A C-Section in Spain – An Expat’s Experience

Previously, I posted about going through the Spanish public health system during my pregnancy. Here, I’ll describe my actual delivery and hospital stay.

DAY OF ADMITTANCE, AUGUST 9:
Nate and I showed up at 8am at the Urgencias of the Materno hospital on Monday, August 9. We had the referral form (volante) but didn’t have an official appointment. I didn’t know if I’d be having my c-section that day, so we decided that I would fast the night before in case they would operate soon after I was admitted.

The nurse saw me right away and took my blood pressure. She then asked us to wait in the waiting area for the doctor. The doctor came at 9am, asked a couple of questions, then wrote out intake papers. She gave me an ultrasound and an internal exam. I was given a wristband, then sent upstairs to the High-Risk Pregnancy wing.

The matrona on this wing assigned me to a room with 3 beds. There was already someone there, in the middle bed, resting. This was at about 10:30am that I got settled into a room. Thankfully we had showed up at 8am, because the doctor on this wing was in our room doing his rounds within 30 minutes. He said he would schedule the c-section for either the following day or the day after that.

After lunch, he saw me again, this time in the office on that wing. He said he’d scheduled a c-section for the next day, but for the “second part.” This meant that I was scheduled, but if someone else needed to have an emergency c-section she would have precedence and I might not have a c-section after all. I was longing to be back in the US at this point, where they say, “Show up at 6am on Friday, January 21, and your operation will be at 8am.” The uncertainty of this culture, and the inability to plan anything concretely, was really exasperating to me this day, in this context.

Still, it was promising that a c-section was actually down on paper for the next day. We agreed I would also have a tubal ligation at the same time. The doctor gave me an ultrasound to make sure the baby was positioned correctly, and I signed consent forms for the tubal ligation and c-section. I also signed a form to donate my placenta for research. I’d never done that before!

The rest of the day was very quiet. They took my blood. I had a fetal monitoring session where I was hooked up to the machine and it recorded the baby’s heartbeat and any contractions. I took walks around the hospital with my roommate and chatted with some of the other pregnant ladies on the wing. I talked to Nate in the family waiting area, and the kids and Nate’s parents came to visit and we were able to hang out for an hour or so. My first roommate was discharged – she had been on this high-risk pregnancy wing for four days with severe anemia and her due date was still weeks away – but they gave me two new roommates to fill up the room. Today I had the strangest soup I’d ever had, too: chicken broth with chicken shreds and diced almonds.

I had to take off my nail polish, and fast after 12 midnight. Then to bed.

DAY OF SURGERY, AUGUST 10:
A nurse came in at 7am and administered an enema, something I’d never had with any of the other three c-sections. I was dreading it but it wasn’t too bad. And it made my post-operation recovery better – going to the bathroom post-op this time was the easiest of my four c-sections. After my enema, I had to take a shower and change into an operating gown.

At 8:45, three nurses descended. One gave me an IV and the other two put in a catheter. They also put on a hat and some paper socks. Nate showed up at 9am right as they were wheeling me down to the operating area. Here, no one except the patient is allowed in the operating rooms, so Nate had to stay out in the waiting area. It would be the first time that he wouldn’t be present for the birth of a new baby.

Right before they wheeled me into the operating room, the surgeon introduced herself and felt my tummy to make sure the baby was good to go. I also heard a familiar, friendly voice – the anesthesiologist that I’d met a couple of weeks ago. I had had to remove my glasses and give them to Nate, but when the anesthesiologist tried to introduce herself to me and realized I couldn’t see her well enough to recognize her, she went out to Nate and got my glasses so I could see the baby when he was born.

At 9:15, it was time to go into the operating room. The anesthesiologist put in the spinal block, and after a few seconds it was time to lie back down. They strapped my arms down so that I looked like a big T and started to swab my tummy. Then they started the c-section.

As always, I started getting shivery and cold. The anesthesiologist was fabulous, trying to make conversation with me. She wanted to know where we lived in the US and how we liked Spain. It was hard to talk through my chattering teeth, but she was so sweet to try to take my mind off of things. She even told me that everyone in the operating room was female – the surgeon, the pediatrician, the nurses, and herself. It was great to have her at my head, especially since Nate wasn’t there.

After a while the surgeons were pushing and pulling. It seemed to take a really long time before the baby was born this time, probably because of the scar tissue from the previous c-sections. Finally, at 9:50, the anesthesiologist said, “Oh, I see the baby! Here it comes!” and I heard the baby’s high-pitched scream. They cleaned him up, and the anesthesiologist unstrapped my arms “so you can touch him, because right now it looks just like you’re crucified” and while we waited for the baby to come over to us, she held my hands crossed over my chest so I wouldn’t reach down to the places on which they were operating. Then they brought over the baby, all clean and bundled up. I got to touch him a bit, albeit awkwardly, and they even lowered him to me and told me to kiss him – THAT was funny – and then they took him away, presumably upstairs to the nursery. The anesthesiologist then strapped down my arms again.

Then – and this was the second-best part of the c-section (the best part was, of course, meeting the baby) – she gave me a drug through my IV line to help me relax. She said it would be like sitting in front of the TV after eating lunch and dozing off. She told me to close my eyes. And the next 20 – 30 minutes flew by as I “napped.” I say this was one of the best parts because during my US c-sections, this stretch was always the worst – the baby would be out and they’d be sewing me back up, and I would be so cold and shivery and just longing to get the surgery over with. Whereas this time, I napped through that entire part.

Finally, the anesthesiologist told me to wake up, that we were almost done. They lowered the curtain and I could see, in the overhead lamp, a line of staples and what looked like a tube of blood. I watched as they put bandages over the incision. The nurse that had wheeled me in came back to wheel me out, and together everyone moved me from the operating table onto the bed, and then we left. We passed by the doors that led to the waiting area, and the anesthesiologist called Nate to come over. She told him that I would now go into the recovery room, and that I’d be there for about 2 hours, so if he wanted to go get a coffee he’d have plenty of time.

RECOVERY ROOM:
Here, I started feeling my contracting uterus and my legs again. They gave me morphine for my pain through my IV, and I was able to rest for about two hours.

At the end of my time here, I started to feel extremely nauseous. A nurse came in to wheel me up to the room, and on the journey I totally heaved and puked. He said it was from the morphine and the anesthesia. It also might have been because I had forgotten to fast from all food and drink after midnight the night before and had had about 3 sips of water over the course of the night. My incision hurt badly every time I heaved but I was relieved when he said I wasn’t damaging it. You may know how much it hurts to cough, sneeze, and laugh after a c-section, and heaving right after the c-section was very painful.

Anyway, Nate met us and we went to the room, where my roommate, her husband, and her new baby were already in residence. Nate had already dropped off my stuff earlier during his two hours of waiting so everything was ready. He also had needed to go in search of the new baby; he hadn’t seen him at all after an hour or so and he finally asked someone, “My wife had her c-section a while ago and I still haven’t seen the baby.” “Oh!” she’d said, “Go up to the fourth floor and ask there.” So he’d gone up to the maternity ward and found a nice nurse who’d shown him the baby. (One thing we’re realizing while we live here is just how much initiative you have to take!)

Here’s the room I was in. I took the picture on the day we were discharged:

IMG_1462

Over the next few hours I rested. I still had in my IV, catheter, and – this was completely new to me – a tube coming out directly from my uterus. It was a “closed wound drain” and it was draining the blood from my uterus into a bag so that the nurses could measure my bleeding. It was crazy to see this tube coming straight out of my bandage and into a bag that I would have to hold every time I wanted to take a walk around the maternity wing on subsequent days.

Nate drove home and picked up the other kids and his parents and they all came to visit. Visiting hours were very loose, which was nice. Sometimes the nurses needed to do a procedure and they would kick out the visitors from the room and have them wait outside, but for the most part people could visit at any time, and husbands could stay overnight. The rooms weren’t all that cozy, though – the husbands had to sleep in uncomfortable recliner chairs. The rest of the room had two other upright chairs and a bathroom that had a shower with no curtain.

Twelve hours after my surgery, at around 10pm, two nurses came in to help me out of bed and into a chair. It went very smoothly, especially with all the maneuvering of tubes and such. They took out my IV line but left the needle in. They also brought me some food: yogurt and some cookies, and a glass of Cola-Cao (this kind of snack would’ve been unheard of in the US after a c-section, but if you’ve lived in Spain for a while I’m sure you’re not surprised).

P1010806

They also gave me my first dose of pills. Every eight hours I took 500 mg of Paracetamol (like Vicodin) and then every eight hours I took 25 mg of something called Enantyum.

We hadn’t been planning for Nate to stay overnight, so he left to go sleep at home. I sent the baby to the nursery, and then tried to get some sleep.

AUGUST 11 – 15, POST-OP DAYS:
Each morning, a nurse came in at around 8:30 to take my blood pressure and give me a thermometer. Another nurse came in and took the baby to give him a bath. They took my blood again the first morning after the operation, and later they took out the IV needle. They also removed the catheter the day after the operation. They took out the uterine drain three days after the operation.

Instead of wrapping ankle squeezers around my legs like they did in the US, here they gave me anti-coagulant shots for three days in a row. These shots were horrible. They did the job and prevented blood clots, but they were painful and caused huge bruises on my arms.

Every day, a different doctor visited all of the patients on the maternity wing to see how we were doing. I was wondering if I’d see the surgeon who performed my c-section, but I never did see her again.

Back in the US, in the hospital where I had our older three kids, the policy was that all of the nurses on the maternity wing be female. Here, there was no such policy and it was common for the nursery nurses on duty to be male. These men were also lactation consultants.

I had met some of the other moms already on the high-risk pregnancy ward, and it was fun to now be on the maternity ward together. I enjoyed meeting everyone else’s babies and talking about how our labors and deliveries had been. It was like our own little community.

FOOD:
Breakfast was usually served at 9:15, comida was around 1:30pm, merienda was around 4:30pm, and dinner was around 8pm. For breakfast every day, we got a bowl of hot milk, an envelope of coffee, orange juice, a bread roll, cookies, some butter, and some membrillo. This was also what we got for 4pm merienda every afternoon, except for the juice and membrillo.

Comida was usually a bowl of soup; chicken, beef, or fish; potatoes or rice; and canned fruit. Dinner was the same. After the first couple of days, I got to choose the dishes I wanted from a menu. 

THE NURSERY:
If we wanted to send the baby to the nursery, we weren’t allowed to wheel the baby there ourselves. Instead, we had to page the front desk and ask them to send someone from the nursery to our room to come and get the baby. Usually, they would come in and pick the baby up, carrying him to the nursery. Sometimes they would wheel the baby out in his bassinet, but most of the time they carried him down the hall in their arms.

Nate and I didn’t know this, but we were only allowed to send the baby to the nursery at night for two nights, and then after that we were on our own with him for the remaining three nights of our hospital stay. No one told us this until the third night, and we hadn’t planned on Nate staying overnight that night (he hadn’t stayed overnight yet, because there was only the recliner to sleep in), so it caused quite a stir when we informed one of the nurses that we’d be sending the baby to the nursery once Nate left for the evening since I was on my own. Five minutes later, her co-worker stormed into our room and informed us that it was now the third night and the baby couldn’t be in the nursery. She said that we had to learn how to take care of him, otherwise what in the world were we going to do when we went home?! She was very rude and annoyed that she even had to tell us all of this. Which, of course, was very frustrating – no one had told us the expectations for nursery use until today.

I started to panic because I knew I couldn’t yet take care of the baby alone (I couldn’t yet lift him out of his bassinet easily). We explained that we hadn’t known about the nursery rules until today and that I’d be alone because Nate couldn’t stay overnight. She said fine, they would take the baby tonight because I was alone, but the subsequent nights we couldn’t put him in. After she left I had a good cry, mostly because she had been so rude about it all.

DOCUMENTS:
In the US, the nurses gave us everything we needed to apply for the baby’s birth certificate. Ignorant as we were, we thought the nurses here would do the same thing. It turned out that we were supposed to have taken the initiative and gone to the Registro Civil to pick up the necessary documents before being admitted to the hospital. We didn’t know this until the day my roommate left, when her husband passed us an extra copy of the papers. We had to fill them out and submit them to the hospital receptionist, who then passed them along to the doctor on duty to complete and sign. Nate had to return to the hospital a couple of days later (the baby and I had gone home by then) to pick up the completed document and then drop it off at the Registro Civil. The first Registro Civil office he went to was not the right one; he had to find the one that specialized in births.

The nurses did give us the necessary documents to apply for the baby’s health card, but these ended up being the wrong ones. Since we were foreigners, we actually needed to apply for his NIE first, then with that number apply for an individual número de Seguridad Social for him.

DAY OF DISCHARGE:
My c-section had been on a Tuesday, and I was discharged the following Sunday. A doctor came around to the room at around 1pm, but we had to wait for a couple of hours before the pediatric doctor came to discharge the baby, and we finally left at around 3:30pm. I had instructions to visit the matrona after 40 days. The hospital didn’t prescribe any painkillers for me; instead, Nate went to the pharmacy and bought a box of over-the-counter paracetamol.

And…that’s it! We had navigated the Spanish maternity system from beginning to end, and it had only driven me to tears twice! For the most part, the doctors and nurses that I met were wonderful – they were kind, relaxed, and knew exactly what they were doing. I really appreciated the care we received, and couldn’t believe that it was all for free. The best part, of course, was finally bringing the baby home, but while we were under the care of the Spanish system, it was a good place to be.

THINGS TO BRING:

These are the things I found helpful to have in the hospital:

* Mom’s clothing:
– Robe
– Socks
– Slippers
– Nursing bras or camisoles to wear under the hospital gown
– Nursing pads
– Disposable mesh underwear (found at Alcampo or Carrefour in the maternity section – the hospital provided me with one pair and that’s it)

* Toiletries:
– Toothbrush, toothpaste, contact lenses and solution, glasses, brush, comb, nail clippers, shampoo. The hospital provided soap and disposable soap-filled sponges.

* Nursing Accessories:
– Boppy (or other nursing pillow)
– Nursing cover (I used this quite a bit since the husband of my roommate, their visitors, and our visitors were always around). My friend sent me a Bebé Au Lait cover and I loved it.

* Electronics:
– Camera
– Cell Phone and charger (the hospital had a phone in the room but you had to pay for it by buying a card in the lobby)
– Laptop and charger (I brought my laptop so I could watch movies and sporadically check the Internet – the hopsital room had a TV but again, you had to pay for it)

* Medical file

Going-home outfit for the baby

Congratulations if you’re about to have a baby here in Spain!! Please let me know if you have any questions. Leave a comment or email me at faith (at) thesweetroad (dot) com.

 

 

This entry was posted in Cultures, European Living, Kids, Life in La Coruña, Marriage and Parenting, Spain, This Immigrant Life. Bookmark the permalink.
  • Charlotte Brown

    I’m not sure exactly why I find this so fascinating. . . maybe because I had a c-section, or maybe because I love anyone’s story of anything, or maybe because I’m nosy! Not sure. : ) I’ve never faced medical care overseas, or really even thought of what it would be like to be accustomed to one system, but have to experience everything in another. I thought it was interesting the time differences in meals! It always seemed to me that breakfast came way earlier than I wanted it. However, there seems to be a new trend at US hospitals where you have your own menu,and you can call any time to get what you want delivered, sort of like room service in a hotel. At least that is the way it was for my mom over the summer, and my son last month. At the children’s hospital where my son had his surgery they even let the parents order off the menu! We did have to pay in cash, though. Anyway, thanks for sharing your story!

  • Lisa

    Hi, thanks for posting all this info. I live in Spain (I’m from the UK) and due to my age a cesearean will be arranged for me, so knowing what goes on gives me heads up!

    • TheSweetRoad

      So glad you found it helpful, Lisa! Where do you live in Spain? (If you want to share the city with me in private, you can email faith@thesweetroad.com) Best wishes through the rest of your pregnancy and delivery!

      • BettyUK

        I am shocked that they strapped your arms down.
        This is absolutely not done at all here in the UK where I am from. Here in the UK this has never been done so I don’t understand why this is happening in many other counties including America.
        Also here in the UK they don’t do C Sections because you are an older mom. Lisa would be better of staying here in the UK to have her baby.
        From what I heard about Spain it is still a third word county when it comes to hospital care.