Two of the maternity hospitals with the highest number of births in Portugal are private institutions, a shift that analysts link to the country’s rising caesarean rate, now at a record high. The expansion of deliveries in the private sector appears to be a key driver of growing caesarean use nationally, while within the SNS the public unit with the most births is Maternidade Alfredo da Costa. The pattern raises questions about clinical practice variation between sectors, implications for maternal and neonatal outcomes, and the need for policy and oversight to address incentives and standardise care.
The two maternity hospitals with the most births in Portugal are private and this has helped push up the caesarean rate
Saturday, 17 January 2026RSS
Context & Explainers
The Alfredo da Costa Maternity Hospital (Maternidade Alfredo da Costa) is Lisbon’s main public maternity centre and the busiest maternity within Portugal’s SNS (Serviço Nacional de Saúde). For residents and expectant parents it is a key referral hospital for high‑risk pregnancies and neonatal care and often handles more births and complex cases than other public units.
Family medicine (Medicina Geral e Familiar) is the medical specialty that provides continuous primary care through family doctors who manage common illnesses, chronic diseases and preventive care. In Portugal these specialists are the backbone of the SNS (Serviço Nacional de Saúde); the story notes 57 doctors finished the specialty and 38 stayed in the NHS, giving family doctors to about 77,500 patients.
Hospital de Braga is the main public hospital serving the Braga district and is part of Portugal's national health service (Serviço Nacional de Saúde or SNS). It provides emergency care and specialist services including oncology, and recent reports said cancer patients there complained of medicine shortages, so residents should check with their doctor or local pharmacy before appointments.
ULS Alto Ave is the Alto Ave Local Health Unit (Unidade Local de Saúde do Alto Ave), a public body that runs hospitals and some primary-care services for the Ave area in northern Portugal. It is part of the National Health Service (Serviço Nacional de Saúde or SNS), and recent staff strikes have affected overtime and complementary work, so residents should check local hospital notices before visiting.
Staffing and shift schedules in the SNS combine permanent doctors, residents and temporary cover (locums or overtime) arranged by each hospital's Clinical Directorate ("Direção Clínica"), which plans rotas to cover on‑call and emergency shifts. Rotas are subject to national labour rules, collective agreements and local shortages, so hospitals may use voluntary shift swaps, incentives or external contractors when regular staff are unavailable.
