How it is to be pregnant in Madeira, typical medical support on the island, and how women prepare to give birth – from my personal experience. Although this is not about travel in Madeira, this story may be interesting for those who think to move her e. Being local is about many things.
The news came in May 2019. One evening on my way back home from work, I bought a pregnancy test when my periods were pretty late. The test showed 3+ weeks. Is it real? Is our life about to change forever? Can the test be wrong? Will I be a mom? Tons of questions are passing in my head in a whirlpool.
After the first shock and thrill – a rationale comes. So what do I do about it all?
Registering with Maternity Service
I call my district public health center, Centro de Saude Bom Jesus. My logic is that they should guide me on what to do next.
Turns out, they have a Maternity Department, and a nice lady makes an appointment for me. As I already have Numero de Utente (patient’s number), registering is easy (to obtain one you need to be Portuguese or to have a residency). They give me a green book – Livro da Gravida which will have all my pregnancy tracked and I must always carry it with me.
Here I meet my family doctor who will follow my pregnancy. The rule is: as long as your pregnancy is fine, a family doctor can deal with it. In case of any pathology, you are transferred to the Nélio Mendonça Hospital where real obstetricians work and babies are born.
The doctor in Centro de Saude sees me every 4 weeks.
She gives me tasks: take tests, buy vitamins, do echography. Also, diet and behaviour advice: eat that, don’t eat that; don’t touch cat’s poop.
A curious thing: writing down my medical history, the doctor asks if my husband and I are blood relatives. Up until the 70s in Madeira, it was quite common to marry your cousins. Now – less so but the question in the form remains.
At the end of the first visit, the doctor puts me on a bed and touches my belly with something like a microphone connected to loudspeakers. Suddenly she catches what she is looking for: the baby’s heartbeat. So rapid!
This whole thing suddenly turns real.
I take blood and urine tests appointed by the doctor – right in the same Centro de Saude. Everything is covered by the government – free for me.
One of my friends had her pregnancy followed by a private doctor – and did analyses in a private hospital too, which cost her a fortune. I bet! She discovered the free option too late and regretted a lot.
Taking tests is annoying but I discover that pregnant women have a priority line, so at least the visits are not too long.
This – and also parking on priority areas in malls, are two things I am going to leverage all 9 months!
Bonus: If you are registered with a public health centre, they cover one visit to the dentist and the nutritionist. I didn’t use it – but you should.
It is an exam with ultrasound which shows fetus development on a screen.
Normally, during pregnancy, you do 3 echographies.
The first one tells your due date (data prevista do parto, DPP).
The second echography gives you the kid’s sex.
The third one is to make sure that everything is developing well.
The first echo is done in the Hospital for free. The two others must be organized by you in a private clinic where you need to pay. I did at Madeira Medical Center and got totally pissed at the service (“Oh you have an appointment now? The doctor will arrive in an hour. Would you like to wait? Oh yes, I know that an hour has already passed. Would you like to wait a bit more? Oh, I am sorry you had to leave your work 3 hours before and will need to work overtime tomorrow”). Another option – Hospital da Luz, they are ok and closer to my home.
Remember to take the referral from the doctor with 2 barcode stickers – from the medic and the establishment. With these two, the test will be cheaper for you. I am saying this because medical staff often forget to glue those stickers. So make sure to remind them. I overpaid a lot before I discovered it.
During the first echography at the hospital, they also check your blood to see if the baby has Down’s syndrome probability and other genetic conditions. With mom’s age, the chances grow.
How I am feeling
I feel dizzy before breakfast but never too bad to throw up. I don’t have any food whims – although often have this question asked.
I would often ask my mom how she felt during pregnancies because I seem to follow her pattern. And since she said she didn’t suffer too much I am tranquil.
When the sea is calm, we take a swim. My point is: Madeira is a good place for pregnancy. I am getting heavier every month. From 62 kg in April I get to weigh 76 kg in December. Swollen feet, cutting severely on salt, but generally keeping active till the end of the term.
At the health centre, you need to provide your vaccination chart. “Otherwise we assume you haven’t been vaccinated and treat you respectively”. I translate my vaccination chart into Portuguese myself, and a nurse takes time to compare it to the Portuguese chart and fill in a vaccination book for me. “Honey, it will take long. You don’t need to sit here. When it’s ready I will leave it somewhere for you”. Probably the first occasion when someone cares about my time as a patient.
The doctor notices I was missing one shot for pertussis, diphtheria and tetanus – so I take one around 32 weeks of pregnancy. The same month, they give me a flu shot because the baby is due in winter.
The health centre offers a free course to prepare for giving birth. I would attend it – but the timing is stupid: 10 am or 3 pm on workdays. And I still work full time.
Luckily, there is another centre which organizes birthing preparation and many services around – Centro Origem, a private one – which means you need to pay (70 euro per month). The course is once a week at after-work hours, but one class is 3 hours! Too long, as for me – especially after 8 hours at work. But I manage to attend a couple of classes. A nice part: twice a week they have classes in a swimming pool in a luxury hotel where you do exercises which should prepare you for giving birth – basically stretching legs and hearing a lot about your pelvis. And your partner can go with you. It’s already late autumn so it feels good to attend a swimming pool – also a bit reassuring that I do something about my pregnancy.
Gender reveal party
My mom hopes it’s a girl. She keeps asking me this question after we get the results of the second echography.
To remember this period, we invite our family for a gender reveal party.
It takes place 4000 km away but we are on a Skype call.
We had ordered a cake – which is gender-neutral on the top. That is: it has small edible dolls on the top – a boy and a girl. But when our guys cut the cake they see the layers and the cream – all pink.
It’s a girl!
You better know some Portuguese – because English is not widely spoken at the hospital. I engage in a conversation in Portuguese with a nurse at the public health centre. She pronounces every word in my face as if it will make it understandable. In a minute, she gets that my perception is quite ok (but forgets about it every new time that I come – so volume on again).
Nurse: “I tell foreign patients: Why would I speak English? I am not in the tourism business. Speak Portuguese or come with a translator”.
And then after a long pause.
“When I was young, about 17 years ago, I went to visit my cousin in London. One day I walked into a bakery and asked “Van kek” (“one cake”), and the baker asked “What?” and looked at me like an idiot. I repeated “Van kek!”. And he didn’t understand again. Was it so difficult? I had to call my cousin for help. Since then, I don’t like English people and English altogether”.
Maternity leave in Portugal can be 4 months with 100% of payment or 5 months with 83% of payment. You can also add 3 more months to your maternity leave and receive 25% of payment during the extension. The payment is your average salary over the last 6 months before baby birth.
Families receive governmental support for the baby and also a subsidy to support your parental leave. But you need to prepare the documents
– A certificate from the National bank stating that you have/don’t have a bank account (from you and partner)
– A certificate from your bank for Social Security, they definitely know the form (from you and partner)
– Latest IRS (from you and partner)
– Baby’s birth certificate.
Once submitted, the Social Security analyses your case quickly, and soon you receive money on your bank account.
Maternity Photo session
At the end of the 7th month, we did a pregnancy photoshoot. I usually keep away from such things but I really wanted to capture this precious moment. Who knows, if I am pregnant only once in my life, I want to remember how I looked and felt these days.
After my third echography, the doctor notices that the baby slowed down her growth. Not critically, but she orders one more echography to make sure everything is fine. And that fourth test shows that the baby flipped! Now she is with her head up! (which is totally wrong)
Such a position is called breech, and the problem is that natural birthing is almost impossible. Most probably, I am going to have a C-section.
The news comes as a shock, and I spend the next week totally depressed. But then I calm down: having a planned surgery is sometimes better than natural birthing – those can be a trauma, too! Curiously, statistic shows that if given a choice, Portuguese women opt for C-section even when there is no medical need for it.
At the preparation centre, I take a class called Spinning Babies – to be easier on myself when I know that I tried all means. They show exercises to ease birthing, and also some tricks which allegedly help babies flip inside. The positions are most awkward I’ve seen in my life, and they also suggest Chinese medicine of heating my little toe – which again allegedly helps babies to flip.
That’s not for me – so I calm down and embrace the future.
Now, thinking back I think I know when the baby flipped. At 7.5 months, we took a sailboat trip to the island of Porto Santo with friends. The sea was rough, and I was extremely seasick. Maybe the baby didn’t enjoy it either. Or maybe – as a local prejudice goes, the baby flipped because the mother was scared when the sail was touching water – so tilted the boat was. Now I understand it was a stupid thing to do – a sail adventure at such an advanced term.
But all is well what ends well, and I am eventually happy it was a C-section.
Start of Maternity Leave
When do you start your maternity leave? I didn’t hear any definite term. But I heard from my colleagues that women often try to take sick leave as early as possible.
I took mine 3 weeks before the birth date – although my doctor recommended it earlier because of the baby’s position and the C-section. I could not: needed to transfer my work to a colleague. And also didn’t want to stay at home – and overthink.
At the Maternity department, they give you a list of things to prepare for the hospital. It is recommended to have the bag ready at week 36.
The bag 3 sets of baby clothes, washed with baby-friendly detergent and ironed (I prepared 4 because with C-section you spend at hospital 1 day extra. However, if you expect regular visits of your family, you don’t need to take all things at once).
Baby diapers, towels, a blanket. Sanitary and hygienic things for yourself. At the hospital, turns out, you have many things provided for you.
But I am still pregnant, week 37, without the bag and the list makes me nervous. I almost have a breakdown thinking that my sweet little baby doesn’t have a blanket. To avoid a scandal, my husband takes me to a shop on the same day, and I buy 2.
Meeting the hospital
Here in Madeira, you can schedule a visit to the hospital – get familiar with the place, probably to know the routine and feel less stressed. I didn’t do it because I had a visit there to plan my C-section.
If your baby is in the breech position, the protocol in Madeira is only a C-section. On the continent, they can try a natural delivery but here on the island – only a surgery.
Planned C-sections are done on Wednesdays. Week 39 when I need to have it, Wednesday is overbooked. So they don’t tell me the date of the delivery until 3 days before. Finally, I am in the schedule. Tuesday, 17 December 2019.
I know my baby’s birthday before she is born.
One particular thing I am grateful to the preparation center about is recommending what to do before the delivery date. Go to a restaurant and enjoy a romantic dinner with your partner. Also don’t be afraid to have 1 glass of red wine, nurse’s words.
Which we did with my husband. Although it was Monday, not a traditional day for going out, we knew our life would never be the same, so we went to a nice steak house in Zona Velha in Funchal and enjoyed the dinner and wine. We remembered many sweet and funny stories from our 10 years together and took time to account for the changes to come.
On 17 December I went to the hospital.
Here’s my detailed report if you are curious about giving birth in Madeira.
Summary of being pregnant in Madeira
Summing up the pregnancy period, Madeira is a good place for this delicate time. Medical services are professional enough, and nature and people create a good ambient for you and your little one. Totally recommended!
Being pregnant in Madeira was so wholesome and full of events and emotions – I naturally can’t squeeze everything in one post. But if you want to know something particular, comment here or send me a message.