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HEALTHCARE

Brussels warns Spain over tourist healthcare

The European Commission is taking action against Spain for not accepting the European healthcare (EHIC)cards of people seeking medical treatment at public hospitals in the country's tourist zones.

Brussels warns Spain over tourist healthcare
EU citizens on holiday in Spain and carrying a Eureopan Health Insurance Card (above) are entitled to the same standard of care as Spanish citizens. Photo: UK National Health Service

The Commission has launched the procedure against Spain after some hospitals in the country for making people pay for treatments that would be free to Spaniards.

Brussels have made the move in the wake of an increasing number of complaints about the Spain's public hospitals refusing to treat people carrying an EHIC card.

Instead, some hospitals have been demanding that patients provide details of their travel insurance and a credit card.

In a statement, the Commission said it was concerned that Spain wasn't meeting its commitments under European legislation.

"Medical assistance is usually free in Spain and the European healthcare card gives people the right to to be treated under the same conditions as Spanish nationals," said the Commission in its statement.

The Commission also said that the far higher costs of private treatment were being picked up by insurance companies, or directly billed to patients

According to the Commission, the insurance sector has also stressed that most travel insurance policies do not cover private healthcare for people overseas. 

The European Commission initially took up this issue with Spanish authorities in 2010. 

Spain said it was taking measure to fight the problem but the Commission says it has continued to receive complaints.

"Both the Foreign Office and UK Department of Health are aware of issues faced by British holidaymakers in Spain when attempting to use their EHIC cards," Simon Montague, Director of Communications for the British Embassy Madrid told The Local on Monday.
 
“Visitors to Spain are encouraged to report any incidents involving EHICs to the Department of Health representatives based at the British Consulates in Alicante and Madrid," Montague said in an email.
 
"The Department of Health submits an annual report to the EU Commission reporting EHIC use and any misuse, and this includes any examples highlighted by the British public. Case studies will also be taken up with the central government in Spain."

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PARENTS

Readers reveal: What it’s really like to give birth in Spain

Having a baby is an exciting experience, but it can also be daunting with many unknowns. Even if you’ve given birth before, having a baby in a new country where the language and customs are not your own, can be difficult. Here's everything you need to know about what it's like to give birth in Spain.

Giving birth in Spain
Photo: Jonathan Borba / Unsplash

Going private or public?

Many foreigners in Spain have private health insurance, meaning they can choose whether they want to give birth in private hospitals or in public ones. The general consensus among our readers who have given birth in Spain, was that it didn’t matter if you go private or public, as people had both positive and negative experiences with both.

Women didn’t think that by going private you necessarily had better facilities or were given better attention, so it all depends on the actual hospital itself. Several said they had chosen to go public because they had read that rates of cesarean sections were higher in private hospitals in Spain.

Generally, most mothers we spoke to had a positive birthing experience in Spain and felt that the doctors and midwives were very attentive wherever they went. 

Casandra Benalcazar, who had children in both public and private hospitals said: “[In the public hospital] it was actually a great experience. The encouragement was never done in a bad manner and they were always super respectful. In the private hospital, they wanted to do everything I didn’t want and didn’t respect my birth plan”.

Anja Alvarez Petrovic from Croatia agreed when she told us: “I had two babies here and as soon as I arrived in Spain, I learned that public hospitals are better for births than private ones”.

Maya Haim Cicos on the other hand had only had good things to say about the private hospital she gave birth at and not such a glowing review for the public one. “I gave birth twice at Quiron Hospital (in Barcelona) and the treatment, nurses and all the experiences were amazing. They treated me with the utmost care. Due to complications, I had to be transferred the same day to a public hospital and the maternity ward was horrible to say the least”.

Carol M. Arciniegas-Mendoza disagreed with this saying: “We gave birth in a private hospital twice and I expected better. From the moment our baby was born, it was a bad experience…. I was super disappointed with how the hospitals here treat mums after being discharged”.

Our advice is to do as much research as you can on the specific hospital you choose and its practices, so you know what to expect.

Pain management

Epidurals seem to be the pain management of choice in Spain. Epidurals are used in 98 percent of births, which gives you some idea of just how common they are here. Gas and air, which is widely used as pain management when giving birth in the UK, is not widely available. You may only find it at certain hospitals, but it’s not something you should expect to have access to.

Many women also told us that in Spain they increase the epidural when the time comes to start pushing, which seems in direct contrast to their experiences giving birth in other countries where they turn it down.  

Limited options for home births

There are limited options for home births in Spain, mostly because there is no insurance for delivery at home. If you do want to give birth at home and have a low-risk pregnancy, this is something you’ll have to organise and often pay for yourself too.

Anna Korenromp told us that in the Netherlands, “home births are big things, as well as doing it completely naturally”, but that here she did not have that option.

If you really want a home birth in Spain though, it is possible. Nina Krause told us: “I gave birth in Malaga and it was a home birth with midwives (all paid from my pocket). The experience was amazing, and if I have another child, I would wish exactly the same”.

What’s it like to give birth in Spain? Photo: Sharon McCutcheon / Unsplash

Alternative birth plans

Many hospitals in Spain are more traditional when it comes to birth plans, offering limited options for things such as water births, pilates balls, and walk-in birthing showers. However, if these are things that are important to you and you want to do things a little alternatively, then you will find hospitals in Spain that offer them, you may just have to do more research and looking around first.

Is there anything I should be aware of?

Yes, you should be particularly aware of something called the Kristeller manoeuvre, which is not uncommon in Spain, but is actually banned in some other countries such as the UK. The manoeuvre is when the doctor or midwife forcefully presses down on the mother’s womb in a series of strong, sharp movements to create fundal pressure and help deliver the baby during the second stage of labour. It was found to be used in approximately 26 percent of births in Spain. 

READ ALSO: Parents’ reveal: These are the best and worst things about having children in Spain

The World Health Organisation doesn’t recommend the technique because of the potential for broken bones, organ damage, and other complications.

Lindsay Forrest told us: “I specified I didn’t want it used before my birth, but was convinced by my doctor while in the midst of pushing that it was necessary”.

Jasmine Sic also had the manoeuvre performed during the birth of her child in Spain. “I was begging them to stop pressing because it was super painful and was make me throw up, but they wouldn’t stop. The doctor also said it was necessary”.

If you do not want this manoeuvre practiced when you give birth, make sure the doctors know. Tell them verbally and also put it in writing in your birth plan.

Paperwork 

Like many things in Spain, the birthing experience is also hampered down by bureaucracy and paperwork. Many mothers reached out to us to say that the paperwork was one of the most frustrating things about giving birth in Spain and unlike in other countries, you’re expected to do it all yourself. 

Patricia Adjovi told us: “I was mostly surprised that you have to do all the paperwork yourself, and I didn’t find it easy at all. In Denmark, where I’m from, the midwife does all the paperwork when the baby is born, so you can focus on taking care of your newborn instead of running around to 100 different offices to get the birth certificate”.

Shayna Black agreed when she told us: “Our first outing with the baby (before we were ready) was forced on us by an archaic bureaucratic system. I could barely walk and it was a really hot day. So stressful!”

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