Pregnancy care and monitoring in Bulgaria

Healthcare · Last reviewed: 2026-08-23

The first week: start three things at once

On the day you learn you are pregnant, the work is administrative rather than medical, and it has three parts. If they do not run in parallel you will hear your documents are incomplete months later — and a week lost in pregnancy does not come back.

1. 1

   Verify your identifier and address registration

   The whole health system runs on your personal identifier. If it is missing or out of date, fix that first; otherwise neither electronic prescriptions nor system records will open under your name.
2. 2

   Measure your insurance status

   I think I am insured is not a measurement. Check the state of your contributions; if there is an interruption, start correcting it immediately, because correction involves back payment and waiting. See [interrupted insurance rights](/bilgi/bulgaristan-saglik-sigortasi-kesintisi).
3. 3

   Set up the GP and specialist chain

   If you have no GP, choose one; referrals and general health monitoring run through them. Then approach an obstetrics and gynaecology specialist — that is the main axis of monitoring. Choosing a GP is covered in [choosing a GP](/bilgi/bulgaristan-aile-hekimi-secme).

If you are insured: how monitoring works

For an insured pregnant woman, monitoring is led by an obstetrics and gynaecology specialist, and the scope is defined by the annual National Framework Agreement. This article does not tell you so many consultations, so many scans — those numbers are set by agreement and can change from year to year; a figure that is right today is wrong next year. Instead we give you the right question: at your first appointment, tell the specialist which consultations and tests in this pregnancy fall within insurance cover and for which will I pay separately, and ask for the answer IN WRITING. That single sentence cuts off in advance every surprise of the next nine months.

Even though monitoring runs with a specialist, do not cut the link with your GP: health problems outside the pregnancy, chronic medicines and general tests run through them. Keeping information flowing between the two doctors is your job — take a document from every appointment and carry your own file.

If you are uninsured: what Regulation No. 26 provides

The entitlement of an uninsured pregnant woman is not zero. Regulation No. 26 determines the scope and order of provision of medical services relating to obstetric care for uninsured women, the conditions and order for performing examinations outside the scope of mandatory health insurance for children and pregnant women using kits, reagents and consumables provided by the Ministry of Health, and the order and scope of preventive examinations and tests during pregnancy for uninsured women.

The content of the preventive examination is defined in the regulation and is carried out by an obstetrics and gynaecology specialist: history taking, assessment of risk factors, determination of the probable date of delivery, blood pressure measurement, anthropometry with external pelvimetry, gynaecological examination, listening to fetal heart tones if the gestational age allows, ultrasound, interpretation of results, and the performance of tests. Those tests include a full blood count, blood sugar, urine analysis, syphilis testing, hepatitis B testing and microbiological examination of vaginal secretion.

Your file: what to collect and how to keep it

The file you build during pregnancy is the one thing in your hands on the night of the birth. At the hospital you may be met by a team that does not know you; how quickly they understand you depends on how your file is ordered. Keep the following in two copies — on paper and as photos on your phone.

• •Your pregnancy record and the document from every appointment (date, week, blood pressure, weight, findings).
• •Your blood group and rhesus status; where there is rhesus incompatibility, all related records.
• •All laboratory results, ordered by date from the first week.
• •Printouts of ultrasound conclusions — the written report, not the image on the screen.
• •The medicines, vitamins and supplements you take; your known allergies.
• •Your chronic conditions and any discharge summaries from previous pregnancies.
• •The name of the facility where you plan to give birth and its admission arrangements.

If you are an EU citizen or under temporary protection

The European Health Insurance Card is an important right, but for pregnancy monitoring it is usually NOT ENOUGH: it covers medically necessary care during a temporary stay, not planned and regular monitoring. If you live in Bulgaria and plan to give birth here, the right path is either to be insured here, or to obtain the appropriate document from the institution of the country where you are insured, or to pay for monitoring privately. Settle which of the three applies to you in the early months, not in the eighth.

If you hold temporary protection status, the scope of your access to healthcare is set by the Bulgarian authorities and those conditions have changed over time. Rely not on what you have heard but on today's official position: with your status document, ask the facility what scope your pregnancy monitoring will be covered under, and take the answer in writing.

When not to wait

In pregnancy the definition of urgent changes. The situations below need assessment without waiting for your scheduled appointment; if you are unsure, call 112 and say in your first sentence that you are pregnant. How to make an emergency call is covered in [using emergency care](/bilgi/bulgaristan-acil-servis-kullanimi).

• •Bleeding of any amount.
• •Regular and increasingly frequent contractions; in early weeks this matters even more.
• •Waters breaking or persistent watery discharge.
• •Severe headache that does not pass; flashes of light or blurred vision; sudden swelling of hands and face.
• •A marked reduction in fetal movements, or movements stopping.
• •High fever, severe abdominal pain, persistent vomiting, or pain on urination together with a fever.
• •A fall, a blow to the abdomen or a road accident — assessment is needed even without symptoms.

If you work: employment law and payments are a separate path

Benefits relating to pregnancy and childbirth and protections arising from employment law run in a system SEPARATE from health monitoring, and the competent institution is the National Social Security Institute. This article prints neither amounts nor durations; both are set in legislation and lie outside what we could verify. The right step: early in the pregnancy review your contract and your insurance status, then approach the relevant institution and find out IN WRITING which benefit and leave entitlements arise for you. Learning this in the eighth month is the most common way of losing an entitlement.

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