Congratulations if you have just found out you are pregnant - now is the time to start planning ahead. This may include making personal choices & changes to your lifestyle. If you have not already been taking Folic Acid 400mcg daily, do so immediately. This is to reduce the risk of Spina Bifida and related problems (neural tube defects) in your new baby. Stop smoking, cut out alcohol and reduce your caffeine intake – found in chocolate, coca cola & tea, as well as, coffee! This may sound quite negative, but in fact these measures will all have a positive impact on your pregnancy.
The next issue to consider is who is going to care for you over the next 8 months or so?
The common choices in Spain range from care in the
. public social security system (SSS)
. an Obstetrician covered by a private healthcare plan, often in a private hospital
. ‘private’ care with an Obstetrician whom you pay directly
. A mix of options-being seen both by private and public Doctors simultaneously and many Spanish women do this.
. The role of the midwife in the public system antenatal care in Spain varies from one public health clinic [centro de salud] to another, but principally it involves the 1st (booking) appointment, subsequent ones in the later stages in pregnancy and running antenatal classes. Midwives work in either the health clinics or in hospitals and do not inter-change, as the community and hospital systems are separate, unlike in the UK and other EU countries.
. There are a few foreign Midwives living & working in Spain who provide Independent care.
You are required to be registered with a GP in your centro de salud if paying into the SSS in Spain and this is where you make the first appointment with the midwife – or matrona - once you know you are pregnant. If you are not paying into the SSS but have been contributing in the UK up until recently, you may be eligible for full care here in Spain.
To learn more on this, go to http://www.nhs.uk/NHSEngland/Healthcareabroad/plannedtreatment/Pages/Givingbirth.aspx
The EU Healthcard (old E111) is for emergency care in any EU country and is not the correct way to access the Spanish healthcare system for long term care such as is required in pregnancy.
Most private healthcare companies require previous membership to cover your care and the birth of your baby, or may charge you a significant premium for cover. Many foreign women here in Spain will choose a private Obstetrician by hearing about them from a friend or reading about them on-line. Write your important issues or questions down before your first appointment to help you remember them. Do not feel you are unable to meet another Doctor or get a second opinion if you are not 100% happy.
Ideally make your first appointment when you are approx 8-10 weeks in order to be in time to have the choice of having 1st trimester screening between 11-13 weeks.
Your first visit will include taking a medical/surgical and gynecological history and having blood taken for group, rhesus, and hemoglobin, Platelets, Hepatitis B, Rubella, Toxoplasmosis, Lues-Syphillis and HIV – as a general guide. Your weight/height ratio (BMI) will be checked along with your Blood Pressure. Your EDD (expected date of delivery or FPP, fecha probable de parto, in Spanish) will be confirmed by doing a ‘dating’ ultrasound scan.
Antenatal screening is offered to women after 11 weeks in order to give them the possible risk of their babies having certain abnormalities - Downs Syndrome, Trisomy 18 and Trisomy 13. The results are only an indication of a possible risk - written down or expressed as 1:1000 or 1:300, for example - and if found to be high the woman will be offered more accurate and definitive tests. This screening is a combination of three measurements. An Ultrasound scan – to measure the nuchal fold at the back of baby’s neck, a blood test to measure 2 chemicals in your blood – HCG and PAPP-A and your age. There is a new, early and non-invasive blood test [2013] to screen for Downs Syndrome. It is very expensive at >700€ and not yet widely available.
2nd trimester screening @16 wks is to detect neural tube defects the most common of which is Spina Bifida. This involves a blood test to measure serum AFP levels.
Antenatal diagnostic tests. These include a more detailed ultrasound scan and chorionic villi sampling [CVS] between weeks 11-13. These will confirm the presence of certain abnormalities, if possible to perform the CVS - timing and the position of the placenta are important. Amniocentesis is an option later in the pregnancy – usually in weeks 16-18, and whilst the results of some of the common abnormalities may be available in days, full results take 2-3 weeks.
As in many other countries a detailed ultrasound scan at 20weeks will also look very closely at all of the baby’s organs. Other ‘routine scans’ in Spain are at 32 & 40 weeks. In private practice, many more may be offered.
More details of the actual procedures and associated benefits/risks can be discussed with your Obstetrician.
NOTE - This is a general guide and individual women may have specific needs that require different care, advice or screening. More information can be obtained from your Midwife or Obstetrician.
EARLY PREGNANCY IN SPAIN
Course both helpful & informative. I would advise anyone expecting a child to attend. Anne provided...
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ANTENATAL ADVICE – if you need advice about the services available and what best suits your needs... (Read More)
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Please contact Anne +34 630 231 037 anne@irishmidwife.com or Yvonne +34 649 199 116 yvonne@irishmidwife.com