Giving birth in a Spanish hospital: what to expect

Terms used

• Plan de parto — The plan de parto is a written statement of your preferences for labour and birth, made with your midwife.
• Rotura de bolsa — Rotura de bolsa means your waters breaking.
• Urgencias de obstetricia — Urgencias de obstetricia is the hospital's maternity emergency service.
• IHAN — IHAN is the Spanish branch of the WHO/UNICEF Baby-Friendly Hospital Initiative, which accredits hospitals supporting skin-to-skin contact and breastfeeding.

Key rules

• Cost: Birth, epidural and the standard hospital stay are free in the public system for those entitled to it.
• Birth plan: Your plan de parto is not legally binding, but staff must still inform you and ask for your consent.
• Interpreter: Interpreting is not guaranteed, so bring a Spanish-speaking companion if you need one.
• Rules vary: Epidural cover, companion rules and stay length differ by hospital, so ask your midwife beforehand.

The short version

Birth, epidural and the standard hospital stay are free in the public system for those entitled to it. Most routines are built around keeping you and the baby together. Details change from hospital to hospital, so ask your midwife at your antenatal visits how your hospital works.

Epidural

You can ask for an epidural during labour if there is no medical reason against it. Most large public hospitals offer it 24 hours a day, and well over half of vaginal births in many hospitals use one. Smaller hospitals may have less anaesthetist cover, sometimes at night. Some hospitals also offer nitrous oxide, but this is not standard. Ask in advance what your hospital provides.

Companions

One companion of your choice can usually be with you during labour and birth. This normally includes a caesarean, when the situation allows.

On the postpartum ward, one permanent companion, often your partner, is typical. Other visitors usually come for a few hours in the afternoon, with about two at a time. Rooms are often shared, which can limit who stays overnight. Rules were tightened during COVID-19 and have mostly relaxed, but each hospital sets its own and may restrict them again during outbreaks.

Your plan de parto

A plan de parto is a written list of your preferences for labour and birth. You draw it up with your midwife, usually in the second half of pregnancy, and often talk it through at visits or classes from about week 28 to 34. Your region or hospital probably has a template, and the one below can also be adapted. The plan goes into your clinical record, and you bring a copy to the hospital.

It is not legally binding, because safety decisions come first. Staff still have to inform you and ask for your consent, so the plan carries real weight.

Language

Interpreting is not guaranteed. Some regions and large hospitals have telephone or video interpreting, and some have English-speaking staff. If your Spanish is limited, bring a companion who speaks Spanish. Ask the hospital's patient service in advance what is available.

When to go

Go when contractions are regular, about every 5 minutes for an hour, and strong and painful. First-time mothers may wait longer at home. Go sooner if your waters break (rotura de bolsa), especially if the fluid is green or brown. Also go for heavy bleeding, reduced baby movements, fever or severe pain.

Go earlier if you have had a caesarean before, are before 37 weeks, or have a high-risk pregnancy. Call the hospital's maternity emergency line (urgencias de obstetricia), whose number is on your pregnancy record. Call 112 in an emergency or if you need an ambulance.

After the birth

Skin-to-skin contact is standard in most public maternity wards. It is usually offered for at least the first hour after a vaginal birth, and increasingly after a caesarean when you and the baby are well. Your baby normally stays in your room with you. Hospitals with IHAN accreditation follow these practices as part of it, and a growing number of public hospitals have it. How closely hospitals follow them varies.

How long you stay

After an uncomplicated vaginal birth you usually stay about 2 days, around 48 hours, sometimes 24 to 36 hours. After a caesarean it is typically 3 to 4 days. Complications or a baby who needs monitoring mean longer. In some areas a midwife visits you at home after early discharge.

The timeline, bag checklist and FAQ below cover when to leave for the hospital, what to pack and common questions.

Timeline and deadlines

• Go to the hospital early if you are at higher risk: As soon as labour starts, if you have had a previous caesarean, are before 37 weeks, or have a high-risk pregnancy

• Go straight away if your waters break or there is a warning sign: Immediately if the fluid is green or brown, or with heavy bleeding, reduced baby movements, fever or severe pain; call 112 if you need an ambulance

Hospital bag and paperwork checklist for the birth

What to bring to the hospital

• Pack your ID: DNI, NIE or passport, for you and your partner.

• Bring your health card (tarjeta sanitaria).

• Bring your pregnancy record (cartilla del embarazo) and your test results.

• Bring a copy of your birth plan if you have one.

• Pack a nightgown or pyjamas, slippers and toiletries for yourself.

• Pack nursing bras, breast pads and sanitary pads.

• Pack baby outfits, a hat and socks, plus nappies in case your hospital asks you to bring them.

• Fit a car seat in the car for the trip home.

• Save the number of the hospital's maternity emergency line (urgencias de obstetricia) in your phone, and keep 112 ready for an ambulance.

• Leave bed linen, mesh underwear and maternity pads at home if your public hospital supplies them; ask at an antenatal visit.

Birth plan (plan de parto) you can adapt

Fill this in with your midwife (matrona), usually between week 28 and week 34, and ask her to add it to your clinical record. Bring a printed copy when you are admitted. It is a statement of preferences, not a binding contract: if safety requires a different decision, the medical team will make it. It still counts, because you have the right to information and to give or refuse consent. Many regions and hospitals publish their own form, so ask your midwife whether to use that one instead. Cross out or delete anything that does not apply to you.

Plan de parto

Datos personales

• Nombre y apellidos: ______________________
• Fecha de nacimiento: ______________________
• Número de tarjeta sanitaria: ______________________
• Fecha probable de parto: ______________________
• Matrona / centro de salud: ______________________
• Hospital previsto: ______________________
• Idioma en el que prefiero que me hablen: ______________________ (si no hablo bien español, necesito intérprete o una persona que traduzca: sí / no)

Acompañamiento

• Quiero que me acompañe durante la dilatación y el parto: ______________________
• En caso de cesárea, me gustaría que me acompañe, si la situación lo permite: ______________________
• Persona que me acompañará en la planta tras el parto: ______________________

Each hospital sets its own rules on companions and visiting hours, and rooms are often shared. Ask the hospital before the birth.

Durante la dilatación

• Prefiero libertad de movimiento y poder cambiar de postura: sí / no
• Me gustaría poder beber líquidos: sí / no
• Música o ambiente tranquilo (luz tenue, poco ruido): sí / no
• Prefiero que se me informe antes de cada examen o intervención: sí / no
• Observaciones: ______________________

Alivio del dolor

• Deseo anestesia epidural: sí / no / lo decidiré durante el parto
• Me gustaría probar antes métodos no farmacológicos (agua caliente, masaje, pelota, respiración): ______________________
• Otras opciones, si el hospital las ofrece: ______________________

The epidural is offered on request if there is no medical reason against it. In some smaller hospitals, or at night, anaesthetist cover can be reduced, so ask your midwife how it works in your hospital.

Parto

• Postura preferida para el expulsivo: ______________________
• Prefiero evitar la episiotomía salvo que sea necesaria: sí / no
• Quiero que me expliquen cualquier intervención (ventosa, fórceps, oxitocina) antes de hacerla, si es posible: sí / no
• Quiero que mi acompañante pueda cortar el cordón: sí / no
• Pinzamiento del cordón: precoz / tardío (cuando deje de latir)

Cesárea, si fuera necesaria

• Quiero estar despierta y acompañada si es posible: sí / no
• Deseo contacto piel con piel en quirófano o en la sala de reanimación, si mi bebé y yo estamos bien: sí / no
• Si yo no pudiera, deseo que el contacto piel con piel lo haga mi acompañante: sí / no

Después del nacimiento

• Deseo contacto piel con piel inmediato con mi bebé, sin interrupciones, al menos la primera hora: sí / no
• Deseo que las pruebas y los cuidados rutinarios del bebé (peso, medidas, vitamina K, pomada ocular) se hagan después del primer contacto o con mi bebé sobre mí: sí / no
• Alimentación del bebé: lactancia materna / lactancia artificial / mixta
• Quiero ayuda de la matrona o de una asesora de lactancia en la primera toma: sí / no
• No quiero que se dé al bebé chupete, suero ni biberón sin consultármelo: sí / no
• Deseo que mi bebé permanezca en mi habitación todo el tiempo (alojamiento conjunto): sí / no

Situaciones especiales

• Si mi bebé necesita ingreso en neonatos, quiero poder estar con él o ella y recibir información lo antes posible: sí / no
• Creencias, valores o necesidades culturales o religiosas que quiero que se respeten: ______________________
• Alergias, medicación o antecedentes médicos importantes: ______________________
• Otras preferencias: ______________________

Firmas

Entiendo que este plan expresa mis preferencias y que el equipo médico puede proponer cambios si la salud de mi bebé o la mía lo requieren.

• Firma de la madre: ______________________ Fecha: ______________
• Matrona: ______________________ Fecha: ______________

Before you hand it in

• Keep it to one page if you can, because staff read short plans more easily.
• Make two copies: one for your record and one in your hospital bag.
• Ask your midwife which of your wishes the hospital can meet as standard. Skin-to-skin contact and keeping the baby in your room are common practice in most public maternity wards, but how closely hospitals follow them varies.

Frequently asked questions

Can I get an epidural at any time of day or night?

Yes, most large public hospitals offer an epidural 24 hours a day, but cover can be reduced at night in smaller hospitals. Ask your midwife at an antenatal visit how your hospital covers the anaesthetist.

Is the plan de parto legally binding?

No, the plan de parto is not legally binding, because the team's safety decisions come first. It still counts, since you have the right to be informed and to consent to your care.

Will there be an interpreter if I do not speak Spanish?

No, an interpreter is not guaranteed in public hospitals, and it varies a lot by region and hospital.

Can my baby stay with me in my room after the birth?

Yes, rooming-in is standard in most public maternity wards, so your baby stays in your room. Skin-to-skin contact is usually offered for at least the first hour after a vaginal birth, and increasingly after a caesarean if you and the baby are well. Hospitals with the IHAN baby-friendly accreditation follow this routinely.

Can my partner stay overnight on the postpartum ward?

Usually one permanent companion is allowed for the stay, often the partner, but rooms are often shared, which can limit overnight stays. Other visitors have set afternoon hours, with about two at a time. Ask your hospital for its current rules.