Pregnancy is, by far, one of the most amazing things I have done. The way my body naturally did what it was supposed to continues to fascinate me, four years after I became pregnant with my little boy. But while nature takes over, it’s important to get regular check-ups for both yours and your baby’s health during your 40-week odyssey and beyond. Read on to find the most common tests during pregnancy in Spain and their timing.
Spain’s healthcare system is tiered according to private and public offerings; what gets tricky is the public system according to where you live.
Depending on your level of coverage with private insurers, you may have a co-pay for visits, delivery, postpartum care and any blood tests or scans given. I chose to go strictly private for my second baby but found the care to be affordable and the physicians well-qualified; during my first pregnancy, I did a mix of private and public, with all scans, vaccines and tests administered through the public system.
Someone once told me that there is no best time to have children, but there is a best time to be pregnant. When my husband and I considered starting a family, it was extremely important that I felt able to handle the hormonal and physical changes that would happen to my body for the nine months and beyond.
I get yearly gynecology check-ups and was sure to have one before we began trying. Family planning can be important on many levels, but I wanted to speak to my doctor about the best way to prepare for pregnancy. Apart from prescribing me folic acid, the doctor asked me about my daily habits, including how often and with what intensity I exercised, my diet and food weaknesses (beer and potato chips!) and probed my stress level and the type of work I did. As a young, healthy woman with no chronic illness history in my family or my husband’s, I was considered low-risk.
The one piece of advice she had? It wasn’t to stop eating embutidos or to skip the cervecita entirely – it was to stop smoking! As I’m not a smoker, I didn't have to make significant changes to my diet, exercise plan or lifestyle.
My dentist was also paid a visit so that she could make sure I didn’t have cavities or need any work done ahead of becoming pregnant. Cavity free, I popped my folic acid instead of contraceptive pills and began waiting for the pregnancy to take.
Buying my pregnancy test at the pharmacy was weird. I suspected I could be pregnant but figured I’d wait for the tell-tale signs – aches and pains, morning sickness and no menstrual cycle. When none of the woes started, I had to purchase a kit over the counter.
Thus began the cycle of seemingly endless doctor visits for a normal, low-risk pregnancy.
While my American friends waited until the first semester passed to have their first scan, I first visited by GP in the public system, who assigned me to an OBGYN. I went monthly for a general check-up to check my weight gain, blood pressure, overall health and – the best part – have a scan to see the baby’s progress as he went from a small sac to a full-grown, 20-inch baby. I also had blood drawn to test my blood type and levels, as well as a urine test – all routine and meant to become very, very familiar.
During the first trimester, the tests seemed light and I felt well enough to continue my normal day-to-day activities like working out, working as a teacher and sleeping. If anything, my body asked for a bit more of a lie-in each morning.
Scans are also important to ensure a pregnancy will remain viable, predict a due date according to the baby’s size and development and determine how many embryos are in the uterus. At this critical stage, serious problems like ectopic pregnancy can occur, and the risk of miscarriage is highest.
At around 10 weeks, my doctor contacted me about an optional exam that was paid for and available by my local government, called a cribado. The cribado is a Spanish word that means “to rule out” so this blood test “rules out” an embryo’s risk of several chromosomal abnormalities, such as Down’s Syndrome, Edward’s Syndrome and even congenital heart defects by way of a sonogram. This test is typically done during the first nine to 14 weeks of a pregnancy.
Though most pregnant women usually report that they feel more energetic and less ill during second trimester, you will see an uptick in the number of times you see the doctor. The good news is that you will see the baby growing and moving with the abdominal scans, and you can usually find out the gender.
Apart from your scans and routine urine and blood exams, you’ll complete the following tests during pregnancy:
Gestational diabetes can be a concern for women because of diet, heredity or weight gain during pregnancy. Around week 24 (and ideally before week 28), you will be asked to do the curva de azúcar, which measure your glucose levels and how well your body processes sugars. First, you’ll have your blood drawn and immediately drink a few ounces of a sugar-rich drink. Blood is then drawn each hour for two to three hours to determine your body’s ability to break down the sugars and return to normal levels. I posed a low risk but still had to sit in the basement of a hospital for hours on end – and without having had breakfast!
As your delivery approaches (and your nesting instinct takes over), your exams will be more important and frequent. It seemed like I was at the doctor’s office every Monday morning for a check-up, scan and additional exam. My body was tired but, with the help of prenatal classes, I was beginning to feel more excited to meet the baby.
While one of the, ahem, most unpleasant tests in my experience, this anal swab determines whether you are positive for the bacteria that causes strep and meningitis, which can pass to your baby during delivery. If your exam comes back positive around week 35, you will be prescribed antibiotics prior to, and likely during, your delivery.
As your due date approaches and you begin to see the doctor weekly, you will likely be asked to do what’s known as monitores, or fetal heart monitoring. For at least 20 minutes, a heart monitor will be strapped to your stomach to measure both contraction intensity and the baby’s heart rate, which shows how a baby can handle the stress of contractions and, thus, passing through the various stages of labor. I did monitores each week from week 36 until the due date and took the results in for my doctor to see.
As I didn’t rule out an epidural for delivery, the OBGYN had me do an EKG test so that an anesthesiologist could measure how my body would react to the medicine. It ran the whole gamut – blowing into a tube to determine my lung capacity and various stress tests. This must be done around week 36 in the event you go into labor, unless determined by your healthcare provider.
Amniocentesis is a high-risk exam that can determine abnormalities in a pregnancy, usually when other tests have been inconclusive or the mother is 35 years or older on a first pregnancy. In Spain, they are not typical, but women may opt to do them if they consider themselves high-risk.
For a healthy pregnancy and vaginal delivery, I followed my OBGYN’s advice to pay attention to the signals my body gave me when it came to blood, bowels and bad feelings. I have gone back for a check-up at six weeks (known as the cuarentena, or the first 40 days after delivery), three months and one year – and then when I became pregnant with our second in late 2018.
Armed with the experience of already having a baby, I looked forward to impressing my healthcare providers with my more pointed questions – and sharing the experience with my older child, who tagged along to most of my appointments.
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