In 2024, I gave birth to my first child in Spain. As a non-Spanish citizen, I had no idea what to expect. To ensure I received the best possible care during such an important time in my life, I decided to use both private and public healthcare systems.

Here, I'll share my experience to help expats who might be thinking about having a baby in Spain and might not know where to start.

My Birth Story

I gave birth at St Joan de Déu Hospital in Barcelona, part of Spain’s public healthcare system. It is also worth noting that, unlike most other public hospitals, St Joan de Déu offers access to private rooms, which provided extra comfort during my stay. So even though I had access to private hospitals through my health insurance, I chose this hospital because it has the best prenatal unit in Catalonia. My pregnancy went smoothly, but at 41 weeks, after being overdue for a few days, I ended up needing an emergency C-section.

During my pregnancy, I followed up with both public and private healthcare. Public healthcare in Spain only offers three ultrasounds, so using private healthcare allowed me to get more frequent checkups and a second opinion, especially when I was overdue, which I later found out is common for a first pregnancy. Towards the end, the private OB-GYN indicated that a natural birth might not be possible because the baby hadn't dropped, while public healthcare strongly encouraged me to attempt a natural birth.

One thing I noticed is how determined the public healthcare system can be about natural births. While I believe it's a good approach in many cases, I felt somewhat disregarded when raising concerns about the possibility of needing a C-section. In my case, I ended up with an emergency C-section after trying a natural birth for just a few minutes. I'm grateful the doctor recognized that natural birth wasn’t possible. However, I wish there had been more openness to discussing my concerns earlier.

Now, before diving into the pros and cons of public versus private healthcare, I want to emphasize that using both systems gave me peace of mind and a broader perspective during my pregnancy. For those who are expecting and considering both options in Spain, my experience might help shed some light.

My Background

I'm a European citizen working in Spain since 2018, which gave me access to public healthcare. Additionally, I chose to have private insurance as well to cover all bases. However, it is worth noting that if you are a non-EU citizen, private healthcare is mandatory as part of most visa applications including Spain Digital Nomad visa, Non-lucrative visa, student visa, etc.

Giving Birth in Private Healthcare vs. Public Healthcare in Spain

Both private and public healthcare have their pros and cons. Depending on your circumstances, one option might make more sense to you.

Before I start, I want to give a massive shout-out to all medical professionals—whether you choose private or public healthcare, the quality of your experience ultimately depends on the dedicated professionals who support you during this special time in your life. In my case, I would be forever grateful for how well I and my family were treated in both the private and public sectors.

With all that said, let’s begin:

Giving Birth in Public Healthcare in Spain: Pros ✅

During Pregnancy:

Free of Cost: No out-of-pocket expenses for appointments and care for EU citizens, which can be a significant relief financially.
Access to Midwives: Midwives in the public system are often your first point of contact throughout the pregnancy, in most cases I found them to be very gentle and empathetic, providing a more personal touch.
Personal Treatment: I always left my appointments feeling reassured and understood. The midwives took the time to address my concerns and answer my questions thoroughly. The first appointment, for instance, was very thorough and lasted over an hour when we went through my health history and where they talked me through what to expect for the months to come.
Community Support: Public healthcare often has a community feel, with group prenatal classes and support groups that can help you connect with other expectant mothers. Additionally, they provide a gift bag with several useful baby items like bottles, creams, pacifiers, and more, which can be a helpful start for new parents. This extra touch adds to the sense of support and care you receive throughout your pregnancy journey.

During Delivery:

Choice of Hospital: When deciding where to give birth, you can choose your preferred public hospital. I initially didn’t like my local hospital and was pleasantly surprised to learn I could pick another one. The best part is even if you still have the go through your regular check-ups until week 37 to your local hospitals, once you do the switch your hospital of choice has all your information already stored and are able to take you to the finish line.
Focus on Natural Birth: Public hospitals tend to favor natural births, which can be beneficial for those wanting to avoid going through a cesarian.
Short hospital stay: In the case of a natural birth expect your hospital stay to be around 24 hours if nothing abnormal is detected. I had a C-section and ended up staying 2 nights and 3 days.

Postpartum:

Regular Follow-ups: Consistent post-pregnancy check-ups for both you and your baby, ensuring any potential issues are caught early.
Breastfeeding Support: Access to lactation classes and breastfeeding support groups at no additional cost.

Giving Birth in Public Healthcare in Spain: Cons ❌

During Pregnancy:

Language Proficiency: It’s important to note that access to English-speaking staff in the public healthcare system is very limited, so you’ll need a close-to-fluent level of Spanish to navigate appointments and communicate effectively. This becomes especially critical during pregnancy when detailed medical discussions and understanding advice from healthcare professionals is essential for your peace of mind.
Inconvenient Scheduling: Appointments are often at random times during the day, requiring flexible work arrangements.
Strikes: As a French woman, I am not unfamiliar to strikes and in most cases I understand how important they are for professionals to defend their rights. However, it is worth mentioning that in my case frequent strikes led to many canceled appointments with little notice on rescheduling, causing a lot of stress and uncertainty.
Limited Check-ups: Only three ultrasounds throughout the pregnancy, which felt insufficient, especially for a first-time mother. The wait times for these appointments can also be long.

During Delivery:

Shared Rooms: Most public hospitals require sharing rooms, which isn’t always ideal.
Different Delivery Team: The team you see during prenatal visits likely won’t be the same during delivery, which can be unsettling.
Natural Birth Preference: As a general procedure, public hospitals tend to favor natural births over C-sections, which might not suit everyone’s medical needs or personal preferences.

Postpartum:

No cons, I found the postpartum follow-up to be excellent

Giving Birth in Private Healthcare in Spain: Pros ✅

During Pregnancy:

Language Proficiency: In the private healthcare, the situation is quite different from public healthcare, as it is much easier to find English-speaking professionals. This can be an important consideration when choosing a private health insurance for those who prefer to communicate in English during their medical care.
Accessibility: Freedom to choose hospitals all over Spain, offering flexibility and a broader range of options.
Convenient Scheduling: Shorter wait times for appointments, sometimes available next day, which reduces stress and makes planning easier.
Frequent Check-ups: Unlimited appointments with your OB-GYN; I had over six ultrasounds during my pregnancy, providing peace of mind and detailed monitoring.
State-of-the-Art Facilities: Private hospitals often have the latest medical equipment and more comfortable facilities.
Community Support: Private healthcare also provides a supportive environment, often offering prenatal classes and opportunities to connect with other expectant mothers. Additionally, private hospitals typically give a gift bag with several useful baby items like bottles, creams, pacifiers, and more. This added touch, along with the personalized care, enhances the overall experience, making new parents feel well-supported throughout their pregnancy journey.
One important thing to note for anyone considering giving birth in a private hospital is that some insurance providers require you to be contracted with them for several months before you can access this option.

During Delivery:

Consistent Care Team: You can request for the doctor who manages your pregnancy to deliver your baby although this can often come at an extra cost.
Private Rooms: Typically, you get a private room during and after delivery, providing more comfort and privacy.
Birth Preference: Deliveries in the private system will go directly to a cesarean if the delivery is going slowly or if they expect potential health risks, which depending on your birth preference can be good.

Postpartum:

Personalized Follow-up: My private insurance provided access to a midwife who visited my home for free to check on me and the baby, answering any questions I had.
Additional Services: Access to additional services like physiotherapy, nutritionists, and mental health support.

Giving Birth in Private Healthcare in Spain: Cons ❌

During Pregnancy:

Variable Patient Care: Initially, I had a negative experience with my first OB-GYN who left me feeling like just a number. In my case, the first appointment was rushed, and there were very few explanations as to what I should be expecting in terms of the next steps, etc. However, after switching hospitals, I received excellent care, which I would forever be grateful for. So in this case, it is important to note that in both the public and private sector the quality of care can vary greatly between different facilities, regions, and people you come across.
Cost of giving birth: Private healthcare can be expensive, especially if your insurance doesn't cover all the costs. Out-of-pocket expenses can add up quickly.

During Delivery & postpartum:

I gave birth in the public sector, so I can't provide personal feedback on private delivery experiences. However, private hospitals generally have a reputation for being more comfortable and offering more personalized care.

Ultimately, choosing between public and private healthcare in Spain for pregnancy and childbirth depends on your personal preferences and circumstances. Both systems have their strengths and weaknesses. In my experience, combining both gave me the best of both worlds: the empathy and comprehensive postnatal care of the public system and the accessibility and frequent check-ups of the private sector. I hope my journey helps you make an informed decision for your own childbirth experience in Spain.

📜 Living in Spain Planning Guide 📜

Before Moving to Spain

🔍 Research the visa process, residence permits, and other essential documentation early on.

💡 Did you know it’s mandatory to have official documents translated by a sworn translator? Consider hiring a translation service like Translyt for handling any official documents.

💡 Important: If you're moving from a non-European country, private health insurance is required for your visa application.

🧑‍⚕️ Finalize your local health insurance plan with Innoinsure for comprehensive coverage, or opt for the digital insurance services of Feather or ASSSA.

If you are a digital nomad or need travel insurance, SafetyWing provides flexible coverage for individuals living abroad.

🐕 If your pets have joined you, use Petplan for their health insurance and well-being.

Once in Spain

🏠 Use platforms like Spotahome get 15% off with code: CTSPAIN15 or Flatio to find your new home in Spain. They offer verified listings and short- to long-term rental options.

Are you on a tight budget? Check out Trusted Housesitters for free accommodation in exchange for pet sitting (Get 12% off annual memberships with code 12TRUST).

💸 Money Transfers: Set up a reliable currency exchange and transfer service like XE Money Transfer to avoid high banking fees when transferring funds internationally.

🚗 Need a rental car? Use DiscoverCars to easily compare and find the best deals for car rentals in Spain.

💡 Can you live and work in Spain without speaking Spanish?

The answer is YES! But learning Spanish will make your life so much easier. Start learning Spanish using Preply’s language tutor to learn the basics, and expect to see massive improvements within the first few months.