The Ultimate Guide to Giving Birth In Portugal Part 1

Healthcare System and Prenatal Care

Decoding Portuguese Healthcare

Two Paths: SNS vs. Private

In Portugal, there are two options when it comes to healthcare. You can enroll in public health care, Serviço Nacional de Saúde (SNS), or private healthcare.

Public Health Care is available to all residents of Portugal. EU citizens can access services through the European Health Insurance Card, or you can register for SNS once you become a resident. If you are not an EU citizen, you can still register for SNS if you are a legal resident. You will have to register at a local health center with your Número de Utente.

Public Healthcare covers all maternity and pediatric visits with little to no cost to you. While some doctors’ emergency room visits can cost you a small fee, most maternity and pediatric appointments are completely free.

Steps to register for SNS

1. Obtain your residence permit

2. Get your NIF

3. Register at your local Junta de Freguesia or health center

4. Receive your Número de Utente

After that, you will be assigned a family doctor who can help you find obstetric care.

Private healthcare, while sometimes pricier, has some benefits. Private healthcare facilities are more likely to speak English and will provide you will specialize care in a more timely manner.

Most immigrants choose a hybrid system, opting for private and public care.

Finding Your Team

In many English-speaking countries, the obstetrician is the primary point of contact for prenatal care. In Portugal, the pathway is slightly different, especially if you use the public SNS system.

Role	Focus of Care	Where they are found
Médico de Família (Family Doctor)	Primary Prenatal Care (SNS): In the public system, your family doctor at the Centro de Saúde (Health Center) often handles routine pregnancy check-ups, monitoring, and referrals. They are your gatekeeper for the public system.	Public Centro de Saúde (requires Número de Utente).
Obstetra (Obstetrician)	Specialized/Delivery Care (Private/Public): They manage high-risk pregnancies, perform c-sections, and are typically the doctor who attends your birth (especially in private hospitals). If you choose the private route, the Obstetra is your primary contact.	Private clinics/hospitals or referral from your Family Doctor in the SNS.
Enfermeiro(a) (Nurse/Midwife)	Day-to-day Support: Nurses and midwives play a very active role, especially in the Centro de Saúde, providing education, blood work, and health monitoring throughout your pregnancy.	Public Centro de Saúde and maternity units.

In other words, if you choose the SNS system, your family doctor is your starting point of care, rather than an obstetrician. If you choose private care, you will see an obstetrician right away.

Finding the Right English-Speaking Providers:

If you’re worried about finding an English-speaking healthcare team, know that it is possible! When searching for a provider, focus your efforts on these recourses:

1. Private Hospital Directories: the easiest way to find English-speakers is to look at major private hospital websites in your region (such as Hospital da Luz or CUF hospitals in Lisbon). They usually have a filter or an icon on their doctor profiles indicating which languages they speak.

2. Expat Facebook Groups: search active local groups for recurring recommendations or ask specific questions yourself. It’s a great way to get information and build community at the same time.

3. Use the Right Search Terms: (fala inglês: speaks English)

Obstetrician: Obstetra em Lisboa que fala inglês

Pediatrician: Pediatra em Cascais que fala inglês

Midwife: Enfermeira parteira em Lisboa

Prenatal Care Differences

So now that you have your care team, how often can you expect to see them over the course of your pregnancy, and what can you expect to do at these appointments?

Whether you are in the public or private systems, the frequency and content of the prenatal visits follow a similar system outlined by the Portuguese Directorate-General of Health.

Gestational Period	Approximate Appointment Frequency
Up to 30 Weeks	Every 4-6 weeks
30 to 36 Weeks	Every 2-3 weeks
36 Weeks to Birth	Every 1-2 weeks (weekly)

It follows a similar format to other English-speaking countries so it should be familiar to you. At these appointments the healthcare professionals will closely monitor things like your health, weight, blood pressure, and the development of the fetus.

Ultrasound Schedule:

In Portugal, you will usually undergo three prenatal scans.

1. First Trimester Ultrasound 11-14 weeks: this confirms the gestational age, checks fetal viability, and screens for any potential chromosomal abnormalities. This can be combined with a biological screening (blood test)

2. Second Trimester Ultrasound 18-24 weeks: comparable to anatomy scans in other English-speaking countries, this is a detailed scan that checks the baby’s anatomy and growth to ensure it is growing in a healthy way. They will also check the position of the placenta, and screen for things like pre-eclampsia (blood test).

3. Third Trimester Ultrasound 32 weeks: This ultrasound checks fetal growth again, fluid levels, and the final positioning to estimate the baby’s weight as you near full term.

Your healthcare professional will also offer other routine tests throughout your pregnancy.

Gestational Period	Screening Tests	What they screen for
First Trimester	CBC, Blood Type, Rubella, HIV, Hepatitis B, Syphilis, Toxoplasmosis (if non-immune).	General health, anemia, immunity status, and infectious diseases.
Second Trimester	Glucose Tolerance Test (for Gestational Diabetes), repeat infectious disease screens.	Monitoring blood sugar levels and ensuring continued safety.
Third Trimester	Repeat blood work (CBC, HIV, Syphilis), and often the Group B Streptococcus (GBS) swab (35-37 weeks).	Final check for infections and ensuring GBS status is known before labor.

Important Note on Down Syndrome Screening: In Portugal, screening for Down Syndrome (Trisomy 21) is typically done via a combination of the first-trimester ultrasound measurements (Nuchal Translucency) and biochemical blood tests (the "Double Test"). Non-Invasive Prenatal Screening (NIPS/NIPT) is widely available but is not usually covered by the public SNS and must be paid for privately.

How Results Are Communicated

At your first appointment, you will receive a little paper booklet where your healthcare professional records all of your information like, observations, blood pressures, the due date, and upcoming appointments scheduled. This is called your Boletim de Salúde da Grávida (Pregnancy Health Record) . You must bring this booklet to ALL of your appointments.

Sometimes, you may also have access to a digital health portal with your lab results, or discuss those with your healthcare professional at the next appointment.

The Doula Difference:

Navigating a new healthcare system, especially while learning a new language and culture, is mentally exhausting. This is where doula support can be helpful.

While not every doula can act as an English to Portuguese interpreter or translator, they can still bridge the communication and cultural gap by explaining:

·    Cultural Translation: Explaining standard Portuguese practices and procedures so you aren't surprised or confused in the moment.

·    Advocacy Preparation: Helping you formulate your birth preferences (which can be hard to assert in a foreign language) into clear, concise language the Portuguese medical team can understand.

·    Continuity of Care: Providing reliable, familiar, emotional support and informational resources regardless of which hospital or doctor you choose, ensuring you always have a trusted advisor in your corner.

·    Postpartum Planning: Focusing on your transition home, dealing with bureaucracy, and combating the isolation common among new expat mothers.