Moving to Spain while pregnant: timing and continuity of care

Terms used

• Urgencias — Urgencias is the emergency department of a hospital, open to anyone without a health card.
• Centro de salud — The centro de salud is your local public health centre, where routine care and midwife visits start.
• Matrona — The matrona is the midwife who handles routine pregnancy care in the Spanish public system.
• Padrón — The padrón is your registration with your town hall, needed to sign up at the local health centre.
• Tarjeta sanitaria — The tarjeta sanitaria is the public health card that gives access to routine care.

Key rules

• Best timing: The second trimester is generally the most comfortable and lowest-risk time to move.
• Emergencies: Emergency care is available at any hospital emergency department or by calling 112, with no health card needed.
• Airline rules: Each airline sets its own pregnancy cut-off, so check before you book.
• Complications: With pre-eclampsia, placenta praevia or a risk of preterm labour, you are usually advised not to fly.
• Records: Carry your pregnancy records in your hand luggage.

When to move

If you can choose, move in the second trimester, roughly weeks 14 to 27. Early nausea and miscarriage risk have eased, and late-pregnancy risks have not started. The timeline below shows the stages.

How late can you fly?

With an uncomplicated single pregnancy, flying is generally allowed up to about 36 weeks. With twins or more, the usual limit is about 32 to 34 weeks. Each airline sets its own cut-off, and long-haul flights may have earlier ones, so read your airline's pregnancy policy before you book.

Your doctor or midwife must agree that you are fit to fly. If you have pre-eclampsia, placenta praevia or a risk of preterm labour, you will usually be advised not to fly at all.

From about 28 weeks, many airlines want a letter from your doctor or midwife. Some also want their own form. The documents list below says what the letter must contain. Date it close to your flight.

On the flight, walk regularly, drink water and consider compression stockings, to reduce the risk of blood clots.

The care gap when you arrive

You will probably have a gap between landing and your first routine appointment. Plan for it.

• Emergencies: go to any hospital emergency department (urgencias) or call 112. You do not need a health card.
• Routine care: register at your local centro de salud and ask for an appointment with the matrona. Registration usually needs your padrón and the documents showing you are entitled to care. The wait for a first appointment is often a few days to a few weeks.
• Health card: many regions give a provisional document, or allow a first appointment, while your tarjeta sanitaria is processed. Ask your health centre what your region does. Waiting times and processes differ by region.
• Short-term cover: private care can bridge the gap if the wait is long.

Because of this gap, a move late in pregnancy is harder. You may have little time to settle into the system before the birth.

Records to carry

Keep your records in your hand luggage, not in checked bags. They are what let a new midwife pick up where your old one stopped. The documents list below has the full set. Include any screening results and your previous birth history.

English records are usually accepted as they are. For other languages, a simple translation is easier to use. It does not need to be sworn. Individual centres may ask for different documents.

Timeline and deadlines

• Best time to relocate: the second trimester is generally the most comfortable and lowest-risk: weeks 14 to 27

• Fly without paperwork on many airlines: up to about 28 weeks

• Get a fit-to-fly letter from your doctor or midwife if your airline asks for one: from about 28 weeks

• Date the letter close to your flight: within 7 to 10 days of the flight

• Last weeks to fly with twins or multiples, if your pregnancy is uncomplicated: up to about 32 to 34 weeks

• Last weeks to fly with one baby, if your pregnancy is uncomplicated (some airlines use 35 or 37 weeks, and long-haul flights may stop earlier): up to about 36 weeks

Documents you need

• Fit-to-fly letter from your doctor or midwife, needed by many airlines from about 28 weeks. It states your name, weeks pregnant, due date, whether the pregnancy is single or multiple and uncomplicated, and that you are fit to fly. It is signed and dated shortly before travel, often within 7 to 10 days of the flight.

• The airline's own form, if your airline asks for one in addition to the letter.

• Summary of the pregnancy so far, with the estimated due date, plus all ultrasound reports, including the dating and anomaly scans.

• Blood test results: blood group and Rh, haemoglobin, infection screens (rubella, HIV, hepatitis B, syphilis) and glucose tests. Add any combined or NIPT screening results.

• Your medical history and current medications, plus previous pregnancy and birth history, including any caesareans or complications.

• Vaccination record, covering tetanus-diphtheria-pertussis, flu and COVID-19.

• Simple translation of records that are not in English. English records are usually accepted as they are, and the translation does not need to be sworn.

• Padrón (registration with your town hall), needed to register at your local health centre for routine care. If you have no health card, bring the documents that show you are entitled to care.

Checklist

• Ask your doctor or midwife whether you are fit to fly, especially with pre-eclampsia, placenta praevia or a risk of preterm labour.

• Check your airline's pregnancy policy before booking, including its cut-off week and whether it uses its own form.

• Plan to travel in the second trimester if you can, between weeks 14 and 27.

• Request a fit-to-fly letter dated within 7 to 10 days of your flight if you will be about 28 weeks or more.

• Pack your scans, blood tests, medical history, previous birth history and vaccination record in your hand luggage.

• Get a simple translation of any records that are not in English.

• Plan for blood clots on the flight: walk regularly, drink water and wear compression stockings.

• Ask the health centre whether it gives a provisional document or a first appointment while your health card is processed.

• Consider private care to cover the gap until your public appointment.

• Go to a hospital emergency department or call 112 if you need urgent care on arrival.

Quick answers on scans, midwives and flying while pregnant

Up to which week can I fly while pregnant?

In an uncomplicated pregnancy with one baby, flying is generally allowed up to about 36 weeks. With twins or more, the limit is usually about 32 to 34 weeks. If you have complications such as pre-eclampsia or a risk of early labour, you are usually advised not to fly, so check with your midwife or doctor first.

Do I need a fit-to-fly letter from my doctor to fly?

Yes, many airlines ask for a doctor's or midwife's letter from about 28 weeks, though most let you fly without paperwork before that. The letter should give your name, weeks pregnant, due date, whether it is one baby or more, and that you are fit to fly. Get it dated within 7 to 10 days of the flight, and check whether your airline wants its own form.

Will I see an obstetrician in the public system, or only a midwife?

Yes, you will see an obstetrician, but only at key visits, because in a low-risk pregnancy your matrona (midwife) leads your care. The hospital obstetrician usually sees you around week 12, week 20 and weeks 32 to 36. Higher-risk pregnancies get more frequent hospital visits.

Are all ultrasound scans free in the public system?

No, only the routine scans and any scan your obstetrician considers medically necessary are free. Extra scans for reassurance, 3D or 4D scans and souvenir recordings are only available privately for a fee.