Having a Baby: Pregnancy and Birth in Spain

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Having a Baby: Pregnancy and Birth in Spain

Before conception, or in the early stages of pregnancy it is recommended to explore the options available and consider the following:

• Where to receive care during pregnancy
• Where to deliver the baby
• Where to get post natal care
• Entitlements available under the social health care system
• The coverage available from private health care

There are both state-owned social security hospitals and private clinics in all areas of Spain. A person not entitled to social health care has the option of private care. This choice of private care may be influenced by available insurance cover and the cost of individual services. A mother wanting to give birth at a private clinic must have private insurance in place at least ten months before becoming pregnant. If this is not done, it might be difficult to find an insurer. 

Most regions of Spain provide translation services in the hospitals and clinics.

Pre-Natal Care

As soon as a pregnancy is suspected, consult a doctor or midwife. This visit is to confirm the pregnancy, examine the expectant mother and organise routine blood tests and an early ultra sound scan.

Generally (although this may vary) pre-natal examinations will be given by a doctor or midwife. The schedule of examinations is:

• every 4 weeks up to 32 weeks. The mother is seen by the midwife and attends the hospital for scans
• every 2 weeks after 32 weeks (in most regions in Spain). If there are complications with the health of the mother or baby, visits will be weekly, with a second scan at 36 weeks
• between 34 and 36 weeks of pregnancy, the midwife does a compulsory group B streptococcus test (Note, this applies to state hospitals only; in most private hospitals it must be requested - one in four pregnant women have the bacteria Strep B)

The reason for regular pre-natal care is to continually monitor maternal and foetal well-being, to monitor the progress of pregnancy and for early detection of deviations from normal.

Pre-Natal Education

Pre-natal education is a vital part of pre-natal care. Women who receive professional pre-natal education and preparation invariably fair better in labour. Some clinics provide a complete pre-natal education programme. The course should include preparation for labour (what to expect), breathing and relaxation techniques and preparation for infant feeding.

In most cases the education or pre-natal classes start in the 28th week. Most classes invite partners as well.

Where to Deliver the Baby

Although it is seldom possible to choose a particular unit at a Social Security hospital these hospitals tend to offer a very high standard of care, with emergency personnel services readily available.

When choosing a delivery unit the following could be considered:

• Which unit has the highest safety record
• Whether there is a paediatrician resident in the unit 24 hours a day
• If there are facilities for intensive neonatal care
• The Caesarean section rate
• The methods of pain relief available

In the private sector, the chosen obstetrician may only deliver in one particular unit. This would limit the choice. 

Note: When opting for a private clinic, establish what happens in the case of premature birth - the majority of private clinics do not delivery before 36 weeks as most premature infants need specialised 24 hour care.

After the birth

Following a normal delivery, expect to stay in hospital (private and social security) for up to 48 hours. This allows time for at least two pediatric checks on the newborn. 

In the case of a Cesarean delivery, expect to stay in the hospital for up to five days. Make sure to have a family member around, as help will be needed with the newborn.

On discharge from hospital, the baby and mother have a final examination; the mother has a scan. The mother is given a yellow form to be used to register the birth and an infant record book which will be the child's health record from birth to 18 years of age.

Vaccinations

The following vaccinations are recommended: tetanus, diphtheria, whooping cough, (Difteria, tétano, tos farina), Haemophilus B (Haemophilus influenzae tipo B), MMR (Sarampión, paperas, rubeola) TB (BCG), Meningitis. Note that immunisation policy may vary in the different autonomous regions of Spain. 

At one week of age the baby has a blood test to determine if there is any genetic error. This test is sent away for analysis; it takes up to 14 days for the results to be returned. This test is only done on social security.

Home Births

Home births are generally not available in Spain.

Registration of a Birth

Births must be registered within eight days (but up to 30 days is accepted) at the local civil registry office (Registro Civil). It is the parents' responsibility to ensure this is done and it must be carried out in person by a parent or direct family member. In some cases the hospital, clinic or midwife may register the birth. 

The registered name must conform to Spanish regulations regarding compound names and also ensure that the name will not prove harmful or confusing for the child. 

• The Ministerio Justicia English-language pages have a description of registering the birth: Click here

The birth registration includes:

• name of the newborn
• date, time and location of the birth. In the case of multiple births, when the exact time is unknown for each newborn, indication shall be given of the order in which they were born, or that this could not be determined
• gender of the newborn
• the parents, when the relationship is legally recognised
• the number assigned to the birth or verification file
• the time of registration

Birth certificates must state whether a child is legitimate or illegitimate. Children born within 180 days of their parent's marriage, or within 300 days of a divorce, a marriage annulment or the death of the father are considered legitimate.

Registering a child born within a marriage

A parent takes the following to the Civil Registry:

• Medical delivery report (this yellow form is provided by the hospital where the delivery took place)
• NIE (Foreigner's Identification Number) of the parents
• Libro de Familia (Family Book, if available) or marriage certificate legalised and translated

Registering a child born outside marriage

In this case, a declaration is required by both parents, with the father and the mother both registering the birth in person, providing the following documentation:

• Medical delivery report (yellow form is provided by the hospital where the delivery took place)
• The parents' NIEs
• Indication of the mother's marital status
• If a prior marriage existed, the legal presumption of paternity must be removed by providing a marriage certificate and a separation certificate or divorce decree (witnessed)
• In the case of separation, two witnesses must accompany the parent to the Civil Registry

The birth certificate

There are two types of certificate: 

• short/abridged (un extracto de inscripción de nacimiento or certificado simple): contains the date of birth, the names of the child and parents and the inscription number
• full birth certificates (un certificado literal de nacimiento): full certificates may be needed for registration with the Consulate of a baby born to foreign national resident in Spain 

Once the birth certificate is issued, a Libro de Familia (Family Book) is allocated. This book contains the full history of the parents and children of the family.

• Birth certificates for specific regions can be downloaded: Click here  
• For instructions to select the relevant region: Click here (in Spanish) 

Post Natal Care

Post natal care tends to be very limited.

Statutory Maternity Leave

Statutory maternity leave in Spain is currently 12 weeks paid leave from work, which may be taken before (if complications are detected) or after delivery. This is increased by two weeks for each child in the event of a multiple birth from the second baby.

Fathers are entitled to 15 days paternity leave (depending on their job). In 2015 this will be increased to 30 days. If there are complications for either the baby or the mother, the father is entitled to longer leave.

Benefits

In order to encourage more births in Spain, mothers of children born after 00:00 on 3 July 2007 are entitled to a one-off payment of €2,500 - the cheque bebé. Mothers who are Spanish citizens and foreigners who have been resident in Spain for at least two years prior to the birth are eligible. Adoptive parents who adopt a child within Spanish territory are also eligible. 

This allowance is only available if one parent has done the renta (tax declaration) for the previous year. To get the benefit, either contact the local Agencia Tributaria or get the help of a gestor.

Working mothers are also entitled to a monthly allowance for childcare. Application for this monthly benefit automatically generates an application for the one-off €2,500 childbirth benefit. To apply, contact the local Social Security office (Seguridad Social).

• For more information on the cheque bebé: Click here (in Spanish)
• See the Seguridad Social website for the nearest office: Click here
• For further information, see the Tax Agency (Agencia Tributaria) website: Click here (in Spanish)

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With contributions by Dawn Blythe S.R.N. R.M. (UK), a British trained midwife who has worked with expatriate communities worldwide. 
Currently with The English Medical Clinic, Albir
Tel: 966 868 013 / e-mail
 Copyright © 2006-2009 Dawn Blythe. All Rights Reserved