Giving birth in Spain was never in my plans, until I moved abroad at 22 and promptly met the man who is now my husband. First came love, then came the awkward talk about whether or not we wanted kids and, nearly a decade later, came the baby carriage (and all of its darn accessories).
As a first-time mother and the first of my close group of American friends to become a mother, I navigated pregnancy in another language and culture - without the support of having my family close by. Apart from the requisite scans, blood tests and visits to my OB-GYN, I devoured several books on how to prepare for my new role.
I also opted to take antenatal sessions through my local health clinic. As I was in both the private and public health schemes, I chose to the do the classes in the public system with a matrona (midwife) and about 20 other expectant mothers. We covered everything from pain relief during labor to how to care for a newborn, but thinking about how to create a birth plan and really thinking about my preferences during childbirth was perhaps the most relevant thing I took from the course. Birth plans in Spain are commonplace for women preparing for a hospital birth (and, I’d venture to guess, home births) and, although mine went somewhat out the window when push came to eight more pushes, I was glad to have learned how to create a birth plan as a guideline prior to going into labor.
What is a birth plan?
At its most basic, a birth plan, or plan de parto in Spanish, is a brief outline of your preferences during labor and delivery.
While every woman or family will have different preferences, it’s usually suggested that you consider the following when thinking about how to create a birth plan:
Where do I want to have the baby? Which doctor would I like to deliver? In Spain, where you choose to have your baby may depend on whether or not you are in the private or public system, whether or not you’d like a medicated or non-medicated birth and whether or not the hospital of your choice can provide you with the necessary care in the event of a breech position or complications.
Do I want a medicated or unmedicated birth? Most women in Spain choose to have an epidural, and my preference to not get medicated was met with a lot of gasps in my prenatal classes. Laughing gas is not common in Spain as a pain control measure, either.
Who will be allowed in the birthing room with me? I was surprised that my son made his entrance into the world with an OB-GYN, midwife, anesthesiologist and pediatrician in the room - in addition to my husband. Typically, vaginal births can have a +1 and cesareans are done with the spouse, partner or birthing partner waiting outside of the surgical unit.
Your birth plan may also touch on feeding and preliminary care, the atmosphere in the birthing room and visits. I asked for restricted visits and calls, but the rest was not as important to me. Be sure to review the plan with your partner and your healthcare provider, and carry a copy or two with you to the hospital in the event that things don’t go as planned - you may have another doctor or give birth unexpectedly at a different hospital.
How are birth plans viewed in Spain?
Typically speaking, a plan de parto is a routine part of preparing for childbirth in Spain. If you’re confused on where to start and how to create a birth plan, take a look at El Parto es Nuestro, an online community forum for expectant mothers with sample birth plans as well as information about pregnancy, childbirth and motherhood in Spanish.
Do healthcare providers actually read your birth plan?
When I had my 36-week check-up, my doctor and I spoke about the birth plan. Dr. Garcia gave her opinions and asked me to think about all possibilities because childbirth is so unpredictable. She asked me to have an EKG to determine how my body might react to an epidural and to speak to my husband in the event of an emergency. I felt reassured that she spoke to me honestly and didn’t idealize my birthing experience – in fact, my first birth was far from what I expected. Her care and frankness is what ultimately led me to abandon my plan to give birth in a well-known public hospital in Seville and opt for the private clinic just a few steps from my home.
I appreciate that many women choose a non-medicated or home birth, but I put all of my trust in the medical team - and in the end, they talked me through the 12 hours of labor and delivery, and were respectful of my postpartum wishes for skin-to-skin contact, breastfeeding assistance and no visits from those outside of family. I eventually relented and let a few friends come visit (and bring me Iberian ham sandwiches!) but knowing I had some control over an uncontrollable event was paramount.
Tips on how to create a birth plan
Your birth plan is unique to you and to your circumstances, so there is no one-size-fits-all plan. When visualizing your birth, the top tips are to keep the plan simple and concise and include:
Your name (and perhaps pronunciation or a nickname)
The name of who will join you during delivery
Your due date and home hospital or OB-GYN’s name
Labor preferences (pain intervention, emergency interventions, laboring options)
Don’t forget to talk all of these things over with your birthdaypartner before you show your plan to a healthcare provider. As your due date nears, take a look to see if any of your preferences have changed.
Remember that difficulties during pregnancy & childbirth can occur
For starters, I had to tell my mom that, in the event my husband was unable to attend the birth, I preferred my mother-in-law to be in the paritorio with me because of language. Additionally, I wanted to have a natural birth and avoid an epidural if I could, and that a Cesarean should only be performed if other methods failed.
In the end, my doctor suggested inducing childbirth at 40+1 due to slow growth of the baby during his final week in utero, as well as what she qualified as low amniotic fluids level. I cursed my body for needing a boost to go into labor and went back to revamping my birth plan for the umpteenth time.
As a first-time mother, I didn’t feel as in-tune with my instincts as I should have and ultimately let my doctor lead me through some of the decisions. When my body didn’t start labor naturally after induction, the birth team broke my water. When the contractions didn’t speed up, I went with their advice that an epidural would help me enjoy childbirth more.
It was my nerves that got the best of me. Once I had the epidural around 4pm and my husband went to take a break while I relaxed with a book, my body got with the program and dilated quite quickly - so quickly, in fact, that my husband nearly missed his first child being born!
Are there any differences between giving birth in Spain & the US?
When I was speaking with healthcare professionals about what I hoped labor and delivery would be like, doctors and midwives were often startled by my preferences, which were initially cultural but also based on my need for privacy and assessment of my health and the baby’s.
As I am 20 weeks pregnant with my second child, I have very little clear but the hospital where I’ll ideally give birth and that I would like to try for non-medicated as well. But having the experience of a medical team that was clear with my expectations and empowered me to make decisions within their medical advice.
My son is healthy and recently turned two. It seems strange that I’m back to thinking ahead to the sleepless nights and the tiny baby clothes, but I’m ultimately ready for a second go at childbirth and postpartum care. Despite my pigheadedness to deliver 100% on my own terms, having a birth plan helped me think through scenarios that I otherwise might not have considered.
Apart from a birthing plan, it’s important to talk to your doctors about your health and any past pregnancies or miscarriages, as well as family history. As with anything, a certain degree of flexibility with emergencies or unpredictables is important. You are ultimately in as much control as you can be!
Should I get prenatal coverage?
Carrying a baby is a beautiful thing that your body can do, but you’ll need constant monitoring – and so will your baby. From monthly check-ups to blood and urine tests to prenatal delivery classes, your preparation Will be able more than writing up your ideal birth plan.
Private insurance has great benefits when you’re expecting a baby, from direct Access to specialists and exams without the need to pass through your GP, a greater selection of hospitals for delivery and the guarantee that you can do your scans and tests on time. Remember that insurers will typically have a periodo de carencia, or a wait time for some of the services related to pregnancy and childbirth.
If you are pregnant or are thinking of becoming a parent, be prepared! Download Typical Non Spanish's useful guide on coverages with Caser: Guide to Pregnancy-Related Healthcare Coverage with Caser (caserexpatinsurance.com)
If you are searching for health insurance in Spain, Caser Expat Insurance has the right policy for you!