First trimester guide to maternity care in Spain

Published on 11 October 2026 at 12:52

updated with newest sources and information 11-10-2026

Finding out you are pregnant is an exciting moment, but it can also bring up lots of questions. If you live in Spain, especially if you are unfamiliar with the healthcare system or don't speak Spanish fluently, you might wonder what happens next.

Pregnancy care is organised by Spain's autonomous communities, so appointment schedules and some procedures can vary slightly depending on where you live. However, the overall structure of routine maternity care is broadly similar throughout the country.

In this guide, I explain how pregnancy care is organised in the public healthcare system, what to expect during your first-trimester appointments and which choices you have along the way. The schedule is based on official guidance from the Andalusian Health Service (Servicio Andaluz de Salud, SAS), where I live, and serves as a general guide for expectant parents elsewhere in Spain.

How is maternity care arranged in Spain?

If you are eligible for public healthcare in Spain, you can receive pregnancy care through the public healthcare system. In Andalusia, care is shared between primary care services, such as your local health centre (centro de salud), and hospital-based maternity services.

Your first point of contact will usually be your local health centre. Depending on the stage of your pregnancy and the arrangements in your area, you may see a family doctor, midwife or another healthcare professional. You may also be referred to the hospital maternity team for specific appointments, scans or tests.

The usual schedule includes regular check-ups throughout pregnancy. In an uncomplicated pregnancy, appointments are generally around every 4 weeks until week 32, and then every 2 weeks as you get closer to your due date. The exact timing may vary depending on your care provider, the regional protocol and your individual circumstances.

If you're still deciding between public and private maternity care in Spain, read my article on how to choose the right maternity care for you.

Can I choose private maternity care instead?

Yes. Depending on your circumstances, you may choose public or private care, or use a combination of both.

If you have private health insurance, check exactly what your policy covers before booking appointments. Many policies have a waiting period before maternity care is covered, and coverage can depend on the doctor, midwife, clinic, test or scan you choose. The waiting period for the birth to be covered is typically between 6 to 9 months. Although there are some expat insurance that uphold different policies, so it is worth checking that out when you consider private insurance.

Another option is to pay for individual appointments, tests or scans yourself. Most insurers have a network of healthcare providers they work with. If you choose a provider outside that network (for instance because you like them better), you probably have to pay the costs yourself. There are providers that solely offer appointments on a self-pay basis or a combination of some insurances, but not all. Therefore it can be smart to check your policy and confirm the costs with the provider before making an appointment.

Whichever healthcare provider you choose keep in mind that, public or private, you do not have to accept every appointment, ultrasound, test, scan or procedure offered to you. Recommendations are there to inform you and support your care, but you have the right to ask questions and make informed decisions about the care you receive.

Spain's public healthcare system is said to provide high-quality medical care, but workload pressures can mean that appointments feel rushed and there is less time for questions. Private care may offer more time with your doctor, depending on the provider. However, research shows that intervention rates, particularly caesarean rates, are generally higher in private hospitals than in public hospitals in Spain, although rates vary between regions and hospitals. This is worth considering when choosing where to give birth. For more detail, read my article on how to choose between public and private maternity care in Spain.

What happens during the first trimester?

In most autonomous communities, the guidance recommends contacting the healthcare system as soon as possible after a positive pregnancy test, preferably during the first eight weeks of pregnancy. The initial assessment and subsequent appointments are then arranged according to the regional care pathway.

The table below gives you an overview of the usual appointment schedule, based on guidance from the Andalusian Health Service (Servicio Andaluz de Salud, SAS). Although timings and some procedures may vary slightly between autonomous communities, the overall structure of maternity care is broadly similar across Spain. This schedule should therefore give you a useful idea of what to expect, even if you live elsewhere in the country.

The weeks shown are approximate and are counted from the first day of your last menstrual period.

Pregnancy week	Appointment or test	What to expect
As soon as possible, preferably before week 8	Initial contact with your health centre	Your pregnancy is recorded, your initial needs are considered, and the next appointment is arranged. You can discuss any symptoms or concerns and ask about supplements and medication.
Around weeks 8–10	Initial prenatal assessment	Your medical and pregnancy history is reviewed. Your blood pressure, weight and other aspects of your health may be assessed. Your care team considers whether you need any additional monitoring.
Preferably weeks 9–11	Blood and urine tests	These may include a blood count, blood group and Rh factor, blood glucose, urine testing and screening for certain infections. Additional tests depend on your circumstances.
Weeks 11–13+6	First-trimester ultrasound and screening, if you choose it	An ultrasound can help establish the pregnancy's gestational age, estimate the due date, identify a multiple pregnancy and confirm cardiac activity. Combined screening can assess the likelihood of certain chromosomal conditions.
During the first trimester	Dental assessment	Andalusian guidance recommends at least one dental visit during the first trimester to assess oral health and discuss any treatment needed.

This table summarises the Andalusian care pathway. The order, timing and organisation of appointments may differ in other autonomous communities, and your individual care plan may be different.

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photo of the book cover for connecting with your baby in the first 20 weeks of pregnancy

First pregnancy appointment: weeks 6–10 of pregnancy

Your first contact with the healthcare system is an opportunity to confirm the next steps and discuss your needs. The subsequent prenatal assessment is more detailed.

Your healthcare professional will usually ask about your medical history, previous pregnancies, family history, medication, supplements and allergies. They may also ask about your general wellbeing, lifestyle, support network and any concerns you have about the pregnancy.

Your blood pressure and weight may be checked, and your care team will consider whether any factors mean you need additional care or monitoring.

You should also have an opportunity to discuss any symptoms, ask questions and find out which appointments and tests are recommended next.

Blood and urine tests around weeks 9–10 of pregnancy

Blood and urine tests are generally arranged around weeks 9–10, according to the regional schedule. These tests help assess your health and screen for certain conditions that may affect your pregnancy.

Your pregnancy details are recorded in the Documento de Salud de la Embarazada, the pregnancy health record used in Andalusia. In Valencia this is called Cartilla del Embarazo and in Galicia Libro de salud de la embarazada (Galician: Libro de saúde da embarazada) and the Balearic islands refer to it as documento de salud de la embarazada. To give you an idea what to look out for more or less when you want to refer to this document or ask for your information.

During this appointment you can also discuss supplements, healthy habits, vaccinations and any questions or concerns you have with your healthcare professional. It is worth asking questions and looking critically at the recommendations you receive. Why is something recommended? What are its potential health benefits and side effects? Is there good-quality research supporting its effectiveness and safety?

Take supplements, for example. There is currently a lot of information online about folic acid, including discussions about the differences between folic acid and its active form, and the potential benefits and downsides of each. The ingredients used in supplements are also being questioned, including whether some might have unwanted effects.

These are valid questions to raise with your healthcare professional. You don't have to accept a recommendation without understanding why it is being made. Ask for the evidence behind it and discuss any concerns you have before deciding what is right for you.

First prenatal apointment in pregnancy doctor and patient

Follow-up appointment: around weeks 11–13

Around week 12, you will usually have an appointment with an obstetrician or the hospital maternity team for your first-trimester ultrasound and screening, if you choose to have them.

The ultrasound can help establish how far along the pregnancy is, check whether you are expecting one baby or more, and assess early development. The combined screening test uses information from the ultrasound, blood tests and other factors to estimate the likelihood of certain chromosomal conditions.

Your healthcare professional should explain what the screening involves and what the results could mean. Screening estimates likelihood rather than confirming a diagnosis. If the result indicates an increased likelihood, further tests may be discussed.

At this appointment, your care team will also review your pregnancy record, check your general health and consider whether you need any additional monitoring.

What happens if a test result needs follow-up?

If a result is outside the expected range or suggests a possible concern, your healthcare professional should explain what it means and whether further tests or a specialist appointment are recommended. An unusual screening result does not necessarily mean that your baby has a condition.

You can always choose not to have further testing. Before deciding, consider whether the results would make a difference to your choices and discuss the potential benefits and downsides with your healthcare professional.

For more information about prenatal tests, their benefits and limitations, and the choices available to you, read my article on prenatal tests, scans and screening in Spain.

Preparing for the next trimester

Your pregnancy care continues after the first-trimester screening. In Andalusia, the next routine assessments are generally around weeks 16 and 20. The week-16 appointment includes a review of your test results and a check of your health and pregnancy progress. The week-20 appointment usually includes the second-trimester ultrasound, which looks in more detail at the baby's anatomy.

Your own schedule may differ depending on your region, the results of earlier tests and your individual circumstances.

Tests, scans and high-risk pregnancy classification

During pregnancy, you will be offered various tests, scans and other procedures. These can provide information about your health and your baby's development, and help identify situations where additional monitoring or care may be recommended.

It is worth taking the time to understand what each test or procedure is for and what its results might mean for you.

You can ask questions such as:

Why is this test or scan being offered to me?
What can it tell me, and what are its limitations?
What are the potential benefits and disadvantages?
What would happen if I decided not to have it?
Are there alternatives?
Would it change anything for me (terminate pregnancy, feel more/less stress)
If the first test is done, would I also do the tests that come after?

What does a high-risk pregnancy mean?

During your prenatal appointments, your healthcare team will assess your pregnancy for factors that may increase the risk of complications. This assessment helps determine whether additional monitoring, specialist care or a different follow-up schedule is recommended.

If your pregnancy is considered high-risk, ask what this means in your particular situation. Which factors have led to this assessment? What additional monitoring is recommended, and what are the potential benefits and disadvantages?

A high-risk classification does not automatically mean that something will go wrong. It means that certain factors may require closer monitoring or additional care.

Understanding the reasons behind a recommendation helps you take an active role in decisions about your care.

What's next?

Knowing what to expect during your first trimester can help you feel more prepared for pregnancy care in Spain. As your pregnancy progresses, you'll have further appointments and tests to help monitor your health and your baby's development.

Continue reading my guide to maternity care during the second trimester in Spain to find out what to expect next.

You can contact your local health centre (centro de salud) as soon as possible after a positive pregnancy test. In Andalusia, the guidance recommends making contact preferably within the first eight weeks of pregnancy. Your healthcare team will arrange your initial assessment and explain the next steps according to the regional pregnancy care pathway.

English-language pregnancy care is not guaranteed, particularly in the public healthcare system. Availability depends on your location, healthcare centre and individual professionals. Ask your health centre or hospital whether English-language support is available. It can also help to prepare your questions in advance and bring someone you trust for support, if you wish.

Yes, it may be possible, but access and costs depend on your circumstances. If you are visiting from another European country and have a European Health Insurance Card (EHIC), medically necessary pregnancy care during your temporary stay may be covered, including childbirth. The EHIC does not cover travelling to Spain specifically to give birth without the required authorisation.

If you are visiting from outside the EU, check your travel or health insurance and contact the local public health service to ask about your options. Spanish regulations also provide routes to public pregnancy, childbirth and postpartum care for certain foreign nationals without legal residence, but eligibility conditions apply. Do not assume that all routine appointments will be covered automatically.

The overall structure of routine pregnancy care is broadly similar across Spain, but each autonomous community has its own healthcare protocols. Appointment schedules, screening procedures and some aspects of care may vary by region. This guide uses guidance from the Andalusian Health Service (SAS), so check with your local health centre for the exact schedule where you live.

Contact your new local health centre or maternity care provider as soon as possible so your pregnancy care can continue. Bring your pregnancy health record, test results, scan reports and details of any treatment or follow-up already arranged. Ask which appointments or screenings are due next, as the schedule and procedures may differ between regions.

Yes, if you are entitled to public healthcare in Spain or have private health insurance, from before you got pregnant, that covers maternity care. If neither applies, your options will depend on your personal circumstances, so check with your regional health service about access to public care. If you have private insurance, check whether pregnancy and birth are covered and whether waiting periods or exclusions apply.