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CHILDREN

The real reasons young Italians aren’t having kids

An Italian campaign to raise awareness over fertility issues has provoked outcry, with protestors accusing the government of doing nothing to tackle the real reasons behind Italy's slowing birthrate.

The real reasons young Italians aren't having kids
Why have Italians seemingly stopped making babies? File photo: Pexels

Italy has the lowest birthrate in the European Union and one of the lowest in the world, with only eight babies born for every 1,000 residents in 2015, according to EU figures released in July.

A total of 485,000 babies were born in the country last year, a record low and less than half the level of the 1960s. Mums are also getting older; the number of women over 40 giving birth doubled between 2002 and 2012, according to Eurostat, and the average age at which mothers have their first child is 31 years and seven months.

Yet a campaign from Italy's Health Ministry to make couples aware of issues surrounding fertility – and to encourage them to have babies sooner – has been widely criticized.

Its first series of promotional material was scrapped after an outcry over ageism, with criticism levelled at a poster with the message 'Beauty has no age. But fertility does', and the second iteration was labelled as racist after a poster used a group of white friends to illustrate 'good habits' and people of different ethnicities to represent 'bad habits'.

Though Health Minister Beatrice Lorenzin quickly announced the ministry's Director of Communications had been fired, it wasn't just the posters being questioned, but the entire reasoning behind the campaign.

Lorenzin had organized Fertility Day to host talks, debates and health screenings promoting awareness of infertility, but in cities across the country, counter-protests with the slogan 'Fertility Fake' were organized.

Demonstrators held signs reading 'siamo in attesa', a play on the Italian term which means 'we're expecting' but also translates as 'we're waiting'.

A Facebook group which organized the protests, which 1,400 people marked an interest in, said: “The government wants us to have children – and fast. Lots of us don't want to, and in fact, we are waiting. For creches, welfare, salaries, benefits.”

The thing is, many Italian women do plan to have children. The average Italian woman wants to have 2.3 'more' children (whether they already have any or not), data from national statistics agency Istat in 2012 showed, while three quarters of women with one children said they planned to have at least one more.

So why don't they?

To start with, while overall in Italy the unemployment figures have declined in recent years, youth unemployment is still high, with many young Italians forced to live at home into their late 20's and beyond.

A lack of money and a house is off-putting for many would-be parents, and there is no 'child benefit' scheme equivalent to that in the UK and numerous other European countries.

Working women face the added fear of losing their job if they have a child. Among Italian women who are employed when they become pregnant, one in four loses her job within a year of giving birth, according to data from national statistics agency Istat – a risk which increases with each subsequent child.

And a worrying 42.8 percent of those who had continued to work admitted to struggling to reconcile their work and family life.

In 2014, the IMF said Italy had done the least of any European country to encourage women to work, with only around half of women in the workforce and even fewer in the south.

Aside from financial concerns, a lack of childcare options is another key issue in a country which has traditionally relied on close links within the family and community to look after children. One in two Italian families regularly use grandparents as a babysitting resource, with 20 percent providing daily or almost daily care.

But those for whom this is not an option are left with limited choices.

State-run and state-subsidized pre-schools are available in Italy, but are often very over-subscribed, particularly in cities, leaving women to pay for expensive private care.

While private childcare is a preferred option for some, half of Italian women who didn't send their children to daycare said the reason was that they couldn't afford the cost, while almost 12 percent said they couldn't find a place for their child, Istat data reveals.

One mother took to Twitter on Thursday to say that childcare for her two children over six years had cost her €56,000, while many other women said caring for their children without family support would have been impossible.

One said that without the help of grandparents, she and her children would be living “under a bridge”.

Most of the messages on banners at Thursday's protests repeated these concerns, saying they were waiting for Italy to guarantee better salaries, stable work, affordable childcare and gender equality.

Others took their frustrations to social media, using the slogans '#siamoinattesa' and '#vorreimanonparto (roughly: I'd like to, but I can't have children).

Some people were even less optimistic, saying that they were waiting for a “miracle” or “a better country”.

No job. No money. Simple.

Women still earn less than men, and female employees lose their jobs when they become mums.

Because it takes a moment to go from 'woman in society' to 'burden' on society.

I have two children despite endometriosis. Without grandparents, in six years, nannies, creches, after-school and summer centres have cost €56,000.

A job and greater stability. Children aren't a game.

Work, support, benefits; too much is lacking, you can't pretend to be 'fertile' if you live in arid terrain.

We are waiting for salaries, nurseries, university tuition and the chance to be able to choose our own lives.

 

 

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HEALTH

Pregnancy in Italy: What are all the tests you’ll need to have?

Italy’s healthcare system offers tons of free testing during pregnancy, but how many tests are there exactly, and are they free of charge? Here’s what to expect and when.

Pregnancy in Italy: What are all the tests you'll need to have?

Expecting a baby can be an anxiety-inducing experience, no doubt. Fortunately, Italy is rightfully famous for its healthcare system, which produces some of the world’s best maternal health outcomes.

Part of the secret to that success is a robust schedule of testing that residents can access for free as part of their pregnancy.

In fact, the amount of testing offered during pregnancy in Italy can be surprising to those who aren’t familiar with the Italian health service.

Here’s what to expect:

Getting started: the first appointment (6-11 weeks)

Before you can get any testing done, you will need to arrange for a first appointment with an obstetrician via a local hospital, private clinic, or family counselling center.

In the early stages, your pregnancy will be dated to the first day of your last menstruation, so be prepared to provide that date a lot. It will be included on all your paperwork as you go from provider to provider.

READ ALSO: Pregnancy in Italy: What are the options for public or private healthcare?

Your first appointment should generally be scheduled after the sixth week of pregnancy, so that the fetus is clearly visible on an ultrasound, and ideally before 11 weeks. Because there are sometimes delays in securing appointments, it makes sense to plan ahead as much as possible.

At this first appointment, you’ll get a general orientation to the process laid out below and be scheduled for future check-ups. You’ll get a basic physical and they’ll take a full medical history.

Then, you’ll be scheduled for your first battery of tests to establish a baseline of health and confirm your pregnancy.

On the first visit, or shortly thereafter, you’ll receive the following tests free of charge:

  • A first ultrasound to confirm your pregnancy and determine the age of the fetus;
  • A Pap (smear) test, if one has not been performed in the last three years;
  • A series of blood tests to check for blood type, blood sugar, red cell antibodies (the Coombs test), rubella, toxoplasmosis, syphilis and HIV; and
  • A urine test.

If you’re deemed at risk for Hepatitis C, chlamydia or gonorrhea, you may also receive tests for these as well.

The Bi-Test (11-14 weeks)

Starting at 11 weeks, you’ll be eligible for the so-called Bi-Test or Combined Test, which screens for common genetic and developmental disorders.

Until 2017, this test was only free for women over 35, but it’s since been made a standard part of pregnancy health screening in Italy.

A midwife monitoring a pregnant woman. (Photo by MYCHELE DANIAU / AFP)

The non-invasive test involves an additional blood sample and ultrasound between 11 and 14 weeks that checks for abnormalities in the fluid beneath the fetus’ neck.

Because the test is only about 92 percent accurate, if it detects any issues, your physician will refer you for follow-up testing — either non-invasive DNA testing, which is more accurate, or an invasive amniocentesis procedure, which samples a small amount of cells from your amniotic fluid and provides a definitive positive or negative result.

READ ALSO: 15 practical tips for pregnancy in Italy

If you miss the window for the bi-test, there’s an optional non-invasive blood test known as the tri-test, available from the third trimester, that can screen for the same issues. It also tests for neural tube defects, another common disorder.

These tests are optional but are covered by the national health service. In practice though, whether you can access this test for free depends on whether there is a trained, public technician in your area.

In some regions, only the invasive tests can be performed in the public system.

Regular checkups

After these initial tests, you’ll be scheduled for regular checkups every month to 40 days. At these checkups, you’ll receive a basic physical and blood pressure check and your doctor may listen for the fetus’ heartbeat.

You’ll also be regularly tested for toxoplasmosis, rubella, and your blood glucose levels, so be prepared to roll up your sleeves a lot.

Photo by National Cancer Institute on Unsplash

Sometime between 24 and 28 weeks, you’ll receive another urine test, and at 28 weeks, you’ll be scheduled for another round of the Coombs test, which checks for red cell antibodies.

All of these tests are simply part of ensuring your health and that of the baby is ideal as you head into the later stages of pregnancy.

Depending on your hospital or physician, you may also receive additional ultrasounds during this period. Most Italian women report receiving an average of 4 to 5 ultrasounds over the course of the pregnancy, despite only two being required by law.

Second ultrasound (19-21 weeks)

At minimum, your second ultrasound should occur between 19 and 21 weeks, and this is the big one — your fetus should be looking like a baby and you are likely to be able to determine the sex.

If you don’t want to know the sex of the baby, you should speak to your gynecologist in advance. They can withhold the information, or even provide it in a sealed envelope to a trusted friend if you are planning on organizing a reveal.

Third trimester: Tests, tests, and more tests

By the 28th week, you may be recommended for a follow-up ultrasound if your doctor has any concerns about the baby’s development.

You’ll also receive another blood test, including a Coombs test, and will be scheduled for tests for toxoplasmosis, Hepatitis B, HIV, syphilis, and vaginal streptococcus, to occur sometime between 33 and 38 weeks.

Lastly, you’ll also be required to do another urine sample between 33 and 38 weeks, to ensure you won’t have a urinary tract infection at the time of delivery.

More tests?

The above is just a baseline — your doctor may order additional tests if they are concerned about any aspect of you or your baby’s health.

If anything goes wrong with your pregnancy, you may be referred to specialist care. This should all be free of charge, so long as they are requested by a physician in the public system. (If you opt for private care, you may be required to pay fees for these same services.)

After delivery

The Italian national health service also covers postpartum care, including psychiatric screening and postpartum counselling. If you are experiencing signs of postpartum depression, it’s worth talking to your doctor about referrals to this care.

The cost of birthing and parenting courses are also covered by the government, so ask your physician about what is available in your area.

READ ALSO: Who can register for national healthcare in Italy?

All these tests are available free of charge to EU citizens regardless of whether or not they have an Italian health card (tessera sanitaria). Any non-EU citizens with a long-stay visa (permesso di soggiorno) may access them also with referral from a physician.

If you do not have a visa or are undocumented, you can access many of these services via a local family counselling center (consultorio familiare), which are obligated by law to provide care to all women irrespective of immigration status.

Keep in mind that if you opt for a private gynecologist or pregnancy clinic, you may have to pay extra for tests available for free from public hospitals. Price lists are rarely posted online, so do your research before choosing a provider.

For more information about healthcare during pregnancy in Italy, see the health ministry’s official website here.

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