Maternity System in Andalusia: Second Trimester

Informed Choice and Medical Procedures

It is crucial to understand that all medical procedures during pregnancy – including ultrasounds, blood tests, screenings, vaccinations, and examinations – are entirely voluntary. While healthcare providers may recommend these tests, you have the absolute right to decline. 

Ultrasounds

In my first pregnancy I was so excited to see my baby for the first time! I had read that it´s not recommended to have too many ultrasounds and that you can decline them, so I thought i would just reduce them as must as possible. So I merged the 8 and 12 week one and that was it. I was looking forward so much to knowing the sex and preparing for the birth I didn't spend another thought on it. I wish I knew more about the ultrasounds back then. I would have made different decisions for sure.  

Ultrasounds, often portrayed as a harmless "preview" of your baby, are medical procedures with potential biological effects. Despite being commonplace, they involve exposing the developing fetus to sound waves and thermal energy. Medical guidelines recommend limiting ultrasounds to medically necessary situations, not routine entertainment or gender determination. Each test, no matter how routine it may seem, carries potential risks and side effects. Do not simply accept a doctor's assurance that a procedure is "safe and effective" – take the time to research independently, consult multiple sources, understand the potential consequences, and make an informed decision that you feel comfortable with.

Choosing to do or not to do the ultrasound is absolutely up to you and your partner. Your body, your baby, your choice.

Maternity care in the social healthcare system in Spain - second trimester

These are the prenatal visits that will be offered to you and what each visit will include:

Fifth Prenatal Visit - Weeks 16-18 (Midwife)

During this appointment, your medical history will be updated, and previous laboratory test results will be reviewed. A clinical examination will be conducted, including measurements of your weight, blood pressure, and uterine height.

If the first-trimester combined screening was incomplete, you'll be offered the Quadruple Test for congenital anomalies. This screening assesses the likelihood of Down syndrome, with a high-risk threshold of 1 in 150. The test involves:

• Analyzing maternal age
• Blood draw
• Precise measurement of fetal head circumference

Sixth Prenatal Visit - Weeks 19-21 (Obstetrician)

Gestational Diabetes Screening

• If previously diagnosed or at risk, you'll be offered an Oral Glucose Tolerance Test (OGTT)
• Otherwise, screening will be conducted between weeks 24-28

Vaccination Recommendations: two vaccines may be discussed:

1. Tdpa (Tetanus, Diphtheria, Pertussis): Recommended during pregnancy
2. Flu shot: May be offered simultaneously

Important when you are not getting tested on Hepatitis B

A special consideration concerning vaccines is that if you decide not to get tested for Hepatitis B during your pregnancy, your status when giving birth is unknown. In this case your baby will be treated as if you would be positive for Hepatitis B. This means:

• As a standard of care within 12-24 hours of birth, your baby may receive:
  • Hepatitis B vaccine
  • Anti-HB immunoglobulin

As with other medical procedures also this you can decline, but you have to be very clear about it. Check here the vacination schedule of Andalusia, by the Junta de Andalucía.

Important Vaccination considerations

While these vaccines are routinely recommended, it is crucial to approach them with a critical and informed mindset. Vaccination is not a one-size-fits-all medical decision. Consider carefully:

• What is the actual risk of the disease you're vaccinating against?
• Are you capable of naturally fighting off the illness?
• What are the potential short-term and long-term effects of introducing these vaccines into your body?
• Are you comfortable with the additives and foreign substances being introduced directly into your bloodstream?

Vaccines contain more than just the targeted pathogen – they include adjuvants, preservatives, and other substances that may raise questions. Take time to conduct thorough, independent research from multiple sources, including scientific studies, medical journals, and alternative health perspectives.

For those seeking additional information and resources about vaccination, I'm happy to provide guidance on books, documentaries, and research materials that can support your decision-making process. Feel free to reach out if you would like to explore this topic further and gather comprehensive information to make an informed choice.

Conclusion

Conclusion As with any medical recommendation, these procedures are guidelines. Your health and comfort are paramount. Always feel empowered to ask questions, seek clarification, and make decisions that you believe are best for you and your baby.

In this article I've shedded a light on the standard care offered to pregnant women in Spain and more specifically in Andalusia. While I've strived to provide clarity and accurate translations, it's important to note that there may be variations in care provided by different healthcare providers. This document is subject to change, the version I've referenced was updated on 03/06/2022. If you have any questions or concerns, I encourage you to reach out to your healthcare provider directly for clarification or check the document for yourself.

Next Steps: Stay tuned for my final article covering the third trimester of pregnancy in Andalusia!

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