Italy’s prestigious University of Padova made its name in the Middle Ages, when its medical scholars pioneered the dissection of human bodies to study anatomy.

These days, Dr Maria Teresa Gervasi, director of the medical school’s obstetrics unit, is dissecting the demographic crisis afflicting her university town.

An economically and culturally vibrant city akin to Oxford or Cambridge, Padova recorded a 27 per cent fall in annual births in the decade to 2020. Local primary schools are struggling to enrol Children, raising the prospect of mergers or closures.

Yet the administration of the vast University Hospital of Padova — with nearly 9,000 employees, of whom 70 per cent are Women — is resisting pleas for an on-site crèche to help staff reconcile child-raising with long, irregular hours as healthcare workers.

That, Gervasi says, sums up the social climate driving what alarmed Italians have dubbed their “demographic winter”. Annual new births are falling relentlessly as women delay motherhood, or opt out altogether, in a nation lagging far behind its European peers in support for working mothers.

“Women who desire children are deciding not to get pregnant because the social organisation here is not good for women who have children,” Gervasi says. “Women still need to be the caretakers of their children first — with no help from the government. So they wait; they wait until it’s late.”

Low birth rates — and greying populations — are a concern for many advanced economies, including European nations and Japan as well as China, now confronting the fallout from its draconian one-child policy. Challenges of older populations include pressure on state pension schemes; strained national healthcare systems; potential hits to sovereign credit ratings; and pervasive labour shortages as employers struggle to find manpower, including care for the elderly.

Italy’s demographic crisis, though, is among Europe’s most acute — the result of decades of economic stagnation and political indifference to women’s aspirations. Italians still view themselves as a traditional, family-orientated society, and the stereotype of devoted mothers sacrificing for their children looms large. Surveys by Istat, the national statistics agency, found 46 per cent of Italians ideally want two children, while a quarter would like three or more.

Yet the country’s fertility rate — at just 1.24 babies per woman — is one of Europe’s lowest and has been for years. In 2022, Italy recorded just 393,000 births, down 1.8 per cent from 2021; a 27 per cent drop from two decades earlier, and the fewest since Italy was unified in 1861.

Istat is now warning of a “crisis scenario” with Italy’s population of 59mn projected to drop to 48mn — with an average age of 50 — by 2070, further straining an economy already struggling with one of Europe’s heaviest debt burdens. Some independent demographers say even that gloomy forecast is an optimistic outlook — dependent on the fertility rate picking up to around 1.5.

Prime minister Giorgia Meloni — whose Brothers of Italy party campaigned on the motto of “God, Fatherland, Family” — is sounding the alarm. Her rightwing government is determined to reverse the trend and entice Italian women to have more babies, offering tax cuts and other financial incentives.

“Children are the first building block for any kind of future,” Italy’s first female prime minister, who has a six-year-old daughter, told a conference about the demographic crisis at the Vatican last month. “We have made the birth rate and the family a top priority . . . for the simple reason that we want Italy to have a future again.”

Minister for family, birth rates and equal opportunities, Eugenia Maria Roccella, a 1970s-era feminist and abortion rights activist who has since lurched rightward, says women should see child-rearing as a valid choice. “Maternity has been largely devalued,” she says. “If I say, ‘I am a mother’ I have no social reward. If I say, ‘I am a career woman,’ it’s different. There must be social gratification for those who say, ‘I am a mother’.”

The falling birth rate — coupled with a high number of arrivals of undocumented migrants from Africa and Asia — is also stoking uglier rhetoric. A controversial recent cover of the conservative news weekly Panorama depicted a map of Italy filled with photos of black people and women in Muslim head-coverings and the headline: “Italy without Italians”. It provoked a social media stir, with critics slamming it as racist.

Agricultural minister Francesco Lollobrigida has publicly warned that Italians will be at risk of imminent “ethnic replacement” unless more of them embrace parenthood. “Italians are having fewer children so we are replacing them with someone else,” Lollobrigida, who is Meloni’s brother-in-law, told a trade union conference.

Yet economists and demographers are sceptical that financial incentives and pro-motherhood propaganda will be sufficient to lift birth numbers in a society where raising children is often seen as incompatible — either ideologically or practically — with paid jobs.

What Italian women really need in order to have more children, feminist academics argue, are better job opportunities and more support both from the state — and the men in their lives — to help them reconcile work with a family life.

Critics worry that Meloni’s rightwing government instead sees Italy’s fertility crisis through a “patriarchal” lens that focuses on making it more financially feasible for women to stay home to raise children.

“They say a lot about families, and helping women to be mothers, but not about pushing female employment,” says Azzurra Rinaldi, an economist at Rome’s La Sapienza University. “The framework is very clear: your main duty here is to be a mother.”

It takes a village

Italy’s last baby boom, with fertility rates well above the 2.1 rate that demographers consider necessary for sustaining the population, was during the post-second world war “economic miracle” — a time of robust growth and social optimism. At its peak in 1964, Italy recorded 1mn births. 

But deliveries have declined steadily since the 1970s, as more educated women delayed motherhood to break into a tough job market. “Women tried to first consolidate themselves in the labour market and then to start families,” says Maria Rita Testa, a demographer at Rome’s Luiss University.

Other European countries, such as Sweden, Germany and France, responded to similar trends by increasing state childcare, promoting flexible work and encouraging gender equality among couples. This paid off in what Rinaldi, the economist, calls a “virtuous cycle” of more women working and raising children. 

Across Europe today, higher fertility is correlated with higher female employment rates, both due to women’s higher aspirations and because raising children on a single income is difficult. Italy, though, has the EU’s lowest female employment rate with just under 52 per cent of working age women in paid jobs, around 20 per cent below Germany.

Unlike other European nations, Italy has clung to the idea that children should stay home with their mothers until starting school at age 6. That has taken a demographic toll: of Italian women born in 1980, more than 22 per cent have no children, compared to just 15 per cent who remain childless in France.

“Italy did almost nothing,” says Testa of Luiss University. “The only external help women had was from their parents and their parents-in-law.”

Today, slots at state-run nurseries remain scarce while private care is so costly as to eat a large chunk of women’s earnings. Things do not get easier as kids grow. Middle schools, for children age 11 to 14, typically end at 1pm and have neither canteens nor on-site after-school activities. “Everything is built with the idea that mothers are at home,” says Maria Letizia Tanturri, a University of Padova demographer, and a working mother herself.

Though Italian women without children work at the European average rate, mothers tend to drop out of jobs or are pushed into part-time or short-term contracts. Fifteen years after the birth of a first child, working mothers are earning just half what their childless female counterparts of similar ages, skills and initial salaries earn, according to the Bank of Italy.

“I have patients who, having had two children, decided to stay at home because they couldn’t make it [work] any more,” Gervasi, the obstetrician, says.

Meloni has lamented that many women “cannot fulfil their desire for motherhood without having to give up on professional fulfilment”. But she has also sent complicated signals about women’s roles.

Many feminists were dismayed that the premier took her daughter, Ginevra, to the G20 summit in Bali and asked why, while representing Italy on the world stage, Meloni also had to be the primary caregiver and whether the child’s father could not have helped. The prime minister lashed out angrily on Facebook declaring: “I have the right to do all I can for this nation without depriving Ginevra of a mother.”

How such pressures affect women’s fertility is now at the centre of a public debate, with books like last year’s No Country for Mothers — which examines motherhood’s heavy toll on Italian women’s economic prospects — and The Children I Do Not Want, essays about the decision to become a parent or remain child-free.

Roccella, now 69, argues that Italy needs a “cultural revolution” to make it easier for women to pursue personal and professional fulfilment. “My generation were multitasking — we tried to do everything,” the minister says. “Today girls are fed up. They rightly don’t want to do double what men do . . . They don’t want to make all the sacrifices we have — and they are right.”

Yet it is unclear just how Meloni’s government intends to help.

So far, it has halved the VAT on infant products such as nappies and baby food; extended new financial support for families with four kids or more; and cut taxes on fringe benefits for employees with children. These moves supplement a scheme launched by the previous government in 2021 to give parents monthly allowances — from €50-€175, dependent on household incomes — for each child from birth until age 21.

However, plans to spend €4bn from Italy’s €200bn, EU-disbursed Covid recovery fund on new childcare facilities, with places for around 264,000 kids under age six, are lagging far behind schedule.

Rome is pushing employers to adopt family-friendly policies, like flexible work and on-site childcare, but that only goes so far in an economy still dominated by small and medium family-owned enterprises. In Italy, more than a third of workers are either self-employed or on precarious, short-term contracts.

Even while Meloni calls on Italians to “rediscover the beauty of being parents”, her government still sees parenthood as a privilege to which some people, such as members of the LGBTQ community and single women, are not entitled. In Italy, IVF is only legally available to heterosexual married couples — restrictions the government has no plans to ease. 

“Whatever each person’s legitimate choices and free inclinations may be . . . we are all born from a man and a woman,” Meloni says. “Children are not over the counter products that you can pick up, as if you were at a supermarket.”

‘We need people’

Back in Padova, many young women — discouraged by the traditional stereotypes and crushing social expectations of mothers — believe having a child requires a level sacrifice they are not prepared to make. “Here, it’s considered that if you become a mother, you lose your life,” says Tanturri, the university demographer. “This is the narrative people see from the older generations.”

Writer Marta Zura-Puntaroni, 35, moved to the city’s historic centre three years ago to join her boyfriend, a scholar at the university. She has seen some of her friends struggle with isolation and the challenge of keeping up with work since having children. She has no desire to follow suit.

“I never feel the urge to have babies,” says Zura-Puntaroni, the author of a novel and two memoirs. “Even if my partner is a wonderful human being — a feminist, a cook and all the domestic work is half and half — I don’t think it would be the same if we had a baby. The main part of child-raising is always on the mother, even now . . . He wouldn’t have to change his lifestyle so deeply like me.”

The precarity of work is also a concern for younger women. Zura-Puntaroni, who also earns money as a social media influencer, points to a friend, a communications consultant, who lost a longstanding contract with a major brand right after giving birth. “Lots of us [millennials] are freelance so it’s not an easy task to decide to have a baby,” she says. “I’m not in a bad place with money, but my lifestyle would be a lot different. All the money I spent on myself, on the house, travelling, wine — all my little luxuries — would go to the baby.”

Across town, the lively Arcella Quarter is home to many of the 36,000 immigrants among Padova’s 209,000 residents. It is one of the few areas where classrooms and playgrounds are full. City council member Francesca Benciolini says the ethnically diverse neighbourhood is a vital part of the city, and she chafes at the alarmist anti-migrant rhetoric coming out of Rome.

“Italy is a place that from the very beginning was in contact with all Mediterranean people,” she says. “It’s part of our history. Now, we think we have ethnic substitution? It’s crazy.”

Maria Castiglioni, a University of Padova demographer, says that Italy will have to reconcile itself to immigration as part of the answer to its worsening labour shortages and demographic woes.

“We need people,” she says. “Yes, this needs to be regulated but on a practical basis. We are too ideological. We need migrants, but we have to change our attitude towards them [and] see them as a resource and not a burden.”

Yet even among Italy’s ethnic minorities, demographers say birth rates tend to drop as people assimilate.

Giada Wang, 35, was born in Italy to Chinese immigrants and acquired Italian citizenship at 18 years old, the earliest Italian rules allowed. A year ago, she and her Chinese-born husband, Wu Jing, opened Xiang Dim Sum, a popular 28-seat restaurant serving what Wang charmingly calls “Chinese ravioli”.

Wang thinks about having a child, but has put it on the backburner for now, as she works to ensure the success of her fledgling business. “No one is against having babies. By nature, people tend to want them,” she says.

“This trend of not having them is because there is no support. The wind is not favourable. For me, having a child is not a priority. Maybe next year.”

Additional reporting by Giuliana Ricozzi