maternity care in Spain is a very delicate subject. Until around 30years ago, all births were in the home. The government then decided to move birth into the hospital and homebirths became a thing of the past. The hospitals were staffed with doctors who got involved in births, despite their lack of qualifications and it was decided to cut back on the training of midwives to train the obstetrcians. Midwifery schools closed and the nurses were given extra training when needed. The doctors took firm charde of the whole birth process. As the midwives aged, and then retired, it became apparent that there was an acute shortage and there were none being trained. The midwives left were allocated to the labour wards and nurses were left to undertake the pre and post natal care. After 8years the midwifery schools were opened again, and some students leave for Britain to train as midwives. Now there is some new blood enetering the scene, however, maternity care is still given solely by obstetricians.
The initial breastfeeding rate is very high, as Spanish women want to breastfeed their children. While it may be 95% or more after the birth, there is no support in hospital and by 2weeks the breastfeeding rate has dropped dramatically and by 6weeks is almost non-existent. Formula feeds are freely available in the hospital and samples are given out post partum.
Midwives are firmly under the control of the doctors, who dictate all the protocols and demand strict adherence to rigid routines.
All women give birth on a narrow table with their legs in stirrups - they will have had a perineal shave, an enema and an episiotomy. There is routine starvation of women in labour; borth plans are unheard of and not taken seriously. Needless to say the epidural rate is very high and so are the caesarean, forceps and ventouse rates. None of the obstetricians would aloow a woman to birth in an upright position or on the floor, on a mat. fathers are not aloowed in the delivery rooms - there presence is to be negotiated with the particular hospital. IV is put in the arm of a labouring routinely and 99% of the time drugs are given to the mother withouther permission (that is to say they dont ask permission)
The rights of pregnant women are disclosed in the local and Spanish health laws. The maternity care is free under the Social Security system, but Spain has a very medicalised approach to birth and the unnecessary routines and procedures have become a national standard. Tjere are virtually no midwives willing to visit a home birth and they are VERY VERY rare. Moidwives in the hospitals see themseles as lower qualified than obstetricians and thus see themselves as unqualified to attend births with obstetric supervision. The private clinics as well as state hospitals are strictly against natural birth and 100% of births are totally controlled by obstetricians, equipment and are fully medicalised. Natural birth is frowned upson, not recommended and most medical practitioners do not know how to do deal with it.
Epidural is readily available to all that want it, it is recommended by law for every woman giving birth. Every woman in Spain goes for a CTG each week from 36weeks. If a baby is not born by 40+2 a caesarean is performed, with or without consent. The doctors have the idea that this is common practise in other countries. This practise is a prime example of setting women up for intervention. A caesarean is offered with ease to all that want one. Spain has one of the highest caesarean rates in the world - some 67% give birth on an operating table. Episiotomy rates are 100%. Ultrasound scans are every 4weeks.
STM's new man summed it up like this: "In Spain, they believe in a non-interventionist approach to birth - under no circumstances should any intervention be permitted by either parent!"