The craving for consumer goods rather than bambini has given Italy the world's lowest birth-rate in the world
Italy is going through a population crisis of extraordinary proportions. It may be a country that loves babies, but there are almost no babies around any more. In truth, many Italians are more interested in acquiring a mobile phone than a son and heir.

When I visited a well-known maternity hospital in Rome to see some friends with their new-born baby, there were 130 cots in the place, but only two were occupied. That's nothing unusual. My wife went to a clinic widely reputed to be the best in the city to have our baby. There is room for only five babies at a time, but while we were there we had the place virtually to ourselves.

In an industrialised world that has seen a decline in birth rates, Italy has the lowest rate of all - 1.17 children per couple, according to one study, compared with 1.7 in France and 2.1 in the United States. Even Germany, where a sharp fall in child-bearing in the 1970s prompted Gunter Grass to write a book entitled The Germans are Dying Out, managed a rate of 1.24 in 1995.

The Germans may be dying out, but the Italians are dying out faster. According to Antonio Golini of the Institute for Population Research in Rome, the country has become the first in the world to reach the "crossing- over" point at which the population of over-60s has overtaken that of the under-20s. Moreover, trends suggest that the average Italian worker will be 70 years old by 2050. In other words, barring a turnaround or an influx of immigrants from younger populations in north Africa and eastern Europe, the country is two generations away from dysfunctional paralysis.

In terms of abstract statistical projection, by the year 2150 Italy will have millions of new cars, buildings, refrigerators, computers, mobile phones and video recorders - but no people.

The causes of this crisis are many and complex. Some are part of a trend in the western world - changes in patterns of affluence and living habits; the changing status of women; improvements in education and greater access to family planning; perceptions of overcrowding, especially in big cities, and so on. But many of the causes are specific to Italy. There's probably no better way to gain insight into them than to actually have a baby in the land of bambini.

The picture that emerges, after nine months of eventful pregnancy and four months with the real thing, is of a society struggling to square the demands of image-conscious consumerism with the traditions of what has been a largely agrarian peasant population. Babies were once part of the natural rhythm of Italian life, cared for and reared by extended families. They may still be desirable, but they impose enormous pressures on nuclear, largely urban families. They have become obstacles to a designer lifestyle.

While Italian society moves on, government support structures, the health system and Italy's over-cosseted men and the older generation of women who brought them up have remained stuck in a 1950s time-warp of paternalistic family values, strict cultural codes and high aspirations for children that derive from the optimism of the post-war economic boom, but have long since become misguided and misplaced.

And that is only one deterrent to motherhood. There is generous maternity leave of five months, but the state provides next-to-nothing in the way of child support, creches or other facilities. The health system is not user-friendly; sometimes it is downright dangerous. The common currency of modern Anglo-Saxon baby lore - low-intensity medical care, epidurals, home births, feeding on demand and the rest - have barely made an appearance in Italy. There are ways around the system but the overall impression is that pregnant women are expected to suffer and be grateful.

Moreover, the list of obligatory consumer items for a new baby is long, complex and expensive. Fail to buy that beautifully designed chest-of- drawers with baby bath on top and fold-down changing table, and your friends and family will consider you cheap and negligent. Dress poppet in anything other than bright, impeccably clean designer wear, and there will be whispers about your suitability to be a parent.

The babies that are born are still considered public property. No mother is safe from persistent prying. Nursing mothers have been approached by total strangers who squeeze their breasts to check whether they contain enough milk. Parents are berated anywhere for underdressing babies when it is cold, overdressing them when it is hot, putting them in slings ("the little darling can't breathe!"), and for paying them too much or too little attention when they cry.

As foreigners with a regular income and private health insurance, these problems have not affected us significantly. We had excellent perinatal care and have found doctors in tune with our approach. Friends and neighbours behave impeccably, but we do see examples of difficulties that might well make Italians think twice about parenthood.

From the first gynaecological visit, the thing that struck me is that expectant mothers go to the doctor with their mothers, who issue rafts of instructions. The lack of personal control over pregnancy is heightened by a medical culture that insists on testing for every last possible ailment. My wife Kathleen had more than 50 blood tests, including one to see if she was allergic to herself. Paranoia inevitably threatens to set in.

Testing takes place in impersonal private laboratories, where the expectant mother has to queue once to give blood and queue again a few days later to pick up the results. These have to be taken back to the doctors' surgery for interpretation, followed by new instructions for further tests.

The hospital admission list included six nightshirts for mother and six fiddly outfits for baby (no one-piece suits, and an insistence on a camicina, a fine cotton apron unique to Italy).

At almost all public hospitals and many private ones, labour is conducted in a strictly horizontal position, enemas and pubic hair shavings are de rigueur, episiotomies are performed regardless of their medical necessity and there is little or no pain relief. Caesareans are performed under general anaesthetic, making the mother groggy for longer than necessary. Fathers are excluded from the delivery room.

While the mother is expected to perform like a howling beached whale, the newly-born is given the Christian Dior once-over. There is no opportunity for bonding with the mucus-covered new-born, much less for the father to cut the umbilical cord; instead, baby is whisked off for a bath and returned fully-dressed, sometimes with a dollop of gel in his hair and after-shave sprayed around his jowls. The nurse who dressed our Max berated us for our poor sense of colour co-ordination.

Cultural indoctrination carries on at a cracking pace. Girlfriends ask why the new mother hasn't bought herself a girdle to get her belly back into shape (at one clinic they place sandbags on the lower abdomen to achieve the same result more quickly). Nurses bring baby for suckling on a strict four-hour rotation, sabotaging the chances of successful breast- feeding by stuffing the little ones with sugar-water or formula. Many Italian women give up, complaining of poor milk supply and severe nipple pain.

Once out of hospital, the shopping experience begins. Partly because of Italy's low birth-rate and partly because of a dearth of consumer consciousness, there is little choice for baby clothes and toys, which tend to be fiddly, impractical and expensive. In theory, there are two baby-shopping chains, Prenatal and Chicco, but it turns out Chicco bought Prenatal last year. As a result there is no competition in the marketplace. If you like your baby dressed in fussy numbers then there is no lack of pricey boutiques to chose from; for solid, practical items the best solution is to have them sent from abroad, which is not an option open to most Italian families.

Throw into the equation Italy's jobs, budget, and housing crises, and the pitfalls of private child care. Add a battle of the sexes in which women are trying to assert themselves while men still instinctively put up their feet and wait for dinner to be placed in front of them, and you begin to understand why the Italian birth-rate is the lowest of all.

Those who do embark on the parental adventure often stop after the first pregnancy, arguing that running after one little mite is quite enough work. In a country where parents are expected to keep a protective eye on their children's every move, to smother them with presents and affection, to provide them with decent housing and recreational activities and to keep them and their clothes clean at all times, who could not sympathise?

The answer? France and Germany responded to their own population crises by introducing state-sponsored pregnancy and child care programmes. Italy can't afford to because of years of abuse of its public finances. According to Professor Golini, intervention would have no more than a marginal effect. The birth-rate statistics have become so dire, he says, that "unless each fertile woman starts having 10 children now, there is nothing we can do to reverse the decline". This is not a likely scenario.