With access to affordable healthcare, excellent maternity care, and free education system, Spain is one of the best places to have a baby and start a family. But giving birth as an expat in a foreign country will no doubt leave you asking several questions. Is home birth or hospital birth more common? Who’s there to help me after delivery? Do both mothers and fathers get paid time off? What about appointments with paediatricians?

If you plan to give birth in Spain, you'll need to know plenty about the process before you begin to search for rentals in Barcelona or discover rental properties in Madrid.

To ease your mind and answer your burning questions, here’s a rundown of everything you need to know about having a baby in Spain: from prenatal care to delivery and maternity leave.

Birth rate in Spain

129,306 children were born in Spain in 2022.

The birth rate in Spain is low, with nearly 8 births per 1,000 people. Of that, transnational couples — where at least one parent is a foreigner — have given birth to 21.4% of the children born in 2021.

While this number is low, it's good to note that this isn’t because of healthcare quality or national laws and incentives. Instead, the downward trend in birth rates is because women are choosing to have children at a later age than before: 33 years on average for Spanish mothers and 30.7 years on average for foreign mothers.

Who can benefit from maternity care in Spain

All legal working residents benefit from accessible public healthcare as they contribute to the social security scheme. You simply need to apply for public health insurance to access Spain’s healthcare system for free.

If you're in Spain with a dependent family visa, you and your new child will be covered by the health insurance of the family member legally working in Spain.

Maternity care in Spain: What’s included

Public health insurance in Spain gives you access to several high-quality maternity services, guaranteeing a well-monitored pregnancy in the care of a midwife and doctors.

Besides that, pregnant women and their newborn barbies will be provided with all levels of care and medical attention. You can expect free extensive prenatal care: at least 3 ultrasound scans, blood tests, medical checkups, and regular appointments with a midwife.

Prenatal care in Spain

You can purchase home pregnancy tests (pruebas de embarazo) for €10 from pharmacies and online for €7. You can also take a test at a local clinic (centro de asistencia primaria). After finding out you’re pregnant, you should contact a doctor or primary care center (Centro de Asistencia Primaria) to discuss your options. If you decide to keep the baby, they’ll assign you a midwife and you’ll start your routine prenatal care. In most hospitals, staff speak Spanish, so we advise you to have someone who knows Spanish to improve communication between you and your physicians.

Routine prenatal care in Spain includes:

• Monthly visits during the first trimesters (from the 1st week to the 32nd week)
• Once every 2 weeks, visits from the 32nd week to the 36th week of pregnancy
• At least 3 ultrasound visits

You’ll have regular blood and urine tests in addition to tests for diabetes, toxoplasmosis, and HIV. If you’re going to give birth in the public hospital, you’ll have a compulsory infection test for streptococcus B. It’s not mandatory but available upon request for those who opt to give birth in private hospitals. But the doctors strongly recommend the streptococcus B test to prevent passing infection to the baby during delivery.

Physicians also recommend the TDAP vaccine against tetanus, diphtheria, and pertussis (whooping cough) between weeks 27 and 36 of pregnancy.

Giving birth in Spain

When you’re in labor, enter the hospital from the emergency (urgencias) section. You’ll need to show your resident card, passport, NIE number, and national health system user’s card (tarjeta de usuario del Sistema National de Salud) at the reception.

While alternative treatments like water birth and home births aren’t commonly available, you can choose to have epidurals and pethidine. Having someone with you who speaks Spanish will also help you here so that you can have your preferred treatments during delivery.

Useful Spanish phrases during pregnancy

• Midwife: matrona
• Scan: ecografía
• Maternity scan ward: tocología2
• Epidural: epidural
• Giving birth: dar a luz
• Cesarean section: cesárea
• High-risk pregnancy: embarazo de riesgo
• Delivery room: paritorio
• Water breaking: romper aguas
• Newborn: recien nacido
• How many months pregnant: Estoy embarazada de x méses
• To breastfeed: dar el pecho
• Maternity and paternity leave in Spain: permiso de maternidad or baja maternal/paternal

Abortion and the morning-after pill

If you don’t want to risk pregnancy, you can get emergency contraception in Spain over the counter. You can buy the morning-after pill without a prescription at pharmacies with no-age restrictions.

If you find out you’re pregnant, you can legally have an abortion on request for up to 14 weeks in Spain. After this date, abortion is only permitted if the pregnancy is a serious health risk to the mother or foetus. Abortion is free at public hospitals as it’s covered by health insurance.

If you decide to have an abortion, there’s a 3 days reflection period from the day they request it until it’s performed.

However, hospitals can reject terminating the pregnancy on request by signing a conscientious objection (refusing to perform a legal role due to personal beliefs) of medical staff. While objection is less common in major cities like Barcelona and Madrid, it’s common in the autonomous communities of La Rioja and Castile y León.

Giving birth in Spain as an expat: Costs and insurance

With health insurance, you can give birth in public hospitals for free. However, if you want to give birth in a private hospital, you must pay from pocket or have private health insurance. Keep in mind that if you wish your private insurance covers the bills, you must obtain your private insurance 12 to 16 months before becoming pregnant.

European Health Insurance Card doesn’t cover maternity care in Spain for EU citizens legally residing in Spain. So if you’re resident in Spain with EHIC, you must apply for public or private health insurance if you don’t want to cover the costs yourself.

Alternatively, you can pay it yourself. Giving birth in Spain is affordable and will cost around €1,800 - €2,000 without insurance.

Private health insurance providers

Popular private health insurance providers in Spain are:

• Allianz Care
• Cigna Global
• Globality Health
• Sanitas
• AXA

Giving birth in Spain as a tourist

Tourists from EU countries who require obstetric care can obtain treatment in the public health care system by presenting a European Health Insurance Card.

If you’re from a non-EU country, you must have travel health insurance to be covered while traveling in Spain during pregnancy. Travel insurance will cover emergency birth, but depending on your provider, you might have to pay other costs yourself.

Since you’re not legally residing in Spain, your child will not become a Spanish citizen. However, there’re exceptions for children of diplomats and stateless parents.

Maternity and Paternity leave Spain

Anyone contributing to the social security system benefits from paid maternity/paternity leave and child benefits.

Maternity benefits include medical, prenatal, and postnatal care for pregnant women. Mothers also receive 100% of statutory base pay for 16 weeks of pregnancy leave. In addition, the benefit includes 2 daily paid half-hour breaks for mothers who breastfeed or express milk.

Social security also covers high-risk pregnancies due to work conditions by compensating 100% of the average wage.

In Spain, fathers have the right to benefit from paternity leave too. They’re entitled to 16 weeks of paid paternity leave with 100% of the base salary. They’ve to take the first 6 weeks of leave immediately after delivery.

Low-income families benefit from childcare up to €100 monthly for children under 3 years old, €70 between 3 and 6 years old, and €50 between 6 and 18.

Postnatal care and nurseries

After the birth, you’ll stay in the hospital for 5 days. Doctors and midwives will monitor the newborn's heart rate, breathing, and reflexes to assess its health. This is pretty much it when it comes to free postnatal care.

But there’re public and private nurseries to help with infant care after birth. Although this service isn't free in Spain, it’s still affordable. Most public nurseries are in Spanish, but you can find English-speaking private nurseries in international cities like Barcelona and Madrid.

Registering your baby’s birth

You’ll have 8 days after your baby’s birth to register the baby at the Civil Registry Office (Registro Civil). If there’s a complication, registration can be delayed for up to 30 days.

You’ll need to bring the following documents with you:

• The yellow form given by the hospital ( Cuestionario para la Declaración de Nacimiento en el Registro Civil) and signed by the physician that contains your baby’s name and birth date
• Health insurance
• Passports of parents
• Resident cards
• Marriage certificate. If you’re not married, both parents must be in the registry office.

Don’t forget to bring copies and translate all non-Spanish documents into Spanish.

Will my baby become a Spanish citizen?

If you’re a legal resident of Spain on a visa, your baby will automatically acquire the same residence authorization as you. But you must apply for Spanish residency as an under-aged child of legal residents. After 1 year of living in Spain with such a residence, you can then apply for Spanish citizenship on behalf of your child.

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