Portugal has one of the lowest birth rates in the EU, standing at 7.7% in 2021. The birth rate has been decreasing exponentially since the 1950s. The average age that a mother has her first child in Portugal is 29.9 years old, a number that has been rising. We can attribute this to an improvement in gender equality, access to contraception, as well as the sad reality that many Portuguese are not paid enough to raise a child.
The Portuguese are having fewer children and choosing to start a family later in life. Is Portugal still a good place to have a baby? Yes. Portugal has a strong public health care system which makes it essentially free to have a child (if you are a resident). The quality education system, public parks, and sunny weather make Portugal one of the best countries in Europe to start a family. The Portuguese government is also planning to implement measures to fight the decline in the birth rate. Along with free childcare, the government will provide fiscal deductions for families with children, as well as free textbooks and free computers.
This guide to having a child in Portugal will help you with everything you need to know about the process as an international.
Pregnancy & Prenatal Care in Portugal: What’s it like to be pregnant in Portugal?
Being pregnant in a country where you are granted basic rights and protections fosters a positive experience. Pregnant women have health and employment rights in Portugal, many that are inexistent in the US and UK, unfortunately.
Under the public health care system, you will have certain free pre-natal care rights. Both Portuguese and foreigner pregnant women hold the same rights if they reside in Portugal for more than 90 days. You will have the right to free consultation all throughout the pregnancy, as well as 60 days after birth.
To be able to access public prenatal services, you must first register with a health center. You will have tests, examinations and ultrasounds carried out by your general doctor or local health care center. Keep in mind that some medical staff do not speak English fluently, so either commit to learning Portuguese or bring someone who speaks the language with you.
When you find out you’re pregnant, book your first prenatal appointment as soon as possible, preferably before the first 12 weeks. You will then have an appointment every four to six weeks until the 30th week, every two to three weeks until the 36th week, and every one to two weeks until birth. At your first appointment, you will receive a pregnancy booklet where your progress and medical records will be recorded. Keep this with you throughout your pregnancy and bring it to the birth.
Pregnant people are also entitled to certain employment rights. To benefit from these, you must inform your employer that you are pregnant by presenting them with a medical certificate. You can obtain this medical certificate through your health care center. Make sure you put this in writing so that you have proof that you are a pregnant worker.
After putting this in writing, as a pregnant worker, you will be protected by the law. If your employer fires you, they must do so for “just cause”, known as justa causa in Portuguese. The case for dismissal must be submitted for evaluation with the Commission for Equality in Work and Employment. If this commission finds that someone was fired because the employer discriminated against them for being pregnant, the dismissal will be revoked. The pregnant person can even ask for financial compensation for injury.
Pregnant women also have the right to maternal leave, which we will discuss in detail further down. This does not just apply to after birth. Women have 120 days to take off while getting paid at 100%, of which 90 must be taken after birth. That means that pregnant women can take off 30 days before birth. However, they do not need to do this and can leave these 30 days for after the birth, if preferable.
Giving birth in Portugal
When you’re closer to your due date, your doctor will send you to a consultation at the hospital where you will be giving birth. You will go over your birth plan, such as what type of anaesthesia you would like or who will be present at the birth. Births in the public health care system usually occur during the 40th week. In Portugal, you will be offered a “natural” birth and a cesarian will only take place if necessary, with your consent. After the birth, you will stay at the hospital under care for 38 to 72 hours.
You can also choose to give birth through the private healthcare system, at your own cost. Here, you are more likely to get a cesarian, as well as be able to have a home birth with a private midwife. If an emergency occurs during delivery, you will still be covered for this through your public health cover. It’s also important to note that while private hospitals can provide you extra comfort such as your own private room, in case of emergency, it’s wise to stay close to a public hospital. Public hospitals have the qualified staff and specialized equipment necessary to tackle emergencies.
How much does it cost to have a baby in Portugal?
The cost of giving birth in Portugal can be zero, under the public health care system. However, if you choose to have a baby in the private sector, you will pay the price. Having a baby in a private hospital in Portugal can cost you between €2,900 and €6,000. If you have private insurance, it will help you cover these costs, many insurers paying for the entirety of the birth and hospital stay.
Registering a birth in Portugal
When you have a baby in Portugal, you MUST register the birth. This is free and mandatory. You can do this in person or online and either parent can do so, they do not need to be married. To do it in person, you need to go to a Civil Registry Office (Conservatoria do Registo Civil), within 20 days after the birth. Sometimes you can also access this service at the maternity ward of the hospital where you give birth. This is where you would also give the documents that could make your child eligible for citizenship which we will discuss further on.
Will my child get Portuguese citizenship?
If as a foreigner you have a baby in Portugal, your child might be eligible for Portuguese citizenship. The child will receive citizenship automatically if one of the parents was born in Portugal or if they don’t have any other nationality through their parents. They can also get automatic citizenship if at least one parent has lived in Portugal for five years at the time of birth. You must prove this when registering the birth of your child. Alternatively, a child can apply for citizenship if they have lived in the country for six years. However, they must take a Portuguese language test and not have been convicted of a crime with a sentence of over 3 years.
Postnatal care in Portugal
Mothers that give birth and reside in Portugal for more than 90 days have the right to free consultations up to 60 days after birth. A nurse will also come to check on you for free, a few days after you have left the hospital. Parents can also join postnatal classes to teach them how to take care of their newborn, as well as how to perform CPR on a baby. These classes happen in your health center, but are not always free. You can also pay for these in private institutions. You will also find several “cresces” (nurseries) and pre-schools in every major city in Portugal. These are good quality and affordable, unlike in many other European cities. However, if you are looking to place your child in an international pre-school, these are more expensive.
Child Vaccines in Portugal
Until your baby reaches 18 months, you will also need to vaccinate your child under the national vaccination program at regular intervals. The hepatitis B vaccine is usually the only one administered at birth. However, the vaccine against tuberculosis is also given to some kids. Although vaccines are not technically compulsory, there are two vaccines that are pretty much obligatory, diphtheria and tetanus shot. Without these, your child cannot enrol or take an exam in an educational establishment. You must make sure these are up to date as they grow. All the vaccines under the national vaccine program are free.
The national vaccine program protects against the following diseases: tuberculosis, diphtheria, tetanus, pertussis, poliomyelitis, Haemophilus influenza type b infection, hepatitis B, pneumococcal disease, meningococcal disease, measles, mumps, rubella, and human papillomavirus infection.
Parental leave in Portugal
If you are employed in Portugal you have the right to parental leave, both men and women. Self-employed people are also eligible. In Portugal, you have initial and extended parental leave. With initial leave, a woman must take 90 days of her leave after childbirth and the remainder may be used before or after childbirth, totalling 120 days paid at 100%. Mothers MUST take at least six weeks off right after childbirth.
Fathers are entitled to 20 mandatory working days leave after birth where they get paid. The first five days can be taken right after birth and the other 15 must be taken within six weeks of the birth. The latter does not have to be taken consecutively.
After initial parental leave, parents can extend the leave to 180 days by adding three months, a period which is shared between the two parents at a rate of 83% of total pay. On the other hand, parents can also choose to extend the maternity leave alone to 150 days with no shared period at a rate of 80% total pay.
Unfortunately, most of the language used in the law refers to a “mother” and “father”. However, since 2019, the parliament officially stated that LGBT+ couples have parental leave rights. Two men and two women who have a baby (through adoption or biologically) will be paid for 120, 150 or 180 days, either at 100% or 80% depending on the amount of time.
Child benefits in Portugal
Along with parental leave, parents might be eligible for allowances from social security. The most common type of allowance is the Prenatal Family Allowance. There are other types of help such as an allowance for grandparents who need to leave work to take care of a baby.
Prenatal Family Allowance
If you are a pregnant woman in Portugal, you might be eligible for the prenatal family allowance. This allowance starts in the 13th week of pregnancy and lasts up to six months. However, you must receive less than a certain income to be eligible. The weekly amount varies according to income, but it’s usually between €96 and €148. The main requirements to be eligible are:
- the pregnant mother must reside in Portugal or having a status comparable to residence
- the pregnant mother must have reached the 13th week of pregnancy
- the entire household must not have an income equal or lower than the third income bracket
- the entire household must not have movable heritage such as bank accounts, investment funds, etc higher than 240 times the amount of the Social Support Indexation
Is surrogacy legal in Portugal?
Surrogacy has always been a controversial and still to this day, complicated topic in Portugal. Surrogacy was forbidden under Portuguese law for a while, and at times even criminalised. However, since August 2016, surrogacy has been allowed under certain scenarios that are quite restrictive. However, the law on surrogacy seems to be improving. In November of 2021, a law on surrogacy passed that says that surrogacy is legal. However, the pregnant woman must already be a mother. Moreover, the surrogacy contract must be approved by the National Council for Medically Assisted Procreation, which is a Portuguese body that oversees the process. The pregnant woman can keep the baby until it is registered, within 20 days of birth. Despite this law passing in parliament, regulations seem unclear. On the official government website, it says that “there is currently no legal framework regulating surrogacy in Portugal, so this practice is not lawful”.
Is gay adoption legal in Portugal?
In 2015, a majority of those in parliament voted to extend adoptions rights to same-sex couples. This had shockingly previously failed in 2012 and 2013. However, in 2015, the conservative President at the time, Cavaco Silva, vetoed the adoption rights bill. Luckily, the Portuguese parliament, particularly due to the left-wing parties, was able to overturn the presidential veto. This made Portugal the 24th country in the world to may gay adoption legal. Gay parents who adopt can request an adoption allowance, similar to parental leave. However, the adoptee must be under 15 years old.
Is Portugal a good place to raise children?
Portugal is a great place to raise children. Everywhere you’ll go, people will smile at your kids and be happy to be around them. They say that grandparents are the pillars of a family, but in Portugal, it is the children. There are so many activities in Portugal for kids from free parks, zoos, oceanariums, and more. The cost of living is also much lower than in other major European countries which is an important aspect to consider when it comes to children. From preschool to afterschool activities and healthcare, they tend to be expensive. Portugal offers affordable education and universal healthcare for kids, making it one of the best places to raise children. One of the safest countries in Europe, you won’t have to worry about your child like you would in a city like London. Portugal also has some of the best international schools in Europe, although these can be quite pricey (between €5,000 and €20,000 a year).
“To be able to access public prenatal services, you must first register with a health center” good luck with that 🤣🤣🤣
The way it will work in reality: your health center isn’t accepting new patients. They will assign you an SNS number, but not a family doctor, and therefore you won’t have access to the public health system. You have 3 options:
– Go fully private, if you can afford to
– Every once in a while, pretend you have pain, go to the emergency of your local public maternity hospital, and wait there for a few hours until someone has time to check on you. It’s free, but no guarantees you’ll get to see a doctor. (In general, if you don’t have a family doctor, and can’t go to a private clinic, the ER is your only way into the public health system)
– Find a gynaecologist who works in both a private and a public hospital (most do). Schedule check-ups in the private hospital. Ask to move check-ups for the last 2 months to the public hospital. Then give birth there. Especially if your health insurance covers the consultations, but not the delivery, this is the option you should pick.
The third option is what we did at the recommendation of Portugese friends who did the same. Our son is now 4 months old, and we still don’t have a family doctor. Which means we have to schedule the (legally required) monthly check-ups in private hospitals. The only thing the health center does is vaccinations, and weighing the baby (just putting him on a scale, and registering the weight in the computer. They don’t check anything else. Not even measure his height). For the vaccinations and the weighing appointments: there is a weekly rotation system with different health centers being responsible for patients without a family doctor. On Monday, you should figure out what health center it is for that week, and go there to make an appointment later that week (for vaccinations, or for weighing.) The health center tells us the weekly weighing is compulsory because the weight needs to be in their computer. But we gave up on it after the first month. We have our own infant scale at home.
Something else to be aware of, when raising children in Portugal: often, GP’s will refuse to attend to young children. They will refer you to a paediatrician in stead. During the day, it shouldn’t be a problem to find a paediatrician, but if you need a doctor at night, or on Sundays, not all private hospitals will have a paediatrician on duty in their ER. They will instead refer you to the nearest public paediatric hospital, where, depending on the judgement of the triage nurse, you might end up waiting the whole night.
Hi Dan,
Thanks for the helpful comment. Keep in mind that a health center cannot deny you as a patient if you are a resident with a NIF, although at time, you are unlikely to get a family doctor, as you said. However, this still allows you to access the public health system and give birth in a public hospital and you have the right to choose any hospital in the country.