Italy’s birthrate is falling. Can the storks help?

As if having a baby wasn’t expensive enough, fathers of newborns in the mountain hamlets that make up Italy’s Val d’Ultimo have an additional cost. In a revival of an ancient myth that white storks deliver babies, carved wooden storks carrying a newborn child in a sling are a common feature outside homes in the valley. They are put there by friends of the father and there they remain until he stumps up for a round of drinks.

“There has been a noticeable increase in storks and other symbols of birth being put outside someone’s house, especially in recent years,” said Stefan Schwarz, the mayor of Ultimo, home to almost 3,000 people spread over three hamlets.

Ultimo welcomes about 40 newborns a year, Schwarz said. “We’ll be needing more nurseries and will perhaps have to make the schools bigger,” he added. It is a dilemma that mayors of other Italian towns look on with envy.

Since the “baby boom” years of the 1960s, the annual number of births in Europe’s fourth biggest economy has fallen by more than half. The decline gathered pace in 2010 and then, last year, Covid-19 struck, contributing to new records for both births and deaths. There were 404,104 babies born in Italy in 2020 – down by almost 16,000 from 2019, which was the lowest birth rate recorded since Italian unification in 1861. At the same time, the gap between births and deaths (there were 746,146 deaths) was the widest it has been since the Spanish flu of 1918.

Istat, the national statistics agency, said last year’s drop in population, by 384,000, was akin to a city the size of Florence being wiped off the map. All of this is a dramatic change for Italy, which has gone from being a country known for its large families to one with among the lowest birth rates in the EU.

However, the demographic situation differs wildly between the country’s 20 regions, and even between provinces and towns within them.

As the rest of Italy grapples with the drastic decline in the birth rate, Val d’Ultimo, along with its wider province of Bolzano in the semi-autonomous Alto Adige region, are somewhat bucking the trend. In 2019, Bolzano was the only area of Italy to register more births than deaths, and even though the province suffered a surplus of deaths over births last year due to Covid-19, it still recorded the highest number of births in the country, with 9.6 children born per 1,000 women.

Compare this with the island of Sardinia, which registered the lowest birth rate in Italy, at 5.1 babies per 1,000 women. On average, women in Bolzano had 1.7 children in 2019 compared with the national average of 1.27, and just 1 in Sardinia.

While Schwarz worries about how to accommodate the new additions to his town, Debora Porrà, the mayor of Villamassargia, a town with a similar-sized population in south-western Sardinia, which has one of the lowest annual birth rates in the country, is fighting to keep the only maternity unit in the area open. The unit is located at the hospital in nearby Sulcis-Iglesiente and serves Villamassagia and Carbonia, the other main town in a province with a total population of 120,000. In Italy, there needs to be a minimum of 500 births per maternity unit a year in order for funding to be maintained.

“This year, we managed to get the closure of the maternity unit postponed, even though we only had 300 births last year,” said Porrà. “But others have closed in other towns, and we’ll be next.”

Moreover, women in the province do not have access to pain-free births. The absence of epidural pain relief is not a rarity in Sardinia and parts of southern Italy.

“The hospitals in our area have never had analgesia services, so women are forced to either give birth in pain or travel to Cagliari [Sardinia’s capital],” added Porrà. “I’m absolutely exhausted trying to fight these battles.”

It would be easy to surmise that Bolzano’s success in increasing birth numbers is down to money. It is, after all, in the wealthy, Italian-German-speaking Alto Adige and regularly ranks in surveys as the best place to live in Italy.

Schwarz joked that the reason for the uptick in procreation in Val d’Ultimo is because “the winters are long”. Other residents concur, adding, “and our TVs don’t work”.

But much more is at play. One of the main explanations has been a comprehensive political strategy, which began in 2005 with generous financial benefits for families, ranging from monthly child allowances and support towards buying a home, and coincided with the development of support services such as nurseries.

“Back then, we didn’t really have a policy for families, it wasn’t a theme,” said Waltraud Deeg, the vice-president of Bolzano province and councillor for families. “Now we have a very active policy. One important thing was to not only think about the city [of Bolzano] but the rural areas, and to have services in place for early childhood.”

In the early 2000s, the Alto Adige region, which lies next to the Austrian border, was the first in Italy to adopt the system of Tagesmutter, or “mother for the day”, a childcare concept that originated in northern Europe and involves a woman adapting her home as a nursery and taking care of up to five children a day, aged between three months and three years.

After two years of training, Sonja Spitaler set up as a Tagesmutter in Laives, a town on the outskirts of Bolzano city, in 2006.

“At the time, this wasn’t exactly my dream job,” said Spitaler. “I also have two children and it was the most convenient thing to do. I wanted some independence, to earn my own income.”

Not only has the childcare system allowed mothers to work and created jobs for others, Spitaler said that it has helped to dismantle the idea that women are “bad mothers” if they leave their children in nurseries.

“This mentality has changed a lot over the last 10 years or so,” she added. “Why should a woman have to give up her job? Especially if it’s not guaranteed that her partner’s income can cover all the costs.”

Across Bolzano province, there are 50 Tagesmütter and 93 so-called “microstructures” – which are basically daycare centres hosted in larger spaces that can accommodate up to around 25 children. The costs of the services are shared between the provincial council, local council and parents, according to their income. In addition, there are several privately-run nurseries.

Aneta Ngucaj, originally from Albania, owns Baby Puffo, a “microstructure” nursery that is spread over three locations. She employs five assistants per nursery. “We have a lot of babies from three months old,” she said. “Mothers leave them willingly but throughout the day we keep in touch, sending them photos or videos, which helps to reassure them that their children are OK.”

One of Baby Puffo’s assistants is Sara Papasergio, who, at 25, is expecting her first child. “I wasn’t planning to start a family,” she said. “But I feel secure enough to begin one now. I’m lucky to work here and have a stable income. Some of my friends are thinking about children, too, but it all depends on work and stability.”

Bolzano stands out from the rest of Italy with a high number of women in the workforce, especially in the public sector, where 70% of women are employed. The advantage of a public-sector job means having a stable contract including benefits such as five months obligatory maternity leave. As elsewhere in Italy, women who are self-employed or working on short-term contracts are not entitled to such benefits. Pregnant women are often forced to leave the workforce or, in many cases, are laid off.

“The fact that such a high percentage of women here work in public sector jobs provides stability,” said Nadia Mazzardis, a political activist. “So long as the province can maintain this number, it will work.”

Nationally, less than 50% of women aged between 15 and 64 work, far below the EU average of 67.3%. Labour market inequalities have been exacerbated by the pandemic, with 312,000 women losing their jobs in 2020 compared with 132,000 men. This is partly due to women being more likely to work in sectors badly affected by the pandemic, such as tourism, but also because a much higher percentage of women are in precarious employment.

“Women lose jobs much more than men because they are on short-term contracts,” said Giorgia Serughetti, a sociologist at the University of Milano-Bicocca. “This means that the moment something changes, such as becoming pregnant, there is no guarantee of keeping your job or, if you do manage to keep it, that job conditions will be flexible upon returning to work.”

Bolzano might be nicknamed “the happy island” but that doesn’t mean to say its economy hasn’t suffered in recent years, as well as from the consequences of the pandemic. And neither has it been immune from the exodus of young people moving abroad in search of better job opportunities. However, people generally have a positive outlook, according to Spitaler. “Covid-19 has changed things a bit for everyone but we tend to still look positively ahead,” she added.

The same cannot be said for Sardinia, which has a high unemployment rate. “There is lack of hope in the future, and those who get the opportunity to do so, leave,” said Porrà. “So if you find work away from home, that’s where you start a family. This also means we have an increasingly older population and nobody to look after them.”

Villamassargia, along with nearby Sulcis-Iglesiente and Carbonia, is among the most deprived areas of the island. But while poverty has contributed to the fall in births, Porrà blames more the absence of a political strategy. “We have never had a serious social plan,” she said. “It’s useless just giving money to people without having the support services in place.”

Porrà, who is in her second term as mayor, set up her town’s only nursery. Called Rosa Parks, it can host up to 23 children. “It’s a huge effort that requires a lot of resources and I’ve never had a cent of support from the state,” she said.

Ada Prunas, a retired maternity nurse from Lanusei, a town in south-east Sardinia, depicts a similar picture. When she began work in 1980, there were about 700 babies born in the town each year; by the time she retired in December, the number had dropped to 300.

“They postponed the closure of the birth centre here, too, but economically it’s not good when you think about the number of staff you need for each birth,” she said. “Nowadays, women are thinking first and foremost about getting a job, and so, if they start a family, they are 38 or 40, whereas before they were in their 20s.”

The alarm bells over Italy’s demographic crisis have been ringing for years. Even though life expectancy at birth fell by almost a year, to 82.3, in 2020 due to the pandemic, the country still maintains one of the highest life expectancy rates in the world. But while this is good news for longevity, unless the birth rate trend is reversed, Italy faces huge economic and social consequences. Sergio Mattarella, the Italian president, said last year that the crisis “is a problem that concerns the very existence of our country”.

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Political inaction is partly down to constantly changing governments – since 2010, Italy has had seven different administrations. It is only now that the relatively new government, a broad coalition led by former European Central Bank chief Mario Draghi, is starting to adopt a strategy similar to the one in Bolzano. From July, families will receive an allowance of €250 a month for each child up to 21.

The measure is the first pillar of the so-called “Family Act”, which includes plans to double the number of nurseries across the country, measures to support women in the workplace and address inequality, the extension of paternity leave allowance, as well as help for young people to live independently, such as providing financial support to study, to buy a home or start a business.

These plans are expected to be funded by some of the more than €200bn Italy is poised to receive from the EU’s Covid-19 economic recovery fund.

“We have never had so much money to invest before, and our responsibility is to make the right choices, because these resources represent not only an opportunity to restart the economy but also to reverse the birth rate trend,” said Elena Bonetti, Italy’s minister for family and equal opportunities.

One of the crucial drivers will be boosting the number of women in jobs, as “the low number of women in employment and declining birth rate go hand-in-hand”, added Bonetti.

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Young people will be counting on government action. A survey in March made for grim reading, with more than 50% of 18- to 20-year-olds saying that they couldn’t imagine ever having children. The main reasons cited were bleak job prospects and the absence of adequate family policies.

Italians stay in the parental home much longer – the average age for leaving is 30. “Everything gets delayed,” said Gustavo De Santis, a demographics professor at the University of Florence. “Work, family … the starting of a family either gets postponed or renounced completely.”

At the same time, the number of single-person households has increased in Italy in recent years, along with the number of people who simply choose not to have children. “In Italy, I know people in their 50s who never got married, never had children and never tried,” said Susan Levenstein, an American gynaecologist in Rome.

If the Bolzano example is anything to go by, it could be years before Italy starts to see the impact of family policies enacted now. But, for Waltraud Deeg, political action is crucial. “It takes time to see the real effects,” she said. “But investing in children means investing in the future.”