For love and money

This month has hit me hard with regard to the realities of being and independent worker or autonomo as they say here in Spain. For one reason or another I lost two clients and am now faced with a real difficult financial situation.In Spain there are few midwives if any covered by insurance and this is causing a lot of difficulty for us midwives and our clients. As the ‘crisis’ deepens, money becomes shorter and shorter. Goverment cuts have hit the one off maternity payment of 2000euros that was offered to all pregnant Spanish women and this financial loss has made it even more difficult for our clients to find the money to pay for our services.

I have a real issue with the fact that we are a private service anyway, but now the situation is worse. Good care, respect and dignity in pregnancy and birth should not depend on how much money you have, specially in Europe! Women pay as much taxes as men and in Spain there are actually more women then men in the country so they must really pay more, but their birth choices are limited to how much savings they can spend on private care, or simply take what is given from an over medicalized health care system.

This is, in my opinion, just bollocks!

I feel that good safe care based in the normality of birth respect and dignity should be available for all women every where and that women should have choice in their care provider and that this choice should not be based on how much money they have. But I am not naive and I know that there are many world problems that stop this from being a reality, but in a so called ‘first world’ country, there really should be choice in care.

I have been told that if independent midwives could pay the insurance companies here in Spain a monthly fee then they could be registered on their books. I had no idea this is how things worked here. I feel very uncomfortable with this idea but also feel that if we want to give more women choice we may have to do this to allow our services to be more widely available. Of course I don’t know where we will get the finances from to pay these fees but it could be possible.

I did not come into midwifery to be a business woman, I came into it to give loving care to women at this very special time of life, but at present, I guess like many people, I am spending much of my time trying to find a strategy to bring more clients into my clinic but not just because I feel passionate about a woman’s rights of choice in pregnancy and birth but also because I need to get paid. Honestly this is not a nice feeling but I guess one I will need to become accustomed to if I want to continue working in this way.

Hard times equal hard realizations and the hardest realizations are about ourselves and our surroundings.


  1. Hi!I've been reading your blog fron the shadows and I feel compelled to post today, although I'm afraid I can't be of much help…As a woman and hopefully someday future mom, I agree that the situation in Spain regarding birth care is (as you put it) bollocks!Working with insurers might be an option, although I get the feeling it won't be easy.I know most insurance company offer "pay-back" policies in where the client gets to choose any doctor, the client pays the doctor, and then mails the medical bill to the insurance company and the insurance company pays a % of the total cost. It's not a great solution either, but it might be a start and it might help some of your clients to be able to afford the birth they desire.


  2. Thanks for your feed back. I was thinking the same thing but have been told by my colleagues that as midwives we can not be insured on our own. We must work with a doctor or rather for a doctor to be insured. Its a shame, because I had thought that it could be a solution.


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