Dangerous Peacetime Jobs - by Kate

I always thought fishing was the most dangerous peace-time job you could do, with construction, operation of heavy machinery and work on oil-rigs all in the top ten. Turns out teaching in a small language school in central Madrid is up there too - or at least if you happen to be pregnant.

I mentioned in an earlier post that my boss and I had been quite amazed by just how hazardous my teaching activities are judged to be by Spain's health and safety people. A report he commissioned ran into several pages and basically left us with the impression that danger lurks in every corner, from toxic chemicals (photocopier), radiation (computers), biological contamination (my students) to exhaustion and acute skeletal stress (from standing up for too long). Basically, the place is a death-trap and the sooner I get out of there, the better for me and my bump.

As previously stated, our family Dr, the genial (!) Dr Paniagua had pooh-poohed our request that I be signed off work because of risk and had demanded a second opinion on that. Because we can't see an obstetrician until Jan 19th at the earliest, that second opinion is proving hard to provide. But my boss needs me to stop work now (apart from stepping in to help cover classes because of snow-bound teachers on Thursday - three classes with a total of three students. Not too risky.) so at the very least I need a baja del medico so I can receive some money while we await the outcome of the embarazada del riesgo business.

So off we toddle to see dear Dr P again, this time without Marina, but with the health and safety report and its recommendations that I give the school a wide berth and presumably be wrapped in cotton wool somewhere out of harm's way until my contractions start. Seeing all this in black and white had the desired effect on Dr P, where no amount of impassioned pleading by Marina had produced results. She read the result of the assessment, asked us if therefore we needed a baja por embarazada del riesgo and at our assent, marched off to get the correct forms, signed, dated and stamped them, before giving us three copies with the instructions to take them to a special social security office to complete the process.

We were slightly thrown by how easily our goal had been achieved. I am now officially at risk and considering the dangerous nature of my employment, I reckon I've had a narrow escape. Phew.

Yes, She's Sitting Comfortably by Kate

In the UK, the NHS allocates you two routine ultrasound scans during pregnancy, here in Spain you get three full scans plus a quick once over every time you have an appointment with your obstetrician. Seeing as we got sent to the specialist radiology department at one of Madrid's biggest hospitals for our twenty-week looksee, we didn't realise that our appointment at our usual obstetrics clinic was for the complete scan minus an obstetrician. That's why my boss' lovely wife came too as part of our ongoing quest to get officialdom to decide my bump is at risk if I continue my teaching job too long.

Our next mistake was to join the queue at the wrong room and wait there until our obstetrician's assistant kindly pointed out that we weren't on her list and maybe we should check downstairs. Having taken the details for the appointment over the phone, doubt was immediately cast on my imperfect understanding of Spanish - we hadn't received the usual follow up confirmation by post. But a quick scouting mission by Theo and Marina established that I had got the date and time right, but the wrong room. It turned out we should have been waiting another five doors down.

We amended this and presented ourselves to the assistant who was brusquely herding various other bumpees towards their scans. She was less than overjoyed to see us and only grudgingly accepted that we formed part of her morning's work after we pointed at my name on her appointment list. Marina, having also experienced our doctor at her least helpful (during our abortive attempt to secure the baja), was shocked by her unhelpful attitude.
"They don't need to be so rude!! What's the matter with them?" Theo and I, having by now spent a lot of time among the white-coated acolytes of the Spanish medical system, were more philosophical. I just hope we don't get a bum deal on the staff front during the actual birth.

So, in we went at last and Marina once again launched into her preamble to try and encourage a recommendation for the baja por emarazada del riesgo, only to be briskly headed off at the pass by the information that we would need to consult the obstetrician, not the radiologist for that sort of thing. Another wasted trip for Marina. Although by compensation, she did get to join Theo and I in viewing our rapidly growing offspring looking sprightly inside the womb.

By now, she's pretty much finished developing her main organs, so a quick check of brain, heart and fetal movement was the main order of the day. Everything appeared to be present, beating and twitching as it should be, so the radiologist was quite satisfied and even gave a us a quick tour of our daughter's main body parts in English. The one problem at this stage is that Fosbella is neatly wedged in an upright sitting position - as I already suspected from numerous proddings at my belly's topography and by noting the position of her kicks and hand taps. To use the official term, she's breech, which is not ideal for a natural birth.

Of course, we still have more than six weeks to go and the statistics are reassuring - most breech babies do turn round before labour begins, (some leaving it to the very last minute). I'm very much hoping young Fos will duly oblige as I'd rather not have a C Section if I can avoid it. In the meantime, the advice is to spend time on hands and knees, waggle your pelvis around while it's higher than your head (this is not very easy with a large bump, believe me), sit up straight, do yoga and tell your foetus to please get off its arse and do a headstand. It's all got to be worth a try.

Getting the Social Security to step in By Kate

In Spain, if you've made social security payments for a minimum of six months, you're entitled to maternity money from the national system. You get four months fully-paid maternity leave and after that it's up to you and your employer to negotiate the remainder (I'm a bit hazy about that part because maternity leave would take me to the end of my contract with the language academy where I've been working anyway).

However, the widely practised way of enhancing one's maternity allowance is to request a baja del medico from your doctor. Basically, you quit work and ask the doctor to officially sign you off on sick leave. 99.9 per cent of doctors are happy to do this for any embarazada complaining of tiredness or a sore back - the usual health complaints that accompany the third trimester. You then lumber back to your health centre once a week and your doctor renews the sick note, usually without any further conversation required. The good part about this is that you start receiving sick pay (70 per cent of your salary) and it continues until the day you give birth, at which point maternity leave officially kicks in and instead of losing part of it pre-partum, you get the whole paid four months once the baby is born.

However, my boss wants me to go one better than this. I had indicated that health-allowing, I would be willing to work until at least the end of January (mainly because I would like to contribute another month's-worth of salary to the domestic piggy bank before earning a living becomes a secondary priority after baby care). He accepts this, but from his point of view, it makes more sense for me to finish my classes at the end of the Christmas term and my replacement to take over at the beginning of the Spring term. Not wanting to cheat me out of my full January salary (and possibly because he would also receive a little financial support from the government) he's been advised by his lawyer that I should request a baja for an embarazada del riesgo.

What this amounts to is that I claim my work is not just becoming difficult for me to perform because of my condition, but that my work is actually putting my pregnancy at risk. A baja obtained for this reason would basically mean I was treated as if I had had an industrial accident. I would receive 100 per cent of my salary from the Social Security until the day of the birth and I wouldn't have to keep heaving myself to the health centre to get it renewed.

When I first consulted my GP about being signed off, I hadn't appreciated the difference between the two bajas. Dr Paniagua indicated that she would be willing to give me the ordinary baja, but I would need to return once I'd actually stopped going to work. Once my boss realised my Spanish wasn't up to the intricacies of discussing the finer points of the other baja, he bade me to make another appointment and lent me his Spanish wife as chief negotiator and translator.

Marina and I arrived at the appointed time in the waiting room, only to observe Dr Paniagua choose that moment to leave her consulting room, lock the door behind her and depart the vicinity. We both treated her disappearance philosophically, as did the other patients in the queue, and settled down to chat until such a time as she should choose to reappear. This she did some twenty minutes later, carrying a shopping bag and with renewed post-coffee break vigour. She then glanced perfunctorily at her appointment list and called my name ("Katt-ee Sal-eess-boorr-ee?"). Marina and I promptly took up positions in front of her desk.

Luckily, I only had to say one sentence in my halting Spanish before Marina took over and laid out the facts of my risky pregnancy to Dr P. The whole time Marina was making her impassioned plea on my behalf, Dr P seemed more interested in trying to disentangle the cord holding her ID, then re-attaching what looked like a small pair of surgical scissors to it - no easy task as far as I could judge. Half way through Marina's brilliant and articulate outlining of my case, another medic unceremoniously walked in and interrupted her flow with some query or other for Dr P, which then became a peripheral discussion. When she thought the other medic had finished, Marina started again, only to be interrupted a second time with another question, which completely ignored the fact that Dr P was in the middle of seeing a patient. Marina and I waited patiently for Dr P's attention to come back to us, such as it was.

When Marina resumed, it seemed clear that Dr P was not buying the risky pregnancy scenario. "So what if she gets tired and has to work late in the evenings, so do I," seemed to be the central tenet of her argument. Eventually - once I'd pointed out that I was awaiting the results of a test for gestational diabetes - Dr P grudgingly gave us a form indicating a suspected risky pregnancy, but told us we would need to get the opinion of an obstetrician before she was prepared to give me the baja.

Both Marina and my boss were taken aback by the doctor's attitude. Apparently, signing people off work for whatever reason is usually a straightforward process in Spain and the medics don't generally fuss too much about establishing the veracity of each case as it's not their problem. Just our luck to get one of the few who was a tougher nut to crack on that score.

Of course the irony of all this is that my pregnancy is unlikely to be risky, given its progress so far (touch wood). Yes, I do get a bit tired (especially when climbing the steps of the Metro) and I have a little backache, but these are relatively minor discomforts. Overall, I feel pretty healthy and have had a very easy pregnancy so far. The only risk element is my age - 39 - but that's hardly unusual nowadays, half my friends have had their babies at around the age of 40 with no serious problems to speak of. As for the diabetes, well I was being honest about waiting to hear the results of my second glucose curve test, but given that I haven't been recalled (beyond a routine 32-week appointment with my obstetrician in January) with any urgency, I rather suspect the result was normal.

Anyway, Marina will come with me to see my obstetrician and have another crack at getting the baja. Only this time she will be armed with a risk assessment my boss commissioned for the academy in terms of hazards for a pregnant woman. Rather to our surprise, they are many - three full pages of them. It seems my work-place is a potential death-trap for people in my condition, with danger lurking in every computer, photocopier and classroom (not to mention the biological hazard of coming into contact with so many germ-infested students). Whether this will convince the Madrid medical profession of my imminent peril - well, we shall see.