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If you're giving birth in a public hospital in Spain, you can usually request an epidural to relieve labor pain at no extra cost. It's administered by an anesthesiologist at the hospital and, barring any medical contraindications or logistical issues, is part of the standard childbirth care.
For many foreign women, the system may be unfamiliar, but you have the right to ask how pain relief is arranged at your healthcare facility during your pregnancy. Discuss this with your midwife and clearly state in your birth plan that you would like to receive an epidural, if possible.
Is epidural anesthesia always available in the public system?
Many Spanish public hospitals have anesthesiologists on call 24 hours a day to provide epidurals when possible, although availability may vary depending on the hospital and its workload. It is a widespread technique supported by the protocols of the National Health System.
Even so, no hospitalization can guarantee absolute availability: there may be times of high healthcare pressure, very rapid deliveries, or health problems of the mother or baby that make an epidural inadvisable.
That's why it's advisable to ask during your last prenatal visits how the anesthesia service works at the hospital where you're going to give birth.
At what point during childbirth is it administered?
Epidurals are most often administered during the active phase of labor, when contractions are regular and painful and the cervix is already dilated several centimeters. Many hospitals offer them starting at around 3 or 4 centimeters of dilation, provided labor is well established.
The procedure usually lasts only a few minutes. The anesthesiologist disinfects the lower back, applies a local anesthetic, and inserts a small catheter through which medication is administered throughout the delivery. You remain awake and can participate in the decisions, while the team monitors your blood pressure and the baby's well-being.
Is there a cost involved, or is it fully covered?
In the Spanish public system, epidural analgesia during childbirth is included in the portfolio of services, so women with a health card do not pay an additional cost to receive it.
Foreigners who are entitled to public assistance, whether by residence, agreement or European health card, have access to the same coverage and it is advisable to bring all documentation upon admission.
After you give birth, it is common for the medical team to suggest basic pain relief, like paracetamol or ibuprofen, to ease perineal or muscle pain, in line with hospital guidelines and your breastfeedingsituation. Do not take medicines or mix different drugs on your own initiative.
This content is for informational purposes only and may not reflect your hospital's protocols. The information is general and does not replace medical advice. Always consult your doctor before making any decisions.





