For members


Ten things you need to know about giving birth in Italy

The prospect of giving birth can seem daunting at the best of times – and expat mums-to-be face a whole host of added challenges, from differences in healthcare systems to language barriers and cultural cues. Patricia Bowden and Rhonda Turnbough, who each had their children in Italy, tell us the ten things they wish they'd known beforehand.

Ten things you need to know about giving birth in Italy
Giving birth in a foreign country can be especially daunting. File photo: Pexels

1) You don’t have to worry about insurance 

The hospital will not charge anyone for giving birth or for any emergency procedures that may occur during labour and delivery.

This means that choices are not limited by any insurance plan, you don’t have to worry about your baby being taken to an in-network NICU (if necessary), and there are no financial forms to fill out. Instead, these services are paid for with our taxes. This is also true for pre- and post-natal classes. Alternative birthing centers, however, are not covered.

2) But you do have to buy your own stuff

Each hospital requires you to bring your own things such as diapers, outfits for your newborn, your robe and etc. Some people have a hospital bag – I had a hospital suitcase!

3) Pre-natal classes are very sociable, but you have to put yourself out there

Butting in on other people's conversations is a huge no-no back in the US and will the most likely response is a nasty side-eye. Because of this, I kept my mouth shut during my pre-natal classes at the hospital, which left me feeling very left out since everyone appeared to be good friends but no one seemed to want to talk to me.

Eventually, I realized that they weren't actually old friends, but had just struck up a conversation at random. Two people would start talking, then another woman would join in and hey presto, she is in the conversation. This would continue until everyone was included in the conversation – but you have to make the first move.

Patricia Bowden gave birth in Genoa while still learning Italian. Photo: Private

Figuring this out took extra effort on my part since I was very early on in my Italian studies and couldn’t yet pick up on the specific social cues. Once I did though, I waited for the opportune moment (which took a while, because I had to understand what was being said before I jumped in) and began making friends. Mastering this skill changed my entire experience. So mums-to-be, don't feel like you're being ignored – just take the leap!

4) Women have comprehensive maternity leave. Men… not so much

Working mothers get five months (or more in some cases) off at full pay. If they work in an environment that could be harmful to the fetus, they can take their whole pregnancy off with full pay.

As Americans, we are used to considering maternity leave from the employer's point of view, so this seems like a lot, but think about how awesome it is for the mom and her new baby to have so much time together. If the mother doesn’t have a job but the father does, he can take a month off at full pay and more months off with partial pay.

When it comes to dads, the situation seems to vary. My friend’s husband got one month with full pay and five months at 30 percent pay, which he can take over the next five years; however, my husband got just two days. If you come from a country where generous paternity leave is the norm, such as one of the Nordics, this may be a less pleasant surprise.

5) Italians are very accommodating towards pregnant women

Once I began showing, no one let me stand on public transport – whether they were old or young. I receive the same reception now when I take public transport with my baby. I am always offered a seat, even if my little one is in his stroller. People also always offer to help me lift my stroller up or down, will hold things if I need it, or even help me open and close my stroller.

Lorenzo at Halloween. Photo: Private

People are also willing to help distract my baby when he is fussy. One restaurant owner carried our baby around while working to give us time to eat in peace.

Some places even have reserved spaces for pregnant shoppers in the parking lot of the mall and grocery store (pink parking!). It was always a thrill to be able to get priority parking, especially when I was huge. The only bad thing is that there are always more pregnant women than open spaces, so sometimes you and your giant belly are forced to park at the furthest away spot and walk, just like the rest of the population.

6) It pays to have children

Italy has a shrinking population. To combat this, Italy offers a subsidy for children to parents with an annual income of a certain amount to encourage people to procreate. Some companies also offer subsidies when an employee (male or female) has a child – a welcome bonus!

Rhonda is from Las Vegas and gave birth in Ferrara. Photo: Private

7) The one-person rule

Most hospitals in Italy only allow one person (of the mother’s choice) into the delivery room and in your hospital room. This is to limit the amount of germs the baby is exposed to during this delicate period, but you should be aware of it in advance to ensure you've chosen your birthing partner.

8) Your child will become the ultimate ice-breaker

This is really helpful if you moved to Italy as an adult and live in a city with few foreigers. When you move to a new place as an adult, usually everyone your age seems to have a full social group so no-one talks to you. But your little one will make you the most popular person in town. Even small children and rowdy teenagers will come up and play with your little one. 

Rhonda and her baby. Photo: Private

9) Italian food!

Probably the best part about giving birth in Italy is that it's home to the world’s favorite cuisine. I was lucky to be at a hospital that actually let me pre-select my lunch and dinner from a menu so I never had to worry about allergies or intolerances. However, hospitals all over the country will make sure you won’t receive anything you cannot eat. This foodie’s tummy was super satisfied with the quality of the food. My only complaint would be that I wish I had more!

10) Some hospitals may encourage you to scream!

It could be said that Italians have a more 'vocal' culture, and perhaps this is why some nurses during your labour will require you to scream bloody murder in order to open your cervix. Whether it works or not is debatable, but I guess everything is worth a try when your baby doesn’t want to come out. One thing this does NOT do is put the other expectant mothers at ease while they are waiting their turn!

Patricia Bowden is an avid traveler and a translator of academic medical articles for publication, government-issued documents, and various cultural pieces from Japanese and Italian into English. Although originally from New York, NY, she currently lives in Genoa, Italy, with her husband and 11-month-old son, Lorenzo, who is currently a child model. In her spare time, she enjoys experimenting with delicious concoctions in her kitchen. To learn more about Patricia, visit her on ProZ. If you would like to work with Lorenzo, please contact B Talent Scout Agency.

Rhonda Turnbough is an artist, originally from Las Vegas, Nevada, U.S.A. who currently lives in Ferrara, Italy with her husband and one-year-old daughter. Her favorite things about living in Italy are the socialized medicine, relative lack of gun violence, and the ridiculously vast selection of yogurt. You can learn more about her at

This article was first published in 2016

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For members


Five essential facts about Italy’s public healthcare system

From overall costs to access for foreigners and essential vocab to navigate the admin, here are the five things you need to know about Italy’s public healthcare.

Five essential facts about Italy’s public healthcare system

Wondering how Italy’s healthcare system works and how it compares to systems in other European Union countries?

Though there are a number of principles and standards of medical care that are shared by all member states, each country has its own unique national healthcare system. 

To give you a general idea of what the Italian healthcare system looks like, here are five essential things that you need to know. 

It’s one of the best in the world

Italy’s public healthcare system (or Servizio Sanitario Nazionale, SSN) is by no means perfect. However, the average level of medical care across the boot is very high, so much so that Italy has been ranked among the countries with the best healthcare systems in the world by the World Health Organisation, Bloomberg and World Population Review.  

Prior to the Covid pandemic, Italy enjoyed the second-highest life expectancy in the EU, sitting at 83.1 years at birth.

Due to increased mortality during the Covid pandemic, that value is now 82.4, though Italy remains among the top five European countries when it comes to life expectancy.

READ ALSO: What can Italy teach the rest of the world about health?

Prior to Covid, Italy also had the second-lowest rate of preventable and treatable mortality in the EU, with mortality rates from conditions such as ischaemic heart disease, lung cancer and alcohol-related diseases all sitting well below the EU average. 

Data relative to the last couple of years has yet to be released.

Italian doctors are usually highly qualified. Suffice to say that as many as four Italian universities figure among the top 130 institutes in the world for medicine-related subjects. Sadly though, the rapidly declining number of doctors working in public hospitals and as general practitioners is raising serious concerns about potential future shortages.

It’s decentralised

Italy’s healthcare system is tax-funded and broadly regulated by the Italian health ministry (Ministero della Sanità). However, unlike other European health systems, it operates on a regional rather than national level, leaving major decisions to the relevant local health authorities (Aziende Sanitarie Locali, ASL).

Though they broadly abide by the national guidelines from the health ministry, each individual ASL acts as a somewhat independent healthcare system, managing its own public clinics and medical services.

This means that service provision (including the costs of individual medical procedures and pharmaceuticals) varies depending on the region one is based in. 

Over the years, many have criticised Italy’s decentralised healthcare system for creating imbalances in the level of healthcare services offered across the country, especially between north and south.

In particular, the EU Commission’s 2019 Health Profile Report for Italy noted that “different fiscal capacities and health system efficiency levels across regions” might undermine “the ability of poorer or lower-performing regions to provide access to high-quality health care services”.

Indeed, concerns of this kind have been validated by multiple reports, including Il Sole 24 Ore’s 2019 Health Index, which showed how provinces located in the south of the country generally fared worse than their northern counterparts in categories such as life expectancy and mortality.

Italian doctors in the ICU of Cremona hospital, Lombardy

The number of Italian doctors working in public hospitals or as primary care physicians is rapidly declining, which raises concerns about potential future shortages. Photo by Miguel MEDINA / AFP

It can be accessed by foreign nationals

Italy’s healthcare system is open to all foreign nationals including, in the case of emergency treatment, undocumented people

All EU nationals holding a valid European Health Insurance Card (EHIC) and British nationals with a UK Global Health Insurance Card (GHIC) have regular access to the Italian healthcare system and enjoy the same benefits as Italian residents. 

They are entitled to free access to public primary care physicians (medici di base) and emergency care, and discounted access to specialist consultations, diagnostic exams and non-urgent procedures.

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

As for non-EU nationals, those holding a valid residence permit (permesso di soggiorno) other than one issued for tourism purposes have the right to register with the Servizio Sanitario Nazionale and receive an Italian health insurance card (tessera sanitaria).

The card grants non-EU nationals the same rights and benefits enjoyed by Italian citizens and its validity expires on the same date as one’s relevant residence permit. For details on how to register with the SSN, please refer to the Ministry of Health’s website.

Finally, non-EU nationals visiting Italy for tourism-related reasons are entitled to emergency care and non-urgent medical assistance, though they must pay for both services.

In Italy, urgent medical assistance is provided to anyone in need, regardless of their nationality or immigration status and without asking for upfront payment.

Fees associated with emergency care procedures are generally paid upon hospital discharge and are usually very reasonable.  

Seriate's Bolognini hospital, Italy

Emergency care and hospital admission are free of charge for all Italian residents and European Health Insurance Card holders. Photo by Miguel MEDINA / AFP

It’s fairly cheap

As previously mentioned, urgent medical assistance and access to primary care physicians are free of charge for anyone holding a valid Italian Health Card, a EHIC or a GHIC. 

Most of the remaining services, including diagnostic procedures, specialist visits in out-patient settings and non-urgent medical interventions, fall under a cost-sharing system, meaning that fees are partly paid for by the SSN

The co-payment fee is generally referred to as ‘ticket’, with the amount patients are required to disburse varying according to the type of service required, patients’ own medical and/or financial status and, of course, regional tariffs – each individual ASL establishes the value of its own co-payment fees but costs must never exceed the threshold set by the SSN. 

READ ALSO: ‘How I ended up in hospital in Italy – without health insurance’

Irrespective of regional differences, fees for standard medical procedures or diagnostic exams are generally very reasonable. The maximum imposable fees for the most common healthcare services and pharmaceuticals are listed in this ministerial decree.

Many categories are completely exempt from payment of the above fees. For instance, esenzioni (exemptions) apply to people with severe forms of disability or chronic conditions and low-income patients (under 8,263 euros per year).

For additional details on exemptions, see the health ministry’s website.

It doesn’t allow patients to choose specialists

People opting to see a specialist (e.g., gynaecologist, dermatologist, cardiologist, etc.) through their local ASL cannot choose the doctor they will be referred to as patients are generally given the earliest publicly available appointment within the relevant medical field. 

Consultations with specialist doctors are usually prescribed by a patient’s own physician (medico di base), though they can also be prescribed by physicians patients aren’t necessarily registered with.

A nurse viewing X-rays in Casalpalocco hospital, Rome

Diagnostic exams and non-urgent procedures are paid for through a cost-sharing system wherein the government contributes to part of the patient’s expense. Photo by Alberto PIZZOLI / AFP

The referral comes in the form of a red prescription (or ricetta rossa in Italian) with letters P, D, B and U indicating the different levels of urgency associated with the consultation – P marks the lowest priority level, whereas D is for consultations that must take place within 72 hours from the time of prescription.

The ricetta rossa allows patients to book their appointments online, in person or over the phone by calling the Regional Central Booking Office (Centro Unico di Prenotazione Regionale, CUP). 

When it comes to booking, foreign nationals with a poor command of Italian may need to seek the assistance of a native speaker as operators are rarely fluent in English and most ASL websites do not provide information in English.

Essential Italian vocab:

  • SSN (Servizio Sanitario Nazionale) – National health system
  • ASL (Azienda Sanitaria Locale) – Regional health unit
  • Medico di base – General practitioner or primary care physician
  • Ricetta – Prescription
  • Visita – Appointment 
  • Specialista – Specialist doctor
  • Farmaco – Drug / Medicine
  • Ospedale – Hospital
  • Pronto soccorso – A&E
  • Ticket – Fee
  • Esenzione – Payment exemption 
  • 118 (or centodiciotto) – Italian emergency number