Since October 29, a new regulation has been in force in Portugal’s public healthcare system, the SNS, allowing low-risk pregnancies to be managed by a midwife at a health centre rather than by a family doctor. The order issued by Health Minister Ana Paula Martins (Despacho Normativo n.º 11/2026) was published in the Diário da República on October 28.
The programme involves EEESMO, nurses specialising in maternal and obstetric health. They will be able to order tests and screenings, prescribe vitamins and supplements, administer vaccinations and issue pregnancy certificates. The government says the measure is a response to the shortage of family doctors. It is primarily intended for women who do not have one.
The first appointment must take place by 9 weeks and 6 days of pregnancy. If a doctor cannot see the patient within this timeframe, a midwife will carry out the initial risk assessment. The risk will be reassessed throughout the pregnancy, and any complications will mean the woman is referred to a doctor or hospital. Participation is voluntary: patients will be informed about the model, asked to give their consent and free to withdraw at any time, JN reports.
In March, the SNS Executive Directorate selected 12 ULS (local health units) for the pilot. They cover Lisbon and its suburbs, the Setúbal Peninsula, Oeste, Alto Alentejo and the Algarve. The final list under the new regulation has not yet been announced. The technical guidelines and IT system are to be prepared within 90 days, so consultations are likely to begin on a wider scale in early 2027. The results will be assessed after 12 months.
The Order of Nurses has called the decision historic. The Order of Physicians had agreed to this model back in November 2025, but only as a temporary measure.
If you are pregnant and do not have a family doctor, contact your local centro de saúde as soon as you get a positive pregnancy test and ask about an appointment with a midwife. You will need an SNS user number (número de utente), so it is best to arrange one in advance.
