# Finding a Dr and Midwife in Spain



## RAL (May 12, 2009)

My husband and I are moving to Calpe in the next few weeks.

I am six months pregnant and have my E111 and E112. 

How easy is it to find a public health care doctor and a midwife in the area?

I would also be grateful for any other advise that anyone would be happy to give.

Thanks in advance.


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## Tallulah (Feb 16, 2009)

RAL said:


> My husband and I are moving to Calpe in the next few weeks.
> 
> I am six months pregnant and have my E111 and E112.
> 
> ...


E111 is used really for emergencies/treatment whilst on holiday. If you're moving here, you can use the E206 which covers you for up to 2 years, but you have to have officially left the UK in order to get it. The idea being that with the E206 the Spanish cover you fully as if you were in their system and then bill the UK NHS. With the E111 however you may not only find that it doesn't cover general maternity care, but also that you would be paying and then reclaiming the money from the UK NHS. 

Once you have your E206 - and once you have declared residency in Spain, it's no problem registering yourself with a doctor/midwife.

Regards,
Tallulah.

ps - by "leaving the UK" I mean, officially leaving - e.g. you've done your P85 for tax rebates that year, etc and you're no longer claiming child benefit or any other benefits for UK residents only. In short, the authorities know you are no longer resident in the UK and can send you the E206 for health, the E301 for history of contributions made, etc etc.


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## jojo (Sep 20, 2007)

how many weeks pregnant will you be when you travel, cos some airlines etc are a little cautious, carrying heavily pregnant women. altho I'm sure you've sorted that!!? and of course there's your midwife team and gp in the Uk who will need to know you're gone, in fact you may need their permission/consent to go at this late stage, and of course they will need to send you're healthcare notes and medical records forward - this can take quite a while, so let them know sooner rather than later!

Jo xxx


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## SteveHall (Oct 17, 2008)

Well, I hope you have a good reason for coming at this stage of your pregnancy and your E111 can not usually be used - it's for emergencies over - so I think you need to get FACTS asap. My initial thought would be to wait 6 months but perhaps this is not possible? 

Calpe is in the Comunidad Valenciana (my home region) which has been the subject of much discussion re offering (or not!) non-urgent medical provision to non-Spanish residents so I hope you quickly get everything in place. Shout if you struggle.


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## RAL (May 12, 2009)

SteveHall said:


> Well, I hope you have a good reason for coming at this stage of your pregnancy and your E111 can not usually be used - it's for emergencies over - so I think you need to get FACTS asap. My initial thought would be to wait 6 months but perhaps this is not possible?
> 
> Calpe is in the Comunidad Valenciana (my home region) which has been the subject of much discussion re offering (or not!) non-urgent medical provision to non-Spanish residents so I hope you quickly get everything in place. Shout if you struggle.


Thanks for your replies.

We are moving out for a year to see how we feel before moving out permanently. 

Both my midwife and doctor are happy with me coming out, and I have all my medical notes.

I understand that E111 is for emergencies only but the E112 covers me to have a baby in Spain and that UK healthcare will cover all costs, so all I really need to do is register with a doctor.

I would like to have public healthcare, but would go private if necessary. I'm coming out for a few weeks holiday but would like a bit of a head start in finding a doctor if possible.


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## jojo (Sep 20, 2007)

I assume you take all the necessary info into a healthcentre local to where you plan to live and they will then get you booked into the maternity hospital and midwife team, much the same as the UK????? That said, I'm not convinced it will be easy tho... Spain is known for its red tape and "jumping thro hoops" mentality.


Tallulah seems to know the "ropes" she is married to a spanish chap and has children here, I'm sure she'll be along in a while and will point you in the right direction.

I was speaking to a friend tho yesterday and she was saying that they dont have pethadine or gas and air in Spain EEEEKK!, only Epidurals???? but the birth procedure itself here is far more hi tech than the UK. I dont know if thats accurate tho

Jo xx


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## Tallulah (Feb 16, 2009)

jojo said:


> I assume you take all the necessary info into a healthcentre local to where you plan to live and they will then get you booked into the maternity hospital and midwife team, much the same as the UK????? That said, I'm not convinced it will be easy tho... Spain is known for its red tape and "jumping thro hoops" mentality.
> 
> 
> Tallulah seems to know the "ropes" she is married to a spanish chap and has children here, I'm sure she'll be along in a while and will point you in the right direction.
> ...



To the OP :

Having a baby in another EU country is completely accommodated by the UK NHS and they even have pages on the web on what will/should be covered or may not be covered (if it ends up costing the country of your choice more than what it would in the UK, you'll end up paying the difference....recouping the 25% if you're in a 75%/25% co-contributor system country), etc. So let's say that your choice is perfectly normal and within acceptable due process of the EC...

What throws a spanner in the works, in my opinion, is your statement that you're coming out for 1 year. This is no longer simply to "have a baby" but for a timespan greater than that allowed by the rules of residency. 

Two choices basically :

a) Having had your baby in Spain, on day 184 of your arrival, you should be a resident of Spain (empadronamiento) - tax/declarations, etc etc. 

b) Having had your baby in Spain, on day 184 of your arrival, you are the only ones who know it's day 184 of your arrival. You still have your address in the UK and are, to all intents and purposes, resident and registered in the UK. 

Obviously, point b) requires a certain mindset when it comes to sleeping easy at night - not worrying too much about everything being above board and pretty confident that you're not going to forget your minor deception and do something silly to entrap yourself, by doing something like opening a residents' bank account in Spain, keeping a car which requires empadronamiento in your local ayuntamiento to allow you to pay road tax to the diputacion....to name but a few of the examples that could ****** up this minor deceit without realising.

Point a) where you do not go back to the UK after having your baby, and stay beyond the 183 days requires you to decide before the year in Spain is up whether you wish to officially leave the UK and live in Spain or not. At this point if you stay, you apply for the E106 that gives you UK NHS payment cover to the Spanish Seguridad Social who will treat you as any other Spaniard. These two years which are covered by the E106 will allow you to sort yourself out as employed contributor/autonomo/private healthcare or whatever.

One thing is clear though, if you don't opt for point a) - you will find it difficult to settle as you have neither left the UK nor emigrated to Spain and as other posters have found, to their detriment, too long in this situation will inevitably lead to problems of one sort or another - not the least of which, usually, are fiscal/legal positions within the country's tax laws.

It's a shame that it's not made as crystal clear as it should be, in my opinion. For example : I have recently found that my UK bank have changed a particular type of account. If I lived in the UK, I would simply change the account I have for the new one and instead of receiving next to sweet FA interest wise, I would go to the new and attractive rate. The problem is that tucked away in the conditions is the fact that you must be a UK resident. 

Similarly, I could have not declared certain benefits from the UK such as interests earned in my Spanish declaration. But I like to sleep soundly at night and again, if you read past threads, you will see mentions of Spanish and UK authorities starting to communicate seriously nowadays, due to money laundering/security threats and all manner of reasons. 

Bottom line, I'm not somebody who can live here but pretend I'm still living in the UK, simply becuase I don't want to watch my step every time I talk to the bank manager here about the latest deal, consider whether I want to buy a new car or whatever, etc. The easy life for me all the time, thanks. Basically, you should make your decision thinking along these lines. 

Back to your point though (are you still with me?!?!) regarding having the baby here, it looks like that process is completely above board, totally do-able and an option covered by both countries with open arms. So do enjoy and the best of luck. 

By the way, regarding drugs available during pregnancy, I was chatting to my sister in law recently regarding this as it had come up before on the forum (I gave birth to mine in the UK and don't have experience of doing it here in Spain - neither do I intend to - three is enough for me thanks!!) - under normal conditions during labour they do not administer drugs. It would have to go for some time and in a great deal of pain, following an epidural after you've signed the forms absolving them of responsibility, that they would consider giving gas because you obviously are struggling and can't take much more.

Reading this, might sound a bit rough - but one needs to consider that what they are doing is taking nature's course as far as absolutely possible without ultimately endangering you or the baby. Not much help for those who of "give me drugs!" school of thought, but ideal for those who want a natural birth with as little intervention as possible and without final extreme risks. Depends which camp you're in. 

Hopefully someone else will be along shortly and will be able to give you their account of actually giving birth in this country from a first hand experience. 

Kind regards,
Tallulah.x

ps : in Spain, you don't have to register with a GP, although obviously people who are resident are assigned according to their empadronamiento and their local GP would be as in the UK. But unlike the UK, a Spaniard can go to any doctor within the health service system. Considering you want to take advantage of midwifery care during your pregnancy leading up to the birth, your E106 would allow you to hook up to a family GP surgery, local hospital etc , but I don't know how the E102 works and as it's mentioned on the NHS web pages I assume it will be the same. It goes without saying that if you choose a private hospital, that is entirely up to you.


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## SteveHall (Oct 17, 2008)

Tallulah said:


> To the OP :
> 
> ps : in Spain, you don't have to register with a GP, although obviously people who are resident are assigned according to their empadronamiento and their local GP would be as in the UK. But unlike the UK, a Spaniard can go to any doctor within the health service system. Considering you want to take advantage of midwifery care during your pregnancy leading up to the birth, your E106 would allow you to hook up to a family GP surgery, local hospital etc , but I don't know how the E102 works and as it's mentioned on the NHS web pages I assume it will be the same. It goes without saying that if you choose a private hospital, that is entirely up to you.



Thanks, Taliban. 

All excellent information and in great depth but the final point is not correct in the CV. You WILL be assigned to a doctor (and you will be expected to have a Spanish translator with you). My doctor is not the nearest but had vacancies for new patients whereas two nearer doctors did not. Those from outside the area or who are not registered locally are only dealt with at an old clinic in the town centre and when the population explodes from 105,000 to 400,000+ in Summer there are huge waits even though doctors are bussed in from inland Spain. 

Also according to another expat web-site you will most definitely NOT be covered on the SS for childbirth. A poster was quoted 7,000 euros when she enquired at 7 months pregnant. She decided to stay in the UK until after the birth. They also confirmed that you can normally fly up until the 36th week although some ailrines will ask for doctor's letter after 28 weeks. 


..and this from a health specialist: 

"Please check with the airline you intend to fly with, each has different rules about pregnant women flying after 28 weeks, many of them changed their ruling at the end of 2006. 

The majority WILL require a letter from your GP, which in some cases must have been written and signed within 72 hours of you flying, please note it is flying not booking your flight. 

If you have had ANY complications during your pregnancy then it is almost certain that they will not fly you. 

E106 WILL NOT cover you for pregnancy other than in an emergency. 

You are looking at €10,000 plus for a normal birth, any complications will cost you more. 

I would check all the ins and outs of your proposal before planning a move as of the one you are considering, I have spent 30 years in the Medical Profession and would ask you to give your proposal some very serious consideration before making a decision. "


Good Luck ...and remember grandchildren will be your reward for the next 18 years!


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## Tallulah (Feb 16, 2009)

SteveHall said:


> Thanks, Taliban.
> 
> All excellent information and in great depth but the final point is not correct in the CV. You WILL be assigned to a doctor (and you will be expected to have a Spanish translator with you). My doctor is not the nearest but had vacancies for new patients whereas two nearer doctors did not. Those from outside the area or who are not registered locally are only dealt with at an old clinic in the town centre and when the population explodes from 105,000 to 400,000+ in Summer there are huge waits even though doctors are bussed in from inland Spain.
> 
> ...


Hi Steve,

Thanks - that's rather interesting about your area in CV - and a little confusing for me. We came here with the E106 and it was made quite clear to us that any doctor within Spanish territory (ie. including the Islands) was open to us under this system. Indeed, as it is with the SS card, although in this case you are assigned the doctor in your ayuntamiento or whomever is they see as handiest for you in theory lol!! 

Also conflicting, with the E102, according to the NHS website, going abroad and giving birth whilst there is an option available to EU citizens. The coverage is there - though the costs coverage be it direct or partly or wholly reclaimable is detail to be looked at - but cover is not questioned.

As always then, personal research required as no third party info will be as good as the official line, preferably in writing.

Also worth noting, that the Oficina de Facturacion at our local hospital which is a leading one, so no small two donkey town  practice, had no clue as to the intricacies of the E106 and it was only when my husband suggested to their manager that they discuss it with Central in Santiago de Compostela, that he received all manner of apologies and reasons as to how it's quite foreign to them up here, but understandably better recognised in the South - to which my husband said "is Galicia not in the EU then"??  Unfortunately, one thing we have realised in Spain is that kicking ass bears far more results than being submissive and polite.

Regards,

Tallulah.x


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## SteveHall (Oct 17, 2008)

Yes, all very Spanish and whilst researching this enquiry I also came across this most disturbing post: 

"I have a young friend who has recently had a baby in torrevieja hospital the after care was very good. Apparently they do not give, gas and air, and my friend was not offered pain killers. 
My friend was unemployed but had temporary SIP card, and has just been billed for the delivery, because the baby has not got a SIP card.and because my friend was not working the baby cannot get a SIP card, its all very confusing 
She has been in contact with the British authorities who have told her she must take the child back to England and get it registered their or pay up. 
It’s all a bit of a mess and very upsetting for the girl. My advice would be to have your baby in England."

I have also availed myself of the excellent Spanish health service in Tenerife and Andalucía without any problems (well, except I was on a stretcher!) but if I should have the temerity to go to my nearest doctor in Torrevieja I will not be seen.


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## SteveHall (Oct 17, 2008)

Tallulah said:


> Hi Steve,
> 
> Also worth noting, that the Oficina de Facturacion at our local hospital which is a leading one, so no small two donkey town  practice, had no clue as to the intricacies of the E106.
> Tallulah.x


a) That comes as no surprise to me 

b) Please do not mention donkeys in this forum. It only excites XTreme who has been quite calm today and it's best to keep him that way!!


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## jojo (Sep 20, 2007)

SteveHall said:


> She has been in contact with the British authorities who have told her she must take the child back to England and get it registered there or pay up.


As I understand it, a baby MUST be registered in the country of its birth to enable it to get a passport to travel. Without registration, no passport and no passport no travel!

jo


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## Caz.I (Mar 21, 2009)

Tallulah said:


> To the OP :
> 
> Having a baby in another EU country is completely accommodated by the UK NHS and they even have pages on the web on what will/should be covered or may not be covered (if it ends up costing the country of your choice more than what it would in the UK, you'll end up paying the difference....recouping the 25% if you're in a 75%/25% co-contributor system country), etc. So let's say that your choice is perfectly normal and within acceptable due process of the EC...
> 
> ...


Hi, 
I dont know all the ins and outs of E111, 106 etc but I have given birth in Spain. :clap2:
And funnily enough, I got pregnant nine months after arrivingreggers:, which was in my "trial year" in Spain. Fortunately, I was working here and paying Social Security so I had access to the healthcare system, was registered with a GP and my local health centre, so was issued with a little book which was updated after every scan and examination, attended ante natal classes (was like an intensive course in Spanish ) and had very thorough regular check ups. Since the hospital I was assigned to was quite far away (without car), I joined an emergency health clinic opposite where I lived, so I would also be covered for an ambulance (because you are not automatically covered on the health system and privately they can cost a fortune.)

A friend of mine says she managed to use her E111 to give birth but I dont know how she blagged her way through that one, as I believe it is for emergencies. And like everyone says, you have to be absolutely sure you are covered, and I think policies do differ depending where you are (which Comunidad) and who you speak to. Plus in general, I know the EU may say certain things but some of the people working on the frontline here in Spain, so to speak, do not always know about such things and may not be easily convinced of them either. But you got to fight for things here.

Re. the drugs during labour: Although the midwife encouraged everyone to practise their relaxation exercises and so give birth without any drugs, I was not convinced. And, having a very low pain threshold :scared: I made sure that I could ask for an epidural in Spanish (quiero epidural! I think I said ). (Frankly, if they had let me I would have ordered it at reception but I had to wait a bit but made enough drama to get it.) I remember a former colleague of mine told me that it is possible to have gas and air, but you have to order it! in advance! I had no idea what it was like anyway, so just went for the heavy duty stuff. I didnt have any complications, apart from the father , and managed to give birth to a lovely boy:baby:. I knew a reasonable amount of Spanish, and understood the important instructions - empuja! abajo! empuja! abajo! ([push down push down!) barked at me. As Steve says, without a translator tho, it could be difficult, and you may not be able to get one in the middle of the night! I have no idea what its like to give birth in the Uk so cant compare it, but could be more complicated here because of language.
Hope you have a happy experience whatever you do.


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## Tallulah (Feb 16, 2009)

Caz.I said:


> Hi,
> I dont know all the ins and outs of E111, 106 etc but I have given birth in Spain. :clap2:
> And funnily enough, I got pregnant nine months after arrivingreggers:, which was in my "trial year" in Spain. Fortunately, I was working here and paying Social Security so I had access to the healthcare system, was registered with a GP and my local health centre, so was issued with a little book which was updated after every scan and examination, attended ante natal classes (was like an intensive course in Spanish ) and had very thorough regular check ups. Since the hospital I was assigned to was quite far away (without car), I joined an emergency health clinic opposite where I lived, so I would also be covered for an ambulance (because you are not automatically covered on the health system and privately they can cost a fortune.)
> 
> ...


Excellent post Caz from someone with first hand experience on giving birth here. :clap2: Glad to hear that your experience went smoothly and thanks for confirming what I wrote earlier about the epidural and other pain relief not being a problem to get. Should apply in all the provinces then, which is good news.

BTW, to add our experience to yours, your experiences with a full SS access as you were working would be exactly the same as the E106 as it is FULL access, just as though you were working - the only difference being that the UK get to pay Spanish SS for the service provided for those first two years. So within that time, the OP's experience should mirror yours.

Tallulah.x


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## jojo (Sep 20, 2007)

Tallulah said:


> Excellent post Caz from someone with first hand experience on giving birth here. :clap2: Glad to hear that your experience went smoothly and thanks for confirming what I wrote earlier about the epidural and other pain relief not being a problem to get. Should apply in all the provinces then, which is good news.
> 
> BTW, to add our experience to yours, your experiences with a full SS access as you were working would be exactly the same as the E106 as it is FULL access, just as though you were working - the only difference being that the UK get to pay Spanish SS for the service provided for those first two years. So within that time, the OP's experience should mirror yours.
> 
> Tallulah.x


I'd just like to say that having gone through this process several times in the UK, unless you're fluent and comfortable with the Spanish language and the way of doing things here, I would think you'd be a lot more comfortable in the UK. Giving birth is an emotional (for emotional read excutiatingly painful!!) experience and I personally couldnt have coped without the help, closeness and understanding of the midwives around me! and perish the thought but if there are complications, you may need to understand fully whats going on and be able to voice your concerns, questions etc..

However, I guess if you are fluent and feel capable of having an adventure during this time, then I say go for it!!!

Jo xx


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## Caz.I (Mar 21, 2009)

jojo said:


> I'd just like to say that having gone through this process several times in the UK, unless you're fluent and comfortable with the Spanish language and the way of doing things here, I would think you'd be a lot more comfortable in the UK. Giving birth is an emotional (for emotional read excutiatingly painful!!) experience and I personally couldnt have coped without the help, closeness and understanding of the midwives around me! and perish the thought but if there are complications, you may need to understand fully whats going on and be able to voice your concerns, questions etc..
> 
> However, I guess if you are fluent and feel capable of having an adventure during this time, then I say go for it!!!
> 
> Jo xx


Yes, think so too, I think I was fortunate that I didnt have complications. And it helped that I have family here too, so went to stay with them for a while after it. I think when you have just arrived in a strange country and are trying to figure out whether to live there or not, it can be an added stress that you dont need.


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