I experienced my entire pregnancy and birth in Spain. I used private insurance, but it's only 30 euro per month and 3 euro per appointment because it is subsidized. Other than that, absolutely everything has been free, from appointments with obstetricians and/or midwives at least once per month, an ultrasound offered at every appointment and a Tdap vaccine to labor, delivery and a 48-hour hospital stay. It would not have cost any more had there been complications during labor. My prenatal classes were free. My lactation consultations and baby massage courses are free. (Or, one could say I got all that for around 33 to 36 euro per month. Had I gone through the public system, it would have been totally free.) It felt strange just waltzing out of the office without stopping to pay after each appointment. My care was and is top-notch, and I'm so glad I was able to have my baby in Spain rather than in the US, which would have left me buried in debt. I have also visited two doctors, a nurse and two midwives in the public system, and have experienced minimal wait times and excellent, thorough care. Here they practice preventative medicine. Of course there are trade-offs. I pay more taxes. It takes longer to go for blood tests, and wait times for non-emergency surgeries are long. But I'd take the Spanish system over the US one, no contest.