The lack of specialized professionals in home births forces pregnant women from Lleida to seek temporary accommodation in Barcelona. This mobility responds to the impossibility of finding a midwife with real availability in the demarcation to attend the birth at home.
The territory has approximately 70 midwives, but only a dozen have specific training to assist births outside the hospital setting. The situation is aggravated because most of these professionals are young women who are going through their own stages of pregnancy or childcare, which prevents them from maintaining the permanent on-call duty that this practice requires.
A single professional guarantees the minimum availability
Inma Marcos, president of the Associació de Llevadores del Part a Casa de Catalunya (Alpac), explains that the nature of the work requires being available 24 hours a day. This demand clashes with the demographic reality of the group in the area, which cannot assume this workload on a continuous basis.
Only one midwife in the entire area attends home births with minimally acceptable availability. This figure leaves most families without real options within their area of residence.
Despite the fact that Catalonia is a pioneer in this field with between 300 and 400 annual home births, Marcos describes Lleida as a hostile territory for this modality. The concentration of available resources and professionals shifts towards the Catalan capital, forcing users to travel.
The COILL warns about the intrusion of doulas
The shortage of qualified healthcare personnel opens the door to unregulated practices. Leyre Estallo, midwife and spokesperson for the College of Nurses of Lleida (COILL), expresses her concern about the intrusion of people without health qualifications, such as doulas, who assist births.
"They do it without any safety, they are not trained to solve possible obstetric emergencies" - Inma Marcos, president of the Association of Home Birth Midwives of Catalonia (Alpac)
Home births must be performed exclusively in low-risk pregnancies. Protocols require a single fetus in cephalic presentation, between weeks 37 and 42 of gestation, and the total absence of additional risk factors. Any deviation from these parameters requires immediate hospital attention.
Estallo highlights that the COILL has managed to improve public infrastructure with the opening of the first individual rooms for childbirth preparation at the Arnau de Vilanova hospital. These new rooms replace the old eight-bed common room, a space considered obsolete by professionals.
"We went to Parliament to ask them to change the infrastructure that had become totally obsolete and it's already done, the women are already enjoying this new space" - Leyre Estallo, midwife, spokesperson for the College of Nurses of Lleida (COILL)
The structural deficit affects the entire care chain. A minimum shortage of 120 midwives is estimated in the demarcation of Lleida. This figure rises to 2,000 missing positions in Catalonia and reaches 10,000 in the entire State.
The training of new specialists also does not cover current needs. Only five places are offered annually for the Obstetrics Nursing residency in the area, a number that the COILL considers clearly insufficient to reverse the trend.
The professional college has prepared a report that audits the state of the specialty in Catalonia. Although the figure of the midwife has a statutory professional category, her social and institutional recognition remains testimonial according to the preliminary data from the study.
Leyre Estallo presented these conclusions during the Diada de les Llevadores i Residents of Lleida, where professionals Laia Casadevall and Inma Marcos also participated in various training talks.