A Guiri Guide to Having a Baby in Spain: Second Trimester

The start of my second trimester, at 14 weeks, coincided with another big event in my life: Leaving Seville for a job and a new life in Madrid.

After a relatively uneventful first trimester, I found out that being pregnant in Spain – especially when your second trimester coincides with the hot summer months and the ghost town that is Madrid – was not going to be a cake walk (and what the hell is up with my lack of cravings for cake?!).

the-guiri-guide-to

I can’t say I have complaints about how I felt during my first third of the pregnancy: no morning sickness, no noticeable weight gain, only nominal sleepiness. But the heat, looking for an apartment and drinking in a new city (and drinking cerveza sin and Nesteas in all of the old man bars we could find) meant afternoon naps and sitting down on benches any chance I got. For many weeks,  I avoided eye contact on the Metro, particularly with old people, because I wasn’t big enough to warrant getting the coveted pregnant lady seat just yet.

Miss the English Guide to Pregnancy in Spain? Just click!

People say that the honeymoon period of any pregnancy falls between weeks 14 and 28, or your second third of the cooking. This is the time to exercise, to travel (we went to Asturias via car and I took a jaunt around Northern Europe for work) or to live life as you would have before the achy joints and doctor visits, to savor the moments before midnight feedings and being covered in baby dribble. Considering I’ve had an easy, low-risk pregnancy so far, my biggest complaints lie in the bureaucratic limbo I’ve been in and not to how my body has reacted to being pregnant.

This side eye goes straight to you, Comunidad de Madrid. But we’ll get there later.

Second Trimester tests and check ups

By the time I was making the transition to Madrid, I was almost ready to take the first apartment I saw because there was something more important in play: finding a doctor and signing up for local healthcare. After we signed a contract on a flat in Chamberí, I googled the nearest public health clinic and was delighted to find it within waddling distance of my house.

Centro Médico Espronceda took care of changing my health care from Andalucía to the Cupo Madrileño, promising a card would be mailed to me within the month (and it was!). In the meantime, they gave me a print off and took care of assigning me a médico de cabecera, or a primary care doctor, and nurse.

spanish-doctors-office

While I was allowed to make my own appointments with the primary care doctor and midwife, I was assigned to another medical center around the corner for by obstetrics appointments. This would be the doctor who refers me for tests required for prenatal care. My plan was to get everything out of the way before beginning my job at an estimated 16 weeks of pregnancy, but it didn’t work out that way…

Being new to the health system in Madrid – remember that every autonomous community in Spain has their own regulations regarding public healthcare – I knew that meant a few more visits than normal. Plus, I was looking for a private doctor and had a few Goldilocks moment: too stern, too aloof… until I found one at Clínica La Luz who was just right.

This second trimester has been marked by a slew of doctor’s appointments, to say the least, and mangled test results. Here are the big tests you’ll need to complete if you’ve got a healthy, low-risk pregnancy:

Analisís del segundo trimestre / second trimester blood and urine analysis: Sometime around the middle of your pregnancy, you’ll be instructed to have blood drawn and a urine sample tested for your sugar, protein and iron, plus toxoplasmosis, rubeola and AIDS. Remember to go en ayunas, or without eating or drinking anything but water.

In the public system in Madrid, test results of this nature are typically ready within three working days as opposed to a week in Seville.

Eco de las 20 semanas / The 20-week scan: Arguably the most beautiful moment of the pregnancy, 20 weeks marks the middle of gestation and the most thorough sonogram you’ll have. A doctor will check to be sure Baby has all its fingers and toes, that most of its organs are fully formed and that he or she is not over or underweight.

In fact, the baby is nearly fully formed at this point, so the last half of your pregnancy will be the time he or she gains weight, sprouts hair on the head, begins growing its lungs and continues to develop brain cells. If you’ve been waiting to find out the gender, you should be able to see the sex organs, too – but remember, be very specific if you prefer to wait! Spaniards tend to want to know as soon as possible, so I had to remind doctors that I was waiting until the 20 week scan so as to avoid mistakes.

Pro tip: I was told to consume a bit of sugar before the scan so that the baby would be active. It must have worked: we got the full frontal, so it was easy to determine the baby’s sex!

Curva de azúcar / glucose test: Also called the test O’Sullivan in Spain, you should have your glucose test between 24 and 28 weeks of your pregnancy. This tests for gestational diabetes and can take several hours to complete, depending on your pregnancy and your immediate test results. I decided to do my test in the public system, which I got done at the same time as my second trimester blood and urine exams.

glucose-test-pregnancy-spain

People often complain about the sugary drink, which tasted like a cracked-out version the McDonalds orange pop that we drank after soccer matches as kids. I jokingly told them woman I’d chug it like a beer, college style, but she ordered me to consume it more slowly, in 5-10 minutes, and then sit. Someone will take blood again at one and two hours of consumption to determine your risk for gestational diabetes, which can provoke an overweight baby or preeclampsia. After the second hour, you’re allowed to have breakfast (what sane person deprives a pregnant lady of food?!) and walk around a bit. Thanks to the Novio feeding me plenty of legumes and fish, my margins were extremely low.

Tósferina / whooping cough shot: If your doctor merits it, you’ll have to also have a whooping cough shot around 28 weeks. I was told to put it off until after my third trimester scan to see if it was actually necessary.

Differences Between Madrid and Andalucía’s healthcare systems 
I fully expected to not have any issues with changes from the cupo andaluz to the madrileño. After all, everything works better in Madrid! There’s an appointment system! The Metro runs on time! You can go grocery shopping on Sunday night!
But, much like moving to Spain in the first place, I ran into a lot of bureaucratic brick walls, head first.
When I first met my gynecologist, an older man who stared at me over his glasses while I pulled out all of my paperwork as if he was late for a delivery, I was not impressed. He continually told me that the Andalusian care system was crap, that he had no access to my records, and that he wouldn’t even see me until I’d done another round of blood tests and a sonogram with another doctor. He tossed my cartilla de embarazada back at me and proceeded to pull out a folder and write my vitals on it. I will remember until the day I die that March 29th, 2016 was the first day of my last menstrual cycle – I have probably recited it 100 times by now.

micro-meets-freddie

Apparently you don’t keep your cartilla de embarazada with you, but at your doctor’s. This wouldn’t have been a big deal had it not been during summer vacation time – but I’ll tell you that story later.

Additionally, my doctor doesn’t make my appointments for me. After getting assigned a test or follow-up, you must make the appointment at the medical center: you can do this by phone or internet, or simply by waiting in line at your assigned center. In the stressful first weeks trying to schedule my 20-week scan, I was jockeyed between medical centers and put on a wait list, finally being called by the public system 30 minutes before an appointment – and I was in Seville for the weekend. My being proactive (as in, calling the sistema madrileño de salud out on their inability to adequately staff a public health clinic during the summer months) succeeded to a point, but even being an “urgente” case did nothing to give me any preference.

Once you do get in to the doctor, be sure to have your appointment print out, called a volante, with you. Rather than being polite and asking what time everyone else’s appointment is, you have to stalk the obstetrics nurse and shove your volante at her when she comes out to call a name. I suppose it’s better than the uncomfortable shuffle of times or cutting an abuelita in line, but I was scolded on more than one occasion for not presenting the paper and being skipped over.

If you don’t have a volante because you called for an appointment, flash a photo ID so that the nurse knows you’ve arrived.

The Autonomous Community conundrum

I was – and have been – optimistic about my pregnancy, and am taking it all in stride as my body stretches, droops and tires. Being proactive, I called my OB-GYN before he called me and made an appointment immediately. It wasn’t that I was concerned, but I wanted to be sure that I had my 20-week sonogram scheduled so that the Novio and I could find out the gender together.

Twenty weeks also coincided with our birthdays, which sweetened the deal.

The doctor ordered me to repeat the tests that he didn’t have access to, which was fine, despite a disorganized system at Hospital San Carlos and a two-hour wait, urine in hand. That afternoon, I went to my local clinic to make an appointment for the results with the hope of scheduling the 20-week scan.

hospital care in Spain

I waltzed up to the appointments counter, flashed my brand-new card and presented the papers from the work up. Without looking up, the man shook his head and said that no one – NOT ONE DOCTOR – was available for the month of August. I laughed, “What do you mean? Every single obstetrician in this medical center has been sent on vacation for all of August?”

Tal y como le digo. You have to go to the Centro de Especialidades Avenida de Portugal in two weeks’ time.” Now, I’m new to Madrid, but generally speaking, a street bearing the name of another country tends to be on the way to that place. I’d been sent to the other side of town to pick up test results, out towards our westernly neighbors!

“Babies usually aren’t born in August.” Again, I laughed, as both of Micro’s parents are August babies, and asked for an hoja de reclamación to make a complaint. I was informed that one could only do that between the hours of 9am and 2pm. Had there been a table, I’d have been tempted to flip it… or at least pound my fists.

I begrudgingly left work after a week of waiting to head to Avenida de Portugal. The young doctor was gracious and apologized for the packed waiting room before folding her hands in her lap and asking what I had come for. I responded that I’d like to get my test results from July 27th, to which she gave me a blank look and informed me that I had nothing on file.

“Well, at the very least, let us weigh you and take your blood pressure since you’re here?”

Public or private?

I’ve long been a proponent of Spain’s public health system. Doctors are well trained and the treatment is free, plus prescriptions are subsidized.

And then I moved to Madrid.

I had absolutely no right to ever gripe about the system in Sevilla, because wait times were half as long and doctors took their time with patients. I felt rushed and unattended in Madrid in the public hospitals, like no one really knew what they were doing or where to send me. Is this how things are in America? Is it really normal to lose three different tests from the same person?

After asking some women at work, I checked out Hospital Clínica La Luz, a private hospital up the road from campus associated with Quirónsalud that accepts my private insurance. Unlike in Andalucía, most people I know choose to go private for healthcare, no matter what it’s for.

I was assigned to Dr. Alvi, a young woman who is specialized in pre-natal care and scans. I briefly explained my situation, and she took a look at the few papers I still had in my possession before performing an ecografía. The service seems more personable here, even if the wait times once you’re in the clinic’s magazine-stocked waiting room are longer.

We’re still undecided whether or not to have the baby in the public or private system, but that’s a tarea for third trimester.

So, does it have a pito or not?

I could tell the Novio was visibly nervous when he arrived at my office the day of our scan. He barely said a word as we quickly ate a menú del día at the nondescript bar next to the hospital.

That morning, I’d gone through the public hospital for my 20-week scan. Despite my previous woes with Hospital San Carlos, I was called just before 9am and shown into a stark room. An intern gave me a quick pelvic scan to measure the height of my cervix before dropping the goo on my stomach.

“For a pregnant lady, you’re very calm,” he said as he spread the jelly around the reaches of my belly, which now domed slightly over my profile.

And I was – this baby has made me mellow.

micro-at-a-wedding

I asked him to turn the screen away so that I could get the surprise (reiterating that I did NOT want to know the sex), but he assured me that the baby was healthy and so was I. Even my worry that I wasn’t gaining enough weight was shot down!

Once I’d wiped the goo off and got dressed, I was instructed to wait in the waiting area. A nurse handed me a few pamphlets and a facts sheets about the baby like how much it weighed and its predicted height.

The private hospital experience was a bit more welcoming. Despite my doctor being away on vacation, Dr. Orozco was pleasant and thorough, explaining every measurement he was taking, showing how the blood was flowing in and out of the ventricles and assuring us that the baby didn’t have Zika (the head was actually a bit bigger than normal – thank you, blue fish).

“What do you prefer?” he asked. I shrugged my shoulders because I had bounced between the gender just about daily, even though I had a feeling our first child would be a boy. The Novio admitted he was hoping for a girl, and the doctor told him to watch the screen.

Between the two wiggling legs was something else, proving that a mother’s instinct is always right (and meaning I didn’t have to stress over choosing a name!).

The 0,0 Smackdown

My body seemed to know I shouldn’t be drinking beer from the time we conceived. In plena Feria de Abril (but seriously, this kid is andaluz through and through), I spent my final day sipping water, followed by cancelling plans for the Patios de Córdoba last minute.

If there’s one thing I miss, it’s beer. The sin alcohol or 0,0 stuff tastes plastic-y and has no gracia, so I’ve been sticking to juices, tonic water and the occasional Fanta when we go out to tomar algo.

which-non-alcoholic-beer-is-best

I’ve been sampling the 0,0 and non-alcoholic beers, much to my dismay. The worst sort? Cruzcampo. I know, Cayetana de Alba, strike me down for this blasphemy, but it is absolute garbage. Amstel has been my favorite thus far, and the Novio even scouted out a German beer bar that boasts a nicht alkoholisch on tap (it’s called Saint Germain at Calle Rios Rosas, 7) with a generous helping of snacks.

I’ve been promised a cold botellín in the puerperio, the recovery period directly after birth. I am holding my husband to that.

Everything that I know about pregnancy is wrong

Admittedly, I was nervous to be pregnant, afraid I’d balloon up like a cow and be unable to keep active. I saw my nine months of carrying a child as the beginning of the end of my freedoms – to travel, to meet friends and to sleep.

Strangely enough, I’m really enjoying it! I lay in bed for 10 minutes every morning – often before my alarm – feeling the baby wiggle around. I haven’t started speaking to him yet, despite having a named picked out and knowing that the earbuds have already developed.

micro-and-his-other-girlfriend

Everything I thought I knew about pregnancy has been utterly wrong. I expected to have the morning sickness, the stretch marks, the discomfort; but I’ve been pretty comfortable all throughout my pregnancy, save a little less spatial awareness. As a heavy eater, I assumed I’d blow up as I gave into cravings and be grazing all day. It’s true that I feel fuller faster, but it’s sometimes a question of blood sugar, and a few nuts or apple slices will suffice.

My biggest complaint is that I can’t eat everything I want. It’s difficult to remember to ask a waiter to skip the jamón in my salmorejo, or to cook the red meat just a little more on each side. I’m trying to eat more blue fish. The biggest surprise is that most of my cravings have been for healthy foods, so I’ve kept my weight under control with very little effort. And from what I hear, breastfeeding is when you really start to feel hungry!

I’ve also been sleeping like a baby, practically falling asleep and staying asleep from the time I shut my eyes until it’s time to stir. Clothes are just beginning to feel tight in the wrong places, as my belly seemed to double in size in the last five weeks of second trimester. My sister finally confessed to my husband, “YES! Cat is finally showing!”

The only complaint? Why isn’t my hair gorgeous and shiny?! The Madrid dryness means that it looks dull and dead; the upside is that my nails are growing.

What’s up in third trimester?

second-trimester-baby-bump-evolution

Apart from getting rounder? Stretch marks? Swollen ankles? I’m beginning to feel pregnant, from having to stand up slowly or feeling my belly descend towards the end of the day. I just bought my first piece of maternity clothing – a dress for a fall wedding – and have dug back out the books to think about the due date and giving birth.

Things we’re still looking into are storing the umbilical cord blood, me eating my placenta (which prompted a, “YOU WON’T EAT GRILLED PIG’S EAR BUT YOU’LL EAT THAT!? from the Novio) and childcare once my 16 weeks of maternity leave end. My OB-GYN switched me to a high-iron pill with folic acid, which I’ll take for two more months so that Micro is getting the nutrients he needs.

One of my biggest question marks still is where to have the baby. All signs point to Seville and a public hospital, and that makes sense – we have a car, the space and one of the best maternity hospitals in Spain. But if Micro comes early, I’ll need a Plan B! And as a planner, I’m remembering that the baby will come when he wants, not when’s convenient to us.

Finally, we’ll begin pre-natal classes with the matrona.

As the due date hurtles towards us, I have a little bit of everything – elation, apprehension, sorrow that it will all end and nothing will be the same. I’m enjoying my pregnancy and the way the Novio and I are savoring our time alone together. I’m sleeping and eating well and still able to take advantage of a new city, traveling for work (Micro hit four countries in one month, and I felt fine but for aching limbs at the end of the day) and feeling like my old self.

I sometimes feel like I’m fumbling for the lights in a dark hallway, bumping into walls and furniture as I try and navigate pregnancy in Madrid and Spain in general. My American friends with kids have admitted a certain degree of jealousy in knowing that I’ve had so many sonograms, but I’m just relieved that Micro is healthy and I’m feeling so good.

Remember: every woman’s body and pregnancy are different – I had very few risk factors in my family and the Novio’s, am at a healthy weight and age for pregnancy, and have not experienced any problems, save a bit of bleeding at the very beginning. I am not a doctor, so this post is a result of my experiences and research. Consult with your health care professional and don’t be afraid to ask questions.

Those of you mamás who have given birth in España: have I missed anything? Any words of wisdom for my readers and me for pregnancy in Spain?

If you missed the first trimester, skip to the first trimester of pregnancy in Spain post!

A Guiri Guide to Having a Baby in Spain: 1st Trimester

Well, if there were ever a cat in the proverbial bag, it’s gotten out of the bag and run around the block.

Yes, I’m pregnant.

Yes, it’s the Novio’s.

Yes, I’m exhausted and have a little half moon of a bump. I am also thrilled. And that’s why I’ve been MIA from this blog, social media and my favorite cervecerías for the last several weeks.

Having a baby in Spain was something that my mind had been programmed since the Novio and I got serious. We’d talked about offspring quite early on in our relationship, bought a house with said offspring in mind, and began conditioning our minds to nights nursing babies instead of beers (oh, and I bought a pregnancy book, which thoroughly scared the Novio).

Being pregnant in Spain

And then it happened.

On a Friday night in May, I was fresh off of a train from two interviews in Madrid. I’d been too nervous to eat, so I sat in a friend’s car snarfing down a pizza I’d begged the Novio to order me before a concert. I was drained, which I chalked up to the 5am wake up, the dizzying cost of breakfast in Madrid (4.80€ for a coffee and slice of tortilla!) and two intense interviews.

“You drive terribly in heels,” he said with a mouth laced with beer.

I cried.

“You’re pregnant.”

Qué nooooo,” I responded, knowing full well that I was late but a bit in denial about the whole thing. I was interviewing for jobs in Madrid! I was making summer plans! I was about to drink the Western Chicago suburbs out of craft beer! And I had no other symptoms.

The following day, I took out the trash and headed to the pharmacy, constantly checking behind my back to see if any of my maruja friends from the barrio was in line.

Uhh, dispone de prueba de embarazo?” I asked the pharmacist, not knowing if I’d be able to get a pregnancy test there or if I’d have to head to the Corte Inglés, the Plan B for anything you can’t find at another store. She handed me a box, which I stuffed at the bottom of my bag.

At home, the Novio urged me to take the exam before he began making lunch. Knowing that the HcG horomone – the horomone that surges in pregnant women and determines the outcome of a pregnancy test – is highest in the morning, I chose to wait until the following day, Mother’s Day in the US.

When the two crimson lines appeared the Sunday, post-churros, on the stick, my mind was sent into a tailspin. Crap! I drank a ton of rebujito at the Feria de Jerez the weekend before! How many weeks along am I? Is everything developing ok? How am I going to keep this from my mother when I call her this afternoon?!

I emerged from the bathroom, and the Novio read my face. “Lo hemos conseguido!

Pregnancy Vocabulary in Spanish: Words to Know

Much like when I got my driver’s license in Spain, being pregnant has come with a slew of news words to learn.

Aborto natural / forzoso – Miscarriage / Abortion. A word that’s also sounded a bit fuerte to me, Spanish uses the same word for pregnancy termination, whether or not it’s natural or by choice. An abortion can be performed in Spain up to 14 weeks; abortions performed due to high risk to mother or baby or deformations can be administered up to 22 weeks. If this is a consideration for you, check this Q&As page in Spanish, or ask your healthcare provider.

Ácido Fólico – Folic Acid. Long considered a must during pregnancy, folic acid helps your baby’s spinal cord form properly and you’ll notice it grows your nails and hair, too. I was advised to start taking folic acid a month or two before planning on being pregnant and to continue all the way through the pregnancy. My prescription is written by my public doctors (many private doctors cannot issue them) and are nearly fully subsidized by the government.

Analisís de sangre / orina – Blood / urine analysis. Get used to needles, cups and doctors. If you have a normal pregnancy, you won’t have to do too many, but the first trimester is rife with testing. Tests will likely be ordered by your tocólogo and/or gynecologist.

Cartilla de Embarazada – Pregnancy Information pamphlet. This document will include information about the mother: her age, her health, any previous pregnancies and medications taken. The same will go for the father (just no previous pregnancies). This information will be filled out by the matrona on your first visit, and your obstetrician will fill in information regarding your subsequent appointments, such as medication prescribed. You should bring this pamphlet with you to all visits.

Cartilla de Embarazada for Andalusia

Cribado – Genetic testing done at 12 and 20 weeks. Stemming from the verb cribar, which means to narrow down, a cribado is a blood and urine exam performed to rule out genetic anomalies, such as Down Syndrome and Edwards Syndrome, plus confirm your blood group. This test is extremely important if you’re over 35. Your results, at least in Andalucía, will be mailed to your home address. If results are positive, you’ll undergo more testing. If it’s negative, do yourself a favor and DO NOT Google what your baby likely doesn’t have.

Ecografía – Sonogram or Ultrasound. These will be vaginal until about week 12, after which the baby will be large enough to detect through an abdominal sonogram. Expect to have 3-4 of these in a normal, non-risk pregnancy.

Embarazo de Riesgo – High-Risk Pregnancy. Women in Spain are considered high-risk pregnancies if they are over 35 years old, have a history of multiple miscarriages, are carrying multiples or have certain medical conditions, such as diabetes. These pregnancies often have more doctor’s visits and testing, though it is all covered under the social security scheme if you’re going that route.

Fecha del Parto – Due Date. This will be 40 weeks after the first day of your last missed period, meaning conception usually happens two weeks after (full disclosure: we’re pretty sure baby Micro came to be during the Feria. Any surprise there?). Note that trimester (trimestre) and weeks (semanas) are important buzzwords, and that your baby’s gestational age is considered week+day, such as 11+4. Many of my pregnant or mom friends also call it, salir de cuentas.

Grupo Sanguíno – Blood Type. I have yet to figure mine out, but this is a good time to do so.

Matrona – Midwife. Though you won’t see a midwife too often in the first trimester, you should ask your GP for an appointment with her so that she can fill out your cartilla del embarazada. She will also measure your weight and blood pressure on each visit, then note it done for your records, plus conduct your pre-birthing classes. This person will be assigned to you if you are in the Social Security Regimen, though you can choose to see a private midwife if your insurance covers it, or you pay out-of-pocket.

Tocólogo/a – Obstetrician. This doctor will lead you through the medical side of your pregnancy, from sonograms to the actual delivery if you so request. This person will be assigned to you if you are in the Social Security Regimen, though you can choose to see a private midwife if your insurance covers it, or you pay out-of-pocket (I chose to change to a friend’s mother in the same building with my public health insurance, and she makes the appointments for me. I feel comfortable asking her questions when I have doubts, and this has made a huge difference in keeping me calm!). This word is extremely Andalusian, from what I can tell.

Toxoplasmosis – This may be way Spain-specific, but toxoplasmosis is a big, big deal: this parasitic disease can spread through toxoplasmos found in raw or undercooked meat, poorly washed fruits and vegetables or even cat feces. I’ve long let go of a rare steak and sushi, but jamón can also be dangerous for your unborn child. Some may say it’s a crime to eat embutidos, cured meats, that have been previously frozen to kill potential toxins, but it’s one way to savor your bocadillo de salchichón!

I’ve found that some people are more lax about what they’re consuming than others – always speak to a medical professional and make the choice yourself. Toxoplasmosis can be scary and require further testing and even treatment, so chow down at your own risk!

First Steps

Once we’d told my mother-in-law (and, yes, she promptly began crocheting bonnets and booties), I made an appointment right away with my GP, which is the gateway to any other specialist. She didn’t do much more than congratulate me and ask how I was feeling before scheduling an appointment with the matrona for the following week. I had also called a friend’s mom personally, who would eventually become my tocóloga in Seville.

An important document you’ll receive is known in Andalucía as a cartilla de embarazada, or a small pamphlet that your doctor will record your stats, your treatment and your ultrasound results, plus all dates. Later, you can write down your birth plan here.

Typical doctor visits when pregnant in Spain

The matrona took down all pertinent information regarding both mine and the Novio’s health history, checked my blood pressure as well as height and weight and talked to us about having a healthy pregnancy. These doctors become more important as you develop a birth plan and begin to take birthing classes, though we haven’t had to see her since.

I’ve been fortunate to have a close seguimiento throughout my entire pregnancy. I have been able to squeeze in appointments before Dr. Sánchez is actually on duty and have her call me when other women cancel. In the two months since we found out the news, I have gotten four ultrasounds in the public health system, all of which have been no cost to me. Additionally, the medicine prescribed to me – folic acid, progesterone and baby aspirin – has been mostly subsidized by my public health insurance – a month’s worth of the aforementioned meds have cost me less than 5€.

Two important tests that you’ll do during your first trimester are blood and urine tests around 10 weeks to determine a few things: your blood type, your risk for genetic diseases such as Down Syndrome, and infections. You’ll also be told if you’re at risk for anemia, gestational diabetes or toxoplasmosis and get a check up of your general health. I was able to do both at the same time (be sure to go en ayunas, or without eating or drinking, for at least 12 hours, and bring a snack for after your blood gets drawn) and got the results mailed right to my house two weeks later.

The cribado can be a little scary – it’s when your mind begins to wonder if anything is potentially wrong – and it requires you to sign a waiver. You can refuse to take it, of course, and any other treatment offered to you by the state. Be sure to take the documentation given to you by the tocólogo, which is both the order for the test and the release form, which you must sign before the tests can be administered.

The best advice I’ve gotten from all four doctors I’ve seen? Keep living your life as you normally would. Don’t overeat, listen to your body when it needs rest and cut out alcohol, drugs and cigarettes. And surprisingly, the ganas to have a beer have been next to none since right before I found out I was going to be a mom.

Público or Privado?

Spain has two healthcare schemes: public and private. If you are working for someone else, you are automatically in the social security, or public, scheme. If you are autónoma, self-employed, you can go public, as well; if you’re not working you would be considered private and thus pay for your insurance, co-pays and medication. Check to see if the baby’s other parent has access to healthcare for you and the baby, as some partnerships can share this right.

Public healthcare is open to anyone working or who has worked in Spain (such as a retired person). Clinics and hospitals are denoted as public and usually subject to regional law, called leyes autonómicas. You would be assigned a general practitioner, or a médico de cabecera, in the clinic or ambulatorio closest to your residence, who will then pass you along to the matrona and tocólogo.

I chose to go both routes, as I have both public and private insurance. Truthfully, I prefer the public route because it’s very wham, bam, thank you ma’am – I go at my assigned time, am seen by the doctor with no frills, and they schedule my subsequent appointments for me. The public doctors can also administer prescriptions and women who have high-risk pregnancies often prefer the public system because of the close eye they keep on pregnancies.

When I saw the private doctor, I felt out of place. There was a higher degree of modesty, which actually made me feel uncomfortable, though the equipment was more high-tech and the tests were more thorough. And because I had my cartilla with me, the doctor could give me a second opinion about the treatments I’d received (and spoke highly of my public doctor!).

Some women prefer to get recommendations from other mothers and pay out of pocket. As you can imagine, those who are at the top of their field are more costly. Most private hospitals and clinics can help you choose a provider. The Facebook group Mums in Seville has been great for searching for recommendations, used baby goods and general questions about raising a baby as a guiri in Spain.

Note that private insurance may require what’s called a periodo de carencia (usually 9-12 months) before you can have a pregnancy covered for free or a reduced cost. This means that you must have been paying your plan for a duration of time, stipulated by the company, before you can have free access to maternity specialists. I’ve had Caser’s Activa Plan for three years, so I qualified for free check-ups and most non-invasive procedures are covered. Plus, they have doctors in every neighborhood, so I can walk to appointments!

Maternity Leave in Spain

If you’re cuenta ajena, praise the social system – you’ll get 16 weeks of maternity leave with 100% of your salary paid by your employer at the time this article was published. As someone procedente de the USA, I am sure I’ll be forever thankful to have that time at home to adjust to my new role and bond with my newborn.

Be sure to double-check local and sector labor laws (type convenio + your sector + your province into Google for a PDF document. For example, “Convenio Enseñanza Privada No Reglada Sevilla”).

Any recommendations for English-speaking doctors in Seville?

Feeling confident in my Spanish and fully knowing the restraints of Spanish red tape, I was satisfied in the public system. That said, I asked several guiri moms for their recommendations for doctors and doulas who spoke English in town:

Doctor: Dr. Guillermo Espinosa at Millenium Clinics in La Buhaíra, a Sanitas clinic who often sees Americans and other English-speaking patients.

Doula / breastfeeding expert: Eugenia Nigro, a Dutch woman who has practiced in several countries and now calls Sevilla home. She does a number of prenatal classes, as well, and can be reached by email at ginanigro@gmail.com.

I have not personally used these professionals, but it could be a good place to start.

Pero bueno, how are you?

Fantastic, actually. Before I could see Micro’s tiny arms and legs, I could hardly believe that I was growing a tiny human. Coming up with excuses for going home early or not drinking has been a fun challenge, and telling our family and friends has been emotional. I was able to tell my mom, dad and girlfriends back home in person.

My only symptoms are a few larger body parts (namely my breasts and butt) and becoming tired at an earlier hour, but I’ve had no nausea or mad aversions to food (miss you, pescaíto frito). Truthfully, these 20 weeks have been eye-opening and have left me with a lot of emotions as I am not only swallowing the changes in my body but also how this baby is going to change our lives. To say the Novio and our families are excited is a gross understatement. Oh, and I moved to Madrid just before starting second trimester.

pregnancy at 11, 12 and 14 weeks

And s/he’s been doing some cool things – a long-haul flight, trips to the beach and festivals in Andalucía, sleeping a TON and witness to a few heavy metal concerts before those tiny earbuds could be damaged. I’ve been able to work and work out normally, though I’m a bit more conscious of what I’m eating, the pace at which I’m living and what my body is telling me. As my father said, “I’m sure you’re healthier than ever if you’re eating a Mediterranean diet.” The legumes, fish and lean meats have been in my carrito and I’m craving fruit juice, salmorejo and spicy foods. I can sleep on a dime (or doze off on the floor or on public transportation). I stopped running, even if just to not wait for a stoplight.

Without getting too Mommy on you all, I’m finding it incredible that my body is made for this and that it knows what to do. Some days I’ll drink gallons of water and other days I crave salty food. I can be up all night or sleep for 12 hours straight. My pace of life has definitely slowed down a bit, but in a good way. Micro hasn’t stopped me, surprisingly!

What’s ahead in Second Trimester

First off, we find out if Micro will be a gitana or a chulapo in the second trimester of pregnancy! Typically, the gender can be revealed as early as 14 weeks, but I wanted to wait until the Novio and I could go to a sonogram together. I believe he’ll be in disbelief, despite my growing belly, until he sees the little one on the screen move around and we find out if it will share a name with him or not.

Pro tip: People in Spain don’t seem to understand why you’d wait to find out the gender, so if you don’t want to know, tell your doctors immediately and remind them again at every subsequent visit. I could have found out far earlier, but I’m enjoying the wait! In fact, by the time I push publish, I’ll be at 20+2 and will know if the baby is a boy or girl (My feeling is that it’s a boy!).

Having a baby in Spain appointments

I’m teetering right in the middle of my pregnancy and between two medical systems and beginning to think about what comes around week 40 – delivery and bringing home a baby to our teeny flat with no elevator. I’m thinking about public v. private in Madrid, where I might have the baby and how I want the birthing experience to be. Nancy and I focus our Skype calls on babies and the topic always sneaks up – my jet set group of friends in Madrid were legitimately shocked when I relayed a list of no-no foods to them.

But it’s been fun and I’m loving the extra sleep. And pastries. I am also loving the extra pastries.

What do you think about the big news? Any lingering questions, moms-to-be, or advice to give? Please note that I was a healthy, 30-year-old woman with no family history or previous pregnancies and low risk factors across the board. This post is meant to be orientative and speak about my experience. I appreciate those of you who have mentioned other treatments depending on your situation and pregnancy. Always, ALWAYS consult your doctor or midwife, ask questions and get informed!

Please read about the second 14 weeks of my pregnancy on my post A Guiri Guide to Pregnancy in Spain: Second Trimester!

Tapa Thursday: 10 Winter Fruits and Vegetables You Should Be Eating in Spain

My stand-alone freezer is currently stocked with enough stews to get me through the long winter days. Even when the sun is shining midday, my cavernous house feels like a tundra, and I usually need a warm bowl of fabada or a crema de verduras to warm me up before ultimately peeling off layers of clothing to bike to work.

Fruit stands at the Mercado de Triana food market

Venturing to my local market once a week, I beeline right to Antonio’s fruit stand. My frutero will carve off a piece of fruit – often from his own orchard – and hand me a piece of his breakfast. Though seasons don’t change often in Seville, the fruit and vegetable products at Antonio’s stand (or in any market) do, and you’ll be hard-pressed to find a carton of strawberries past June or watermelon in December.

While stews and legume-heavy dishes are king during the first few months of the year, your local supermarket will have incredible options that you shouldn’t pass up (they’ll be gone before you know it!)

Citrus Fruits like oranges, clementines and lemons

Winter fruits in Spain oranges and clementines

One of the first indications that winter is coming is visible right outside of your window: orange and lemons trees bend under the weight of branches full of fruit. Winter is high season for naranjas, no doubt.

Sweet Valencia oranges and clementines are even sold on the street by people who have orange trees, and for next to nothing. No excuse to not start the day with orange juice!

Persimmons

Like a try fruit and vegetable hybrid, persimmons – called kaki most commonly in Andalucía – weird me out a bit. It looks like a tomato or bell pepper, but has an extremely sweet taste. My frutero swears it adds years to your life, but I’ll stick to apples.

Quince

Winter fruit in Spain quince membillo and mangoes

Squash and Leeks

If you’re into soups and stews, leeks and squash, in addition to green onions, should be your go-to produce buy. 

Gold star for you if you make leek croquetas.

Green Onions

I grew up in a household full of green onions, and they laced and graced nearly everything my dad cooked. I’ve been buying puños from Antonio once a week and slipping them into my acelgas, on top of fried potatoes and even in to ramen! 

This is also the time of year when their catalán cousin, calçots, take center stage at onion grilling parties. Check out Barcelona Blonde’s post on the calçotada to learn more about an experience at the top of my footed bucket list! 

Avocados

Superfruit lovers can find avocados from late October until the springtime, and they’re used in several Spanish salads. Aguacates are still a bit too far out for Spanish cuisine and even my frutero couldn’t come up with any recipes, but at least there’s guacamole as a back up. 

Sweet Potatoes

Winter Fruit in Spain batatas asadas

Sweet potatoes, like chestnuts, are common street food offerings, cooked over charcoal. Though it’s not a common (or cheap!) staple for Spanish kitchens, many fruterías will sell them already cooked and thus softened.

Mushrooms

Winter food in Spain mushrooms and setas

A popular weekend pastime for Spaniards once the temperatures begin to dip is to forage for mushrooms. In the sierras, nearly two dozen types of shrooms, called setas, grow, and you can find them in sauces, tortillas and croquetas.

As someone who doesn’t love how they feel once I bite into them, I do love anything mushroom flavored! You can find nearly every variety in the produce section, the most popular being the boletus: look for a light brown bulb with a fleshy white stalk.

Artichokes

winter food in Spain artichokes

One of the very first Spanish dishes I ever tried was roasted artichokes christened with small pieces of Iberian ham and olive oil. But it wasn’t the large, leafy bulbs you see in winter time, and it turned me off to the vegetable.

Spain is one of the world’s top three producers of alcachofas, meaning prices are reasonable and artichokes pop up often on restaurant menus.

Nuts like chestnuts, almonds, walnuts

Winter fruit in Spain nuts

Spain literally gives another meaning to chestnuts roasting on an open fire when the castaños trucks hit the streets around November. You can also find a number of other nuts, most notably almonds and enormous, pungent walnuts.

Foreign fruits and veggies like papayas, mangoes and cherimoya

Strange winter fruits in Spain

Although it comes with a higher price tag, winter is prime time for a number of warm-weather fruits from south of the equator. If you’re in Seville, check the special produce stand, El Frutero de Nila, at the Mercado de Triana (stand 4, next to the restrooms).

On my last trip to the market, Antonio split open a clementine and handed it to me. “Toma, guapa. Una frutita tan dulce como tú.” The flesh was sweet, recalling memories of finding California oranges at the bottom of my stocking on Christmas morning. 

And then he pulled out a carton of strawberries, the forbidden fruit that usually doesn’t show up until late February. A sign of global warming, surely, but shopping and eating seasonally makes me feel more fully immersed – and it’s cheap!

WINTER

What fruits and vegetables do you consume in wintertime Spain? Do you like eating seasonally?

Preguntas Ardientes: What kind of health cover do I need for living abroad in Spain?

If you’re planning to move to a new country like Spain where healthcare isn’t free for or guaranteed for all, it’s important to understand that travel insurance isn’t going to protect you if you fall ill. These policies are cheap for a reason – they cover things like lost suitcases and are only for return trips, explain the independent health insurance brokers at Medibroker.

Buying expat health cover is one of the most important, and most complicated, things you need to do before relocating abroad. Nobody is invincible, and medical bills for even routine operations can land expats in hot water if they don’t have the right insurance.

andalusian health card

Spain’s two-tier healthcare system includes both private and public doctors. If you’re working with a social security plan, you’ll be entered into the public Social Security; if you’re on a long-stay visa or self-employed, you’ll be required to get private health insurance. Several big companies exist, but not all plans are created the same.

Medical insurance is a confusing product – it’s something you have in reserve and it’s not tangible, so you have to shop around. Plans offer varying levels of cover and there’s a multitude of add-ons and jargon to wrap your head around.

When it comes to something as important as your health and finances; you can’t afford to buy a plan that isn’t right for your specific needs.

Maybe you think you’re healthy, but that doesn’t matter – nobody is too careful or too healthy to need good medical insurance. Accidents happen, and they have an annoying way of popping up when you haven’t planned for them.

Things to consider when buying expat medical cover

Your health

If you already have a health issue, getting cover is going to be more complicated. Pesky pre-existing conditions affect your choices when it comes to buying insurance, so it’s useful to ask an expert which of the 100s of plans on the market will be flexible enough to accommodate you.

Do you need a global plan?

It’s often tempting to save money by buying a local health plan. However, you should think carefully about this so-called ‘saving’. Local cover in Spain only pays out for medical treatment received within the country and access to some hospitals is restricted. There’s also a level of risk attached to buying a foreign language policy – the small print may not translate.

Ambulatorio Spain

An international plan means you’re covered wherever you go, meaning it’s a lot more comprehensive. It’s increasingly important for Brits living abroad to get international health insurance because changes to NHS rules in the UK means they may no longer be entitled to free healthcare when they return home.

Visa Regulations

It’s important to research the specific country’s rules regarding health insurance requirements for expatriates. How can you be sure that a medical plan you’ve selected is compliant? Speak to an insurance professional and be sure to add repatriation to the plan – it’s required for visas issued from outside the EU for Spain.

Budget

Your budget for health insurance will affect the level of cover you purchase. Plans from UK-based insurers are designed to control costs by limiting geographic cover. An excess or deductible will reduce your premiums, though the higher the excess the more you may have to pay when you come to claim.

Health Insurance is a complex, expensive product because plans try to meet your needs.

hospital care in Spain

The level of cover you need will depend on your individual circumstances. Even if your employer provides you with cover, you should always question its suitability. Your age, health and future plans are all factors to take into consideration and you will also have to think about whether you will need add-ons like maternity or dental cover.

You’re a person, not a category, so a comparison site can’t fully assess your requirements. Understandably, insurance providers are only going to recommend their own plans – even if there’s a better one on the market.

About the author: Medibroker can guide you through choosing a health insurance plan for your time in Spain. A personal advisor calls you to chat about your needs then recommends a plan tailored to you. It’s a completely impartial, 100% free service, regulated in the UK by the FCA.

Seville: Spain’s Most Bike-Friendly City

My ride is a bubblegum pink cruising bike with rusted handlebars, a rickety frame and the name Jorge. Since I live outside the city center (ugh, I know, don’t remind me), I’m constantly busing myself from one end of town to the other to meet friends, run errands and go to work.

When I was a kid, I couldn’t wait to come home from school and ride my bike around the block until my legs practically fell off. Now that I’m an adult, it’s my favorite way to get around, especially in a city with terrible transportation and few parking spots.

Seville is perfect for bikes – it’s flat, has miles of bike lanes and so, surprisingly, nearly one-tenth of sevillanos chose to commute on two wheels. For me, there’s nothing more freeing than pedaling along the Guadalquivir, feeling the burn in my thighs and arriving a little winded to work or to meet my guiritas.

Consider renting a Sevici bike, part of the city’s bikeshare program, for half of what a cab costs from the airport. Yes, the bikes are big and clunky, but it’s the easiest way to get from one place to another. For one week, you can use the bikes for 30 minutes (o sea, between bars or between practically any point in the city), and there are more than 250 rental points.

Is your city bike friendly? Does your bike have a sweet name like mine? For more videos, subscribe to my YouTube channel!

CaminoFTK: Meet my Sponsors, Podoactiva

I’ve been thinking a lot about passion these last few weeks as I wrap up my master’s and mentally prepare for walking over 200 miles on the Camino de Santiago. Many of you have never met me face to face, but it’s clear that my passions are Spain, blogging, and photography. Add with that a love for helping people and connecting, and challenging myself, and you’ve essentially got my reasons for wanting to do the Camino de Santiago.

Pursing my passion led me to Spain in the first place: a passion for Spanish language, a passion for traveling and a passion to do something different while pushing my personal limits. I’m never one to drag my feet when it comes to making a decision and sticking to it – evident by my fight with bureaucracy, my fight against the Spanish private school system and my fight to make a meaningful life in Seville while dealing with my guiri complex.

My parents claim I ran before walking, and have been the first to tell me I’d always have the world at my feet so long as I stayed true to myself and what I wanted out of life. Thanks, padres. This led to a near-obsession with walking the Camino de Santiago, and for carrying something more than a 6kilo backpack for more than 200 miles.

When looking around for sponsors, I had very few criteria. For one, they had to be on board with my reasons for walking and support Dance Marathon and my passion for it. Secondly, they had to be people who personified passion themselves. When Caser Expat Insurance contacted me not three days after my post on why I’m walking went live and shared their interest in me and my story, I was floored.

A few weeks later, I was on a Madrid-bound train to meet Pablo, the director of Caser Expat Insurance, and his team. Their biggest focuses are on health and well-being, so they took me to have a physical…for my feet. Talk about putting your best foot forward!

Pulling up to the Podoactiva clinic near Paseo de la Castellana, it was clear that these people were passionate about feet. Despite having a clientele that ranges from the players of Real Madrid to Shakira, the office was welcoming and calming (it even quelled my nerves about baring my feet to a bunch of strangers).

Carlos got me set up in one of the consults, which was stacked wall-to-wall with machines. Podoactiva uses biomechanics to measure your feet’s resistance, strength, weight distribution and more, which is why they specialize in sports performance. Having been a gymnast my whole childhood, I would have loved to know all of these fators growing up, especially because my body now feels like an abuelita‘s.

After the customary round of questions – birthdate, weight, shoe size – I was made to lay down on a cot while Carlos tested the flexibility and strength of my ankles. He guessed I was a dancer because even the slightest touch or twist meant my ankle bent. “I hope you got boots that cover your ankles” was Carlos’s response.

Oops. They looked funny!

Once finished, I stood still for 30 seconds upon a mat so that the pressure I put on each foot could be properly measured. Carlos and his colleague, Jaime, then fed these images into a computer so that I could see the results. As it turns out, the knee injury I got from gymnastics ten years ago has greatly affected the way I walk and stand – I overcompensate with the right side of my body, particularly in the toes.

Asking me to walk back and forth on the pressure mat, Jaime and Carlos watched closely (and took a video) to see how I walked and how much support my ankles got when doing so. It was evident that my feet turned in, and the effect than four years of marching band had on the “roll-down” way in which I walk. This, Carlos explained, was causing the bones in my feet to become impacted and lose the natural arch (in other words, I have juanetes. Go look up that word, lest it show up in a search engine in English!).

I also walked on a treadmill, both barefoot and in my running shoes before sticking my foot into the patented Podoactiva 3-D scanner. Jaime helped me to Keep my foot still on the soft silicon hammock as each foot got scanned, creating a virtual image of what my custom insoles should look like. The scans are sent to the company’s manufacturing plant in Huesca, where they use lasers and robots to cut the insoles.

In about two weeks, I’ll have custom-made plantillas delivered to Podoactiva’s office in Los Remedios to start breaking in, along with my boots. Since the whole two-week trek won’t exactly be a walk in the park, knowing I have the passion for foot care and a healthy lifestyle behind me and someone to walk in memory of, I’m excited. I’m elated, actually. And dreading how my feet will look afterwards!

Don’t forget to follow my Camino story through my blog and through the hashtag #CaminoFTK. Awareness is key, so please spare a moment to share any posts via social media if you see fit. I couldn’t do all of this without the support of people like you all, Kelsey’s family, Caser Expat Insurance, Walk and Talk Chiclana, Books4Spain, Your Spain Hostel and Dance Marathon.

Podoactiva will be with me literally every step of the way: they graciously picked up the tab for both my consultation and the lime-green insoles I’ll be getting for my hiking boots. I’m still a bit cross that their client Xabi Alonso didn’t come watch me run barefoot on a treadmill, but you can’t always get what you want. 

 

Related Posts Plugin for WordPress, Blogger...