May 22, 2004

Suggestions for pregnant British expats in Spain

An English journalist, living in Barcelona and writing for expats who live in Spain, has approached me for information regarding maternity care in Spain as she is writing an article for women who are expecting babies. She found my earlier comments in earlier Diary entries regarding the Acuario Birth Centre and the birth scene generally in Spain. She thought I could shed some light and provide tips for women planning to give birth in the Spanish hospital system.

I felt unable to give expats in Spain any real hope of having a birth experience similar to women in the UK - the system in Spain is so medicalised and the concepts of choice for women, informed consent for procedures and treatments and evidence based care seem to have been overlooked, from what I have been hearing from the midwives (obstetric nurses) who work in Spanish hospitals.

I was asked if it was worthwhile paying for private care if it could be afforded and I was emphatic in my “NO!”. There is overwhelming evidence , from every western country in the world, that hiring a private obstetrician is asking for unnecessary intervention in birth, frequently leading to caesarean section, high costs and worse outcomes for mothers and babies. The problem for women, however, is that in many countries there are few alternatives available. Midwifery care in hospital, home birth, water birth, birth centres, midwifery-led units are all rare, if they exist at all. Even though “midwives” may be working in hospital, because these institutions are so doctor-dominated and birth is so medically managed, midwives may have no experience of natural birth or confidence in managing labour without the trappings of a hospital labour ward or theatre.

The best suggestion I could offer this journalist was to encourage expat women from the UK that they find a way of returning home for the birth to seek midwifery care there. Although this might be expensive, inconvenient and difficult, the birth of a baby is too precious an experience to squander in a hospital where shaves, enemas, hourly vaginal examinations, drips, drugs, stirrups and routine episiotomy are all routinely performed, without question.

Meanwhile, I will be back in Spain in two weeks, to present two workshops for midwives. The first issue we will tackle will be “what is a natural birth like”“ and to answer this I will start by showing them the beautiful video “Inner Strength”. I know from my previous visits that this will blow them away - they will probably never have seen women labouring like this and giving birth so ecstatically. Once they have an idea of what to aim for, we can start exploring ways they can help women achieve this magnificent outcome and how they can take on the role of midwife, rather than obstetric nurse. It will be a challenge for us all!

Posted by andrea at May 22, 2004 05:28 PM