Midwife - Diana Kosmic
What is the "normal" procedure in terms of check up and scans for pregnant women in Spain ?
I think you are refering to the hospital based procedures in this question. The "normal" procedures here in Spain are very much based on the institution's protocol instead on the holistic and individual needs of the patient. There are mass screenings done without assesment for risk factors. Such is the plasma glucose testing, which here is sometimes done 3 times in pregnancy. In reality, this test is most accurate during a specific time period of the gestation, from 24-28 wks. It is unecessary to do this and other tests on someone that does not present risk factors.
When do women need to choose their hospitals?
Women can choose their hospital at any point of pregnancy, or even during labor.
Are they guaranteed a hospital of their choice or are they given a hospital as assigned by their gynecologist?
Usually women have a choice of hospitals, although not many doctors will inform them of that right. Usually their gynecologist who looks after them during pregnancy will not be at the delivery. The delivery staff will be whoever is on shift that day.
How do your midwifery services differ from the Spanish system?
My services are very different from the Spanish system. At the base of my care is the vision of the mom and baby being a wholistic and healthy unit. I believe that pregnancy and birth are natural proceses and not a state of illness. My care includes the whole family unit, mother, partner, baby, and other siblings. In my appointments I ask that the whole family joins in whenever possible. I offer continuity of care during pregnancy, birth, and post-partum; which allows the family and I to collaborate with trust and ease. I attend home-birth with the utmost respect for the intimacy and comfort a family needs through this process; meanwhile keeping a watchfull guard that everyone is safe and healthy. In the postpartum, I support the family through the transition, care for the mom and the baby, and support breastfeeding.
Why do you feel there is a need to offer alternative midwifery services in Spain ?
I think that alternatives to healthcare are important everywhere not just in Spain. People need to have choices when choosing their care, so they can find what best aligns with themselves. Midwifery care offers people a more holistic, intimate, natural, and trust-based care for their childbearing needs.
Do you think midwifery services are underdeveloped in Spain?
I think midwifery services in Spain need more fusion with the healthcare system. Right now there are midwives working in hospitals, but the system does not support them to work outside of the hospitals and clinics. Home-birth, or free standing birth centers are not supported by the healthcare system, so the independent midwives are working without fusion to the system or to each other (in most cases). Women that choose an independent midwife must also pay out-of-pocket, which narrows down the demographic of who has a real choice.
How accommodating are the Spanish public and private hospitals to natural births?
A few years back, the ministry of health noticed the "tendency" for natural birth and so they proposed that the hospitals offer "natural birth". Many hospitals since have drawn up a protocol and marketing strategy for this, but have not taken the most fundemental action; which is to train the hospital staff. Therefore, only a small porcentage of the professionals working in the hospital have the knowledge of or belief in natural birth. Nowadays, a patient might fill out an accomodating natural birth plan beforehand, but when getting to the hospital finds that the staff on shift is not at all aligned with the birth plan. It is almost like a lottery of who will be on shift and if those professionals that "toca" at that moment will respect the natural proceses of birth. Another common error is believing that a private hospital will be more understanding of the natural birth desires of the parents; when in fact private hospitals have an allarmingly higher rate of C-Sections and other interventions.
What advice would you give a woman looking for a natural birth in Spain?
I would advise women to research all of their choices and take a nautral birth preparation class which will help them understand better what they want and do not want in their birth.
From your experience, what are the main concerns of foreign mums-to-be preparing to have a baby in Spain?
I would say that some of the main concerns are: understanding how the system works here, finding a healthcare professional who will listen to their needs and answer their questions, finding a healthcare professional who understands their cultural and language needs, and undersatnding their patient's rights.
Many expectant mothers believe gynecologists in Spain are overly concerned with their weight during pregnancy, do you think that is justified?
I do not think it is justified to bully every woman about their weight gain. Again, this is another example of how the medical system does not have a holistic view of healthcare.
Do you offer post-natal care to foreign mothers, if so what does this encompass?
Postnatal care encompasses the wole transition process, amongst these are mom's physical recuperation, breastfeeding, normal baby care, emotional support, and fusion of family members. I do not oly offer it, but I insist on it.
Post-natal care is a service which many foreign mums complain is almost non-existent in Spain , why do you think this is?
Post-natal care is not integrated into the system because of the lack of the holistic care vision, and the low-generating funds. At this point, post-natal care is found through private means.
Do you believe there are an unnecessary number of C-sections performed here?
I do think there are unnecessary amounts of C-Sections and it is due to the unnecessary amounts of interventions during pregnancy and labor.
In what areas of pregnancy and birth do you believe Spain excels in?
Compared to other countries, Spain does recognise home-birth as legal even though the system does not do much to support it.
How do people find out about your services?
I can be contacted on kosmic_dz19@yahoo.com or onmy cell phone 637979498
(Nov 2011)
