You’re having a baby! Few discoveries are as momentous, as joyful and as terrifying as the news that from this day forward, you will forever be responsible for a life aside from your own. That bringing this life into the world and helping to shape the person your baby will become are responsibilities that now belong to YOU. So, you start buying books, scouring the internet, talking to friends, family, co-workers – even strangers – and you quickly realize how very, very much you have to learn.
Where to start?
If you are an ex-pat living abroad, the news of impending first-time parenthood brings with it its own brand of hurdles, stresses and, yes, joys. So, if you’re an expecting ex-pat, you know that having a baby outside your home country will be different than it would be back home, but knowing how it will be different can take you from feeling stressed and overwhelmed, to a state of calm preparedness. “Different” doesn’t have to be scary, and knowing what to expect – and what to ask for – will go a long way toward paving a smooth road to delivery.
This is the first in a three part series on Giving Birth and New Parenthood in Milan, which will address the Italian health system and delivery options for birth. Part two of the series will discuss finding a OB/GYN, the role of the ostetrica, and birth preparation (courses, information centers). Part three of the series will help you prepare for ex-pat life with your new baby in tow, and provide you with useful resources for medical, emotional and practical support.
The Italian Health System
For ex-pats who haven’t yet had much experience with Italy’s health system (SSN, Servizio Sanitario Nazionale), it’s important to know that the care is very good and is mostly covered by the State, provided you receive treatment through ASL (Azienda Sanitaria Locale), the local centers which operate health services. Upon registering at a local ASL office, you will be issued a health card (tessera sanitaria), which entitles the holder to low or no-cost treatment. Hospital services are provided free and a 75 percent reduction is given on the cost of outpatient treatments. To register with ASL, you must first obtain Italian residency (residenza).
Since the “where” of having a baby is often one of the first things that expecting mothers think about, it’s important to know what the options are. Birth and delivery in Italy are generally highly medicalized, and 88% of births in Italy occur in a public hospital setting. Over 10% of births take place in a private hospital or clinic, and less than 2% of deliveries occur at birth centers or at home.
In Milan, there is only one private clinic with a maternity and delivery ward, La Madonnina. All other hopsitals are public, the largest being Mangiagalli, with approximately 7,500 births per year, and the second largest being Buzzi, with approximately 3,500 births per year. Other Milan hospitals with maternity and delivery wards include San Giuseppe and Macedonio Melloni.
There is an increasing interest in Italy in both home births and birthing centers, such as Casa di Maternità La Via Lattea, here in Milan. For healthy women experiencing a “normal” pregnancy, i.e., no risk factors such as gestational diabetes or pre-eclampsia, either a home birth or a birth center can be a very welcome alternative to a more traditional and medical approach. In Part Two of this series, we will cover birth courses and preparation for baby’s arrival. On March 21 at 7 pm at The Milk Bar in via Conca del Naviglio, 5, there will be a workshop on Where to Give Birth in Milan, in which we will discuss in more depth the topics in this article series. For more information or to sign up for the workshop, please contact The Milk Bar at Milano@themilkbar.it or at 02 5810 8972.