Neonatologists: “An emergency plan not spot measures against empty cradles”

“We neonatologists are privileged witnesses” of the demographic winter that has been holding Italy in its grip for years. “Let’s touch what is happening firsthand. Unfortunately, in 2021, for the first time in history the number of births went below 400 thousand in our country, with a loss of almost 30% in the last 30 years. very worrying numbers. And there is no magic recipe to solve this problem. ” But that of empty cradles “has now become an emergency and must be treated as such, in the sense that the instruments of the emergency must be used. We ask for a plan, a permanent commission that also includes representatives of scientific societies and addresses in a profound way the problem also with emergency interventions to quickly change the trend “. For Luigi Orfeo, president of the Italian Society of Neonatology (Sin), the watchword must be: “Concrete and structural aid, not spot measures”, he says to Adnkronos Salute. In other words: the demographic winter must be elevated to an emergency, as was the pandemic, even if the number of babies that has been falling inexorably for years makes less noise than a virus. To discuss the problem, neonatologists have decided to put it in the spotlight also in the context of the Sin National Congress underway in Florence. Orfeo tries to analyze what has not gone well so far in the solutions put in place. “Even the Family Act – he reasons – is certainly a first attempt a little more organic, but it uses what are the systems of current legislation. And this, I repeat, is a social emergency that needs the right mix of measures. “. “I read about surveys according to which taking a child to university costs about 700 thousand euros. I point out – he remarks – that there are experiences made in other countries that are very interesting because they are aimed at a conceptual revolution: having a child who is no longer seen as a cost but as a resource “. For this conceptual revolution it is necessary “to use the fiscal lever as happens in France, economic aid is needed – lists Orfeo – Then, the second big problem is that of reconciliation between family and work: analysis by the Bank of Italy tells us that more than 50 % of women after the first child change their work activity. So it is necessary to ensure that there are no penalties in the workplace for women, we need crèches, and parental leave also for fathers: in Italy we are in the last places for the use “of male leave. “These are the most immediate interventions to be carried out”, continues the president of neonatologists. “It will take time. It must be kept in mind – he specifies – that all the interventions that are launched now will probably give results in many years. Politics, on the other hand, would like to see the immediate result in some way, but it will not be so”. What has been done so far is not enough, highlights Orpheus. “The single allowance is a bit of a help for those who already have children, but I believe that 30-50 euros a month does not make them decide to have a child. The problem is working for those who cannot make children. because it cannot find economic stability, because work is precarious, because there are no policies for housing and work “. For the specialist, these are “the foundations on which to place a real relaunch of the birth rate. Because today we have a problem we are screwing up on: there are few women of childbearing age, because the problem of denatality has lasted for a long time. few children and they have them very late. We also have the highest average age of the first child, which reaches almost 33 years. It is evident that, if a woman has her first child at 35-36 years, then it is difficult and much more unlikely to do the second “. “The family quotient tool in France has achieved great results: the more children you have, the less taxes you pay. So we are not talking about 30 euros a month, but several thousand euros a year. Money that is invested in children. the right recipe “, according to Orfeo,” is a mixture of economic and cultural aid, crèches, parental leave, guarantees at work so that women are not penalized. But all the ingredients must be there together “. “We will ask Minister Roccella for a meeting. The birth rate must not remain a label” “The family in recent years has only been used in an instrumental way by politics. There has been much talk and only about the type of family that one must have, as it should be composed, but there has been no real help, if not some measure from time to time. We will ask to be summoned by the new Minister of the Family and Birth “, Eugenia Roccella,” to try to work together. and we hope that not everything remains tied to the name of a ministry, without the facts “, hopes Orfeo. The expert reflects on the prospects that open up:” Having put the word Birth “in the denomination of a department” can mean something. But here we are talking not only about rights, but about concrete help that will be needed. We will see. If there are truly actions in favor, we will be the happiest people in the world. And we would like to launch an appeal. privileged “of the empty cradles phenomenon,” and being in contact with young couples and their problems, we believe we are also important interlocutors for politics. We therefore ask to be involved in the resolution of this problem and in the choices that will be made “, says the number one of the Sin. What are the problems of young couples, seen from the observation point of neonatologists?” extended family of the past – analyzes Orfeo – Many of these young couples work far from their families of origin and there are no services to which they can entrust the children. Grandparents may live 500 kilometers away. My collaborators, for example, are Calabrian, Sicilian and live in Rome, and their parents are in the South. When they have a child they go into difficulty. There are no kindergartens or they are very expensive or far from home “. Society has changed, he reasons, family policies have not.” And there is also another problem to consider, which has been ascertained: families with more children are a little more at risk of poverty “. An element, the specialist points out, that cannot be considered in this phase which is in itself economically difficult. Finally, there is the health issue with which the discussion will probably be with the minister della Salute, Orazio Schillaci. “It is clear that the decline in births needs a complete restructuring of the Italian birth centers – specifies Orfeo – If we had a structure calibrated for one million births a year and now there are 400 thousand, we will have many birth points that are too small and with too low numbers. In this way we do not have the possibility to guarantee, due to a lack of doctors and specialists, the same type of safety in all structures. There is therefore a problem also in these terms, of rethinking the network of birth centers and adapting it to what is the current reality. “A subject to study in schools and universities Does a cultural factor also contribute to emptying the cradles of Italy? “In part, yes”, Orfeo analyzes. “We, together with the gynecology and obstetrics society, also did street activities by meeting people. There was recently an event in Naples and there will be others in other main cities of the country – he says – There is a need to involve and sensitize the population, which perhaps is not always aware of the risk of going to this direction. But if the issue of the birth rate is also a cultural fact, I believe that we must enter schools and universities. We must explain to the children that there is a biological age “and the moment of a child” cannot be delayed too much. “Even” in the media – reflects the expert – the birth rate is addressed only from time to time, but then there are themes that interest more “and have the upper hand. Would a dedicated day also be needed, as was the ‘Fertility day’ in 2016, which aroused so much criticism?” last year they also hosted the Pope “. But it is to young people that we need to talk, points out the number one of neonatologists. Having a child” is a real transition to adulthood and we are seeing that today’s children they tend to postpone it more and more. But on the other hand there is a biological clock that does not stop “. So the rules of the birth rate should be taught among the schools.” To make it clear – says the specialist – that you cannot go beyond a certain limit, because then it becomes more difficult and you risk not having children anymore; that fertility is reduced and it is necessary to resort to assisted reproduction techniques, and things become less simple. In the context of an overall civic education I would also see the theme of the birth rate. I wish we could also talk about some fundamental elements such as parenting, the desire for motherhood and fatherhood. There are surveys on young Italian couples that show that this desire is very much felt in reality, but then it is not put into practice. Because it is postponed and postponed. And in the end there is the risk of never realizing it “.