 3rd degree dependents is €575: less than a third of the real cost of these services.

READ ALSO: Can I claim UK Personal Independence Payments (PIP) in Spain?

Why is the law trouble-ridden?

However, as progressive as the legislation is on paper, in reality things haven’t worked out like that.

In 2023 alone, 40,447 people died while waiting to be assessed or cared for. This works out to 111 people dying a day in Spain while on the Dependency Law waiting list.

As of 31 December 2023 there were 296,431 people still on the waiting list. The time it takes to even process a dependency application and arrange care intervention takes almost a year (324 days).

But these failures aren’t for a lack of trying (or more specifically, money) by the government. In 2021, Spain’s Ministry of Social Rights approved a shock plan that increased state funding for the SAAD to the tune of €600 million. This money was mainly used to try and resolve the backlog in case applications and widen the coverage of benefits offered.

However, the plan hasn’t really worked as anticipated.

This seems to be for two main reasons: firstly, the complexity of the procedures taking a patient from application to dependency diagnosis and finally to care — in other words, slow bureaucratic processes getting in the way.

Secondly, the cutting of funding at a regional level has made an already overwhelmed system even more stretched.

Much of the money for the Dependency Law comes from regional authorities, and in 2023 nine regions reduced their funding for dependency services, including Catalonia (by 57.3 million), Andalusia (51.6 million), Valencia (40.6), Madrid (15 million), Extremadura (11), Asturias (10.8), Cantabria (8.7), Castilla y León (7.4) and Murcia (1).

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