My wife Morena texted me from a hotel in Madrid.
She was down there for just one night, applying for a tourist visa at the Canadian embassy.
The text I got was a blurry photo, apparently of a pregnancy test.
I was expecting something like this any day. Still, I hadn’t seen a lot of pregnancy tests.
“Is that positive?” I asked.
“Yeah.”
And so, my adventure with fatherhood began. That was March. Our daughter is due in mid-November.
Today we’re going to talk about that experience up to now: prenatal care in Spain. So far, it’s going well!
What’s the deal with prenatal care in Spain?
Spain needs new babies.
If you’re having one soon, congratulations! And thanks.
The good news is that the public healthcare system does an excellent job with prenatal care – at least in the major cities. (I don’t live in a small town, so I don’t really know about that.)
In fact, I’ve heard people complain plenty about other aspects of Spain’s public health, and about every other aspect of Spanish life. But not about the prenatal and maternity systems.
Everyone I’ve talked to about having a baby in Spain is pretty happy.
Some other day I might do Spanish baby vocabulary, for people who are looking to learn that. But today let’s just talk about the process.
Public health system vs private insurance
If you’re a legal resident and working in Spain, you’ll have access to the public health system.
Spain’s public healthcare is decentralized, meaning each of the 17 Comunidades Autónomas takes care of its own system.
When I lived in Madrid, we had health centers run by Madrid Salud (because Madrid is the capital but also, with surrounding cities, a Comunidad Autónoma).
Now I’m up here in Barcelona, and I’ve got CatSalud, run by the Generalitat de Catalunya.
The public health covers most people. But if you’re in Spain on certain types of visas, you’re required to have private health insurance.
And many “locals” have private insurance, too. I have a cheap private insurance through my bank, which covers minor things (nothing that would require hospitalization). Morena, through her job, has a complete private health insurance that gives her access to a lot of different clinics.
For the birth of our child, we’ve chosen to use the public health system, mainly because of word of mouth – everybody who’s been through a birth at one of the public hospitals says it was great.
We’re also doing occasional checkups at a private clinic, mostly for Morena’s peace of mind.
Of course, living in Barcelona we have a wide selection of clinics and hospitals. Your situation, if you live in a smaller city or town, may be much different. This is just what we’re doing.
Prenatal Care with the Public Health System
The first step, then, is to call (or walk by) your local health center to tell them you’re pregnant. Morena did this, and they gave her the first of a series of appointments taking her from week six or eight all the way through giving birth.
The first appointment they opened a file for us, and asked her some questions. Do you smoke or drink? Family history of important medical conditions? That sort of thing. After that they scheduled us for an ultrasound at the hospital.
The week-13 ultrasound is about as terrified as I’ve ever been about a medical procedure. But they laid Morena down and put some gel on her belly and showed us a grainy picture of our baby… about the size of my thumb.
All the measurements checked out, and the doctors told us everything was fine. It was too early to know for certain, but the “genital tubercule” was pointing down instead of up, so the doctor told us we probably had a girl. (Apparently, this is called nub theory, and it’s largely accurate after about 12 weeks.)
Every appointment leads to another appointment, and by this time there have been about a dozen. It looks like they do everything in a modern high-tech way: there’s a blood panel, a screening for gestational diabetes, a few meetings with midwives about various things, and a lot of attention generally.
And it’s all free. (Or, more accurately, paid for by those massive taxes we give the government every year.)
Prenatal classes with a doula
Last Wednesday at quarter to seven, we arrived at a “Maternity Support” space over on the left side of Eixample.
Morena and I were the first to arrive, but soon three or four other expat couples gathered outside the door. The doula walked up briskly a few minutes later.
“When I give this class to Spanish couples, everyone’s late! With expat couples, you’re all 10 minutes early…”
We go upstairs and sit in a circle and introduce ourselves. There’s a couple from Trinidad and Tobago, who have just arrived in Spain. A Turkish / Russian couple who have been here for just a few months. An authentic Catalan and his German partner. Etc.
At 210€ for three classes, this is a bit expensive and doesn’t teach me much I haven’t learned online. But the doula describes the whole process of timing contractions and figuring out when to go to the hospital. She points out that amniotic fluid is actually the baby’s pee. And she has an amusing Spanish pronunciation of words like leak (sounds like “lick”) and focus (sounds like “fuck us”) that keeps me giggling on the inside for an hour and a half.
It may be helpful just to be surrounded by some people in a similar situation to us. I imagine my daughter floating in a sac full of her own urine, and look around at the women with their baby bumps, and the expectant dads, and feel fine.
(According to Wikipedia, amniotic fluid is generated from maternal blood plasma and fetal urine adds to the volume in the second half of pregnancy. Also, fetal urine is quite different to the adult variety. I never thought I’d need to know this, but now I do… and so do you. You’re welcome.)
Advice from Other Parents
Since beginning this adventure, I’ve asked plenty of parents for advice.
Most of them – almost all – have said some version of the following: “Having children is the best thing I’ve ever done. Parenting is the best part of my life, by far.” Or something to that effect.
It’s odd that that’s practically the opposite of everything I’ve been hearing from the media my entire life. Maybe the people who work in mainstream media are deranged anti-child monsters or something. I don’t know.
(It certainly seems that way, some times.)
Also, it’s interesting that people with kids never just volunteered this information about the joys of parenting before. Maybe parenting is a sort of secret society and they don’t like talking about it to “outsiders”. Or maybe I just never asked.
I’ve gotten some advice that sounds pretty good. It’s mostly along the lines of “ignore the horror stories you read”. My mom, in particular, said “talk to your child constantly”. Because babies absorb everything, and need to hear language.
And almost everyone agrees that we’re going to love our kid with a depth of feeling we currently can’t imagine.
If you’re a parent, and have any advice for us, let me know in the comments or by email.
Parenting advice from Social Media
As soon as you realize you’re going to be a parent, your algorithm figures it out as well, and your social media becomes parenting-focused.
Morena has followed a bunch of doulas, pediatricians, and motherhood influencers on Instagram, and the result isn’t always uplifting.
Social media, of course, runs on clickbait. And “Don’t worry – everything is going to be fine!” is ineffective clickbait.
There are plenty of depressing things that have a one-in-a-million chance of happening during pregnancy, and the algorithm will tell you about all of them, ad nauseam.
So keep that in mind: you might end up seeing a lot of negativity, and it’s bound to affect your mood about the whole thing.
There’s also the fact that people are putting more of their lives than ever online, so we now know exactly what every celebrity on the planet went through while giving birth.
Our OBGYN at the private clinic told us, on our first visit, that most pregnancies go just fine and that there’s nothing to worry about. I took it to heart – Morena and I have pretty healthy lifestyles, and we eat like medieval kings, so I’m just assuming everything will go smoothly.
Morena, on the other hand, is more immersed in mommy blogs and celebrity culture. So when I say “don’t worry”, she’s likely to respond with “Easy for you to say! The crown prince of Burma was born feet first, with the umbilical cord wrapped around his neck. It can happen to anyone!”
Of course, it’s her body, and these sorts of worries are less abstract for her. Still, I think this is a situation where more information – beyond a certain point – isn’t really better.
English-speaking doctors and the Catalan issue
If you’re looking for an English-speaking doctor, you’ll probably find someone at a private clinic who specializes in treating expats. Here in Barcelona we’re doing the private bits at Teknon Medical Center, which caters to an international crowd.
Having said that, I’ve never tried speaking English to our doctor there, or to any of the doctors, nurses, or midwives at the public health center. Maybe they all speak English, or maybe they don’t.
Another issue I was worried about is that workers in the public health system might try to score political points by speaking Catalan to us, or refusing to use Spanish.
I had heard about some health center staff doing this to people, years ago.
And when Morena and I moved to Barcelona, some folks were quite worked up about the whole Catalan Independence thing. That was eight years ago, just after their illegal referendum, and “the locals” had strong feelings about it.
The independence people have calmed down considerably since 2018. In the event, I’m happy to report that everyone’s spoken Spanish with us so far.
It’s also worth mentioning that quite a few people hanging around the maternity areas at the public hospital are Pakistani or Moroccan or I-don’t-know-what. A lot of them, apparently, don’t speak a word of Spanish. There are signs hung up in Arabic and Urdu. And somehow it all works out.
So if your Spanish isn’t amazing and you can’t find an English-speaking doctor, don’t worry: plenty of people get through having a kid in Spain without a C2 level. Some do it without even an A2 level. You’ll (probably) be fine.
An unexpected Emergency Room visit
The other day, Morena came home worried. The baby wasn’t kicking like usual.
Everything online said: Don’t wait! Go to the ER!
But the baby was kicking a bit. Just not as much as she’d gotten used to. She wasn’t sure whether to panic or not, and chose to stay calm about it.
Long story short: the next morning, she called the health center, and the health center told her to go straight to the emergency room.
She ended up in the “obstetrics and gynecological emergencies” wing of Hospital del Mar, with a baby heart rate monitor strapped to her belly, and another monitor checking to see if she was having contractions.
As soon as she got to the hospital, of course, the baby started kicking – dancing an Irish jig on Morena’s pelvic floor. But the doctors kept her around for half a day, and gave her a complete ultrasound to make sure everything was okay.
It was okay, and the main doctor couldn’t have been nicer about it. She said that if it happens again, just come right back. It can be a big problem if your baby stops moving.
(We also learned that before you panic, you should try eating something sweet and shaking the baby awake. The doula demonstrated by grabbing her belly with both hands and shaking. The baby might just be relaxing in there.)
Spain’s Maternity Leave and Baby Bureaucracy
As far as I can tell, the hospital registers new babies with the Registro Civil – I won’t have to stand in line outside some government office for hours to get a birth certificate.
And Spain doesn’t have birthright citizenship, but our baby will be Spanish because I’m Spanish. Otherwise, babies born in Spain can “become Spanish” after one year living here (legally) with non-Spanish parents.
(The legal situation of having a baby in Spain is a bit more complicated than what I’ve let on here. Talk to Roberto over at Continentalis.eu if you have any questions or doubts your immigration status – or that of your child. He’s the lawyer who helped me get my nationality, and he’ll give you a discount if you mention my name, Daniel, when you sign up with him.)
About maternity and paternity leave, Spain gives 19 weeks to each parent. Six weeks are obligatory, starting when the baby is born. The rest can be distributed throughout the first 12 months.
As an autónomo here, I don’t have high hopes for help from the government, but I guess I get paternity. And if you’re employed “on-contract” with a company they may give you the option to take more leave – or not. It depends on company policy.
The government-mandated maternity / paternity leave is 19 weeks either way.
Prenatal Care in Spain: final thoughts
Our daughter is due in mid-November, and I’ll probably have more to say before then. But that’s our experience with prenatal care in Spain so far.
I have to say, I’m impressed. Especially by the fact that it’s free. (I can only imagine paying tens of thousands of dollars for this same series of checkups and hospital visits in the US. Or dealing with an insurance company.)
A couple of final shoutouts: Morena’s and I are having good luck buying things second-hand on WhatsApp “mom groups”. There are groups associated with a café / daycare near our old house – check out Stephy’s on Calle Wellington of you’re here in Barcelona. And there are groups of moms involved in pregnancy and postpartum Pilates.
A lot of people have cribs, bassinets, baby clothes, etc that they’re selling for cheap, or even giving away. It’s worth a look.
You can also buy second-hand stuff on Wallapop, often at pretty good prices compared to new.
And you can surely find a doula or prenatal course near you (and possibly in English) if that’s what you’re looking for.
My theory, about this and most other things, is that 3/4 of it is marketing and you don’t really need it. Still, we’ve filled up our spare bedroom with baby stuff and we’re here, waiting for the big day.
Yours,
Daniel AKA Mr Chorizo.
P.S. I’m still not sure what the baby’s name is going to be here on the blog. (Morena’s name isn’t really Morena, obviously.) If you have any ideas for an appropriate nom de guerre for a Catalan / Indian / American baby, let me know. Thanks!
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