Alfredo da Costa

Maternity Hospital

The Alfredo da Costa Maternity Hospital (fondly known nationwide as the “MAC”), MHM (institutional honorary member of the Order of Merit, an honorary order aimed at distinguishing meritorious acts, or services that reveal abnegation in favour of the community, performed in the exercise of any function, public or private), is a public health establishment specialising in obstetrics, located in the current parish of Avenidas Novas (New Avenues), but till 2013 in the now-dissolved parish of São Sebastião da Pedreira (Saint Sebastian’s Quarry), Lisbon.

The hospital’s name is a tribute to Manuel Vicente Alfredo da Costa (Margão, Goa, 1859 – Lisbon 1910), a pioneer of obstetrics in Portugal. It was built on the incomplete foundations of a church and was an architectural project designed by Miguel Ventura Terra (Seixas, Caminha, 1866 – Lisbon, 1919). Inaugurated on 5th December 1932, it was the first maternity hospital in Lisbon to be designed and built from scratch.

Its founder and first director was Professor Augusto de Almeida Monjardino (Angra do Heroísmo, Azores, 1871 – Lisbon, 1941). For cost efficiencies, the MAC was absorbed into the Centro Hospitalar de Lisboa Central (Central Lisbon Hospital Centre), EPE (“Entrepreneurial Public Entity”), in 2012. The land on which the maternity hospital was built was originally donated by the Countess of Carnide to the Diocese of Lisbon in 1907 with a view to building a church in honour of Our Lady of the Immaculate Conception.

However, due to the establishment of the First Republic (1910 – 1926) and its congruent anti-clerical dogma, the plan never came to fruition. The state confiscated the land from the nominated religious order and instructed the General Directorate of Assistance to use the land. The construction of the MAC began in 1914 and was carried out by dozens of unemployed workers affiliated with the General Confederation of Labour (1914 – 1933).

Regrettably, the construction of the hospital remained somewhat plagued. Shortly after work had started, the state, faced with unavoidably shambolic finances, opted to tighten the purse strings and withdraw funding for the project. Then, the Great War began and precipitously the lack of materials - especially iron – became ever more serious.

Fortunately, the money problem was miraculously, but only partially resolved, thanks to an unexpected donation of Esc1.5m (about £130,000 at the then rate, equivalent to around a £6m in today’s money) in 1920, coming from an anonymous benefactor (a plaque alluding to this donation exists inside the building today, which attributes the donation to José Rovisco Pais [Casa Branca, Sousel, 1862 – Lisbon, 1932, an industrialist and beer magnate]). Even so, given the First Republic’s propensity for mismanagement (e.g., 48 governments in sixteen years) and graft, this generosity was still not enough. Only when António de Oliveira Salazar (Santa Comba Dão, 1899 – Lisbon, 1970), during the second of his stints as finance minister (1928 - 1932), visited the unfinished building in 1929, was it possible to move forward with the project.

Salazar ordered that the work be completed as soon as possible and put up another Esc1m (by then, thanks to constant devaluations before 1926, only worth about £11,000 at the ten rate and around £740,000 today) of state money. The MAC was inaugurated on 28th May 1932 and, on 8th December of that year, the first child was born, at 11:30 pm, not so ironically named Maria da Conceição (Mary Conception). The heavily censored and pro-Second Republic (1926 – 1974) newspapers never tired of applauding the project; "A real nursing institution - we no longer have to envy the Germans", wrote the Diário da Manhã (Morning Daily) in just one more sycophantic editorial.

In its first twelve months of operation, MAC had 2,073 births – 1,120 "men" (as boys were quaintly then recorded) and 953 girls. After a peak of births in 1977 (13,654) - there has been a more-or-less constant reduction, explained by the drop in the overall birth rate in society and the coming on stream of other maternity hospitals in Lisbon, from the 1980s onwards. The institutional Honorary Membership of the Order of Merit was awarded to MAC on 21st January 1983. Since 1932, over 600,000 children have been born in MAC.

The 19th (of the Third Republic, 1974 to date) Constitutional Government (2011-2015) started its term by continually referring to its intention to close the MAC by the end of 2012, but such is the fondness for the hospital in society and the influence of the public-sector unions, that it saw those intentions contested in the slow-moving courts and defeated in the Administrative Court of Lisbon, which ordered that the hospital remain in full operation. The Ministry of Health filed an appeal which was evaluated by the Southern Central Administrative Court in 2015. This last court decreed in 2016 the maintenance of MAC in full operation until the construction and opening of the new Hospital de Todos os Santos (All Saints Hospital).

In 2023, the date scheduled for the entry into operation of the now renamed future Hospital de Lisboa Oriental (East Lisbon Hospital), in Bela Vista Park, in the area of Chelas, Marvila, the MAC’s services and employees will be transferred to the central maternity and child health unit of the new hospital. All this notwithstanding, given public sensitivity, the authorities still nebulously claim that they expected the MAC to remain “at the service of public health".