Starting pregnancy care with a midwife (matrona)

Terms used

• Matrona — The matrona is a midwife who leads the care of low-risk pregnancies in the public health system.
• Centro de salud — The centro de salud is your local public health centre, assigned by your home address.
• CIP — The CIP is the number on your regional health card, used to book appointments.
• Padrón — The padrón is the certificate that you are registered at your address in your town.
• Cartilla de la embarazada — The cartilla de la embarazada is your pregnancy record, which you keep and bring to every visit and to the birth.
• Médico de familia — The médico de familia is your family doctor at the health centre.

Key rules

• First contact: Start with the matrona at your centro de salud, or your family doctor first where your region requires it.
• Timing: Book as early as possible, ideally before week 10 and no later than weeks 10 to 12.
• No health card yet: Go to the admission desk with your passport and padrón to be registered and given an appointment.
• Regional differences: Booking, the pregnancy record and hospital choice all vary by region.

Who you see first

Your first contact is the matrona at the centro de salud assigned to your address. She leads the care of low-risk pregnancies. Hospital visits and scans are arranged alongside her care.

In some regions you see your médico de familia first. The doctor confirms the pregnancy and refers you on. Other regions let you book the matrona directly. The checklist below tells you to ask which applies where you live.

When to book

Book your first pregnancy visit as early as possible, ideally before week 10 and no later than weeks 10 to 12. An early visit lets the first-trimester blood tests and the first scan be arranged on time. Regional programmes can set slightly different timing, so follow the date your centro de salud gives you.

How to book

You can book in any of these ways:

• By phone with your health card number (CIP).
• Through your region's health app or website, also with your CIP.
• In person at the admission desk (admisión) of your centro de salud.

If you do not have a health card yet, go to the admission desk with your passport and your padrón certificate. Staff will register you and give you an appointment.

What happens at the first visit

The matrona will:

• Take a full history: medical, surgical, gynaecological, obstetric, family, lifestyle, medication and allergies.
• Calculate your due date.
• Measure your weight, height and blood pressure. Sometimes she does a basic examination.
• Request first-trimester blood and urine tests, and book the first-trimester scan and screening for chromosomal conditions.
• Explain the follow-up schedule and healthy habits: folic acid, iodine, diet, no alcohol or tobacco, and vaccinations such as flu, whooping cough and COVID-19.
• Open your cartilla de la embarazada and arrange your referral to the hospital obstetrics unit.

Your pregnancy record

The cartilla de la embarazada holds the key data of your pregnancy: tests, scans, visits, vaccinations and your birth plan. You keep it and bring it to every visit and to the hospital for the birth. Some regions use their own paper version. Others have replaced it with an electronic record in the regional health app.

Your hospital

Scans, specialist follow-up and the birth happen at the reference hospital for your health area. It is set by the address of your health centre. Some regions, such as Madrid, Catalonia and the Valencian Community, allow free choice of hospital within certain rules. Ask at your centro de salud or through your regional health service. Elsewhere the assigned hospital is the default, and changing it needs authorisation. The decision below helps you choose.

Choosing between options

Which hospital will handle your scans and birth?

• Stay with your assigned hospital: Your region assigns the reference hospital for your health area by the address of your health centre, or you are happy with that hospital.

• Ask to choose a different hospital: You live in a region that allows free choice, such as Madrid, Catalonia or the Valencian Community. Ask through your health centre or the regional health service's online procedure.

• Request authorisation to change hospital: Your region assigns a hospital by default and you want another one. Changing it needs authorisation.

If your region allows free choice, you can request a hospital within its rules. If not, your assigned hospital is the default and any change needs authorisation.

Timeline and deadlines

• Have the first-trimester blood tests arranged at that visit: at the first visit, so they are done on time

• Have the first scan: weeks 11 to 13+6

Documents you need

• Health card number (CIP), used to book by phone, through the regional health app or website, or at the admission desk of your centro de salud.

• Passport, to bring to the admission desk if you do not have a health card yet, so you can be registered and given an appointment.

• Padrón (certificate that you are registered at your address in town), to bring with your passport if you have no health card yet.

• Cartilla de la embarazada (pregnancy record), opened by the matrona at the first visit and kept by you. Bring it to every visit and to the hospital for the birth.

What to bring to your first pregnancy appointments

• Book the first appointment with the matrona (midwife) at your centro de salud (local health centre) by phone, through your region's health app or website, or at the admission desk (admisión).

• Ask whether your region lets you book the matrona directly or first sends you to your family doctor, who confirms the pregnancy and refers you.

• Write a short summary of your pregnancy so far, with your estimated due date.

• Gather all ultrasound reports, including the dating scan and the anomaly scan.

• Collect your blood test results: blood group and Rh, haemoglobin, infection screens such as rubella, HIV, hepatitis B and syphilis, and any glucose tests.

• Bring any combined screening or non-invasive prenatal test (NIPT) results.

• List your medical history and the medicines you take now.

• Note your previous pregnancies and births, including any caesareans or complications.

• Bring your vaccination record, including tetanus-diphtheria-pertussis, flu and COVID-19.

• Keep records in English as they are. For other languages, add a simple translation; it does not need to be sworn.

• Bring your health card number (CIP) if you have one, to book and to be seen.

• If you have no health card, bring your passport or identity document and a padrón certificate (municipal registration showing your address) to the admission desk to be registered and given an appointment.

• If you are a non-EU woman without residence status, also bring a signed declaration that you have no health coverage from another source, and ask whether your region wants proof of 90 days of residence in Spain.

• Take your pregnancy record (cartilla or carné de la embarazada) to every visit and to the hospital for the birth. Ask whether your region uses a paper copy or an electronic record in its health app.

What to watch out for

• Waiting too long to book: If you book late, the first-trimester blood tests and the first scan may not fit in their time window. Book as soon as you know you are pregnant, ideally before week 10 and no later than weeks 10 to 12.

• Going to the wrong first contact: In some places your family doctor confirms the pregnancy first and refers you, so booking straight with the matrona may not work. Ask the admission desk of your centro de salud which route your region uses before you book.

• Arriving without your health history: At the first visit the matrona takes a full history covering medical, surgical, family, medication and allergy details, and a gap can slow down the tests she requests. Write down your medical history, medicines and allergies before the visit.

Frequently asked questions

Do I need to see my family doctor before the matrona?

Not always, because many regions let you book the matrona directly without a referral from your family doctor. In some regions you first see your family doctor, who confirms the pregnancy and refers you on.

What happens at the first matrona visit?

At the first visit the matrona takes your full history, works out your due date and checks your weight, height and blood pressure. She orders your first-trimester blood and urine tests and books the first scan. She also explains the follow-up schedule and healthy habits such as folic acid, and opens your pregnancy record.

What is the cartilla de la embarazada and who keeps it?

The cartilla is your pregnancy record, and you keep it and carry it.