Having a baby in Rome: free public care, the birth paperwork and your baby's passports

Italy will look after you and your baby well, mostly for free. Your job is the paperwork, and the one fact many Aussie parents miss: a baby born in Rome isn't Italian just because of where it was born.

The short version

• Pregnant women with a permesso di soggiorno are entitled to compulsory, free SSN enrolment during pregnancy and for six months after the birth, even if they'd otherwise have to pay [1].
• The national health package (LEA) makes core pregnancy checks free: blood tests, two routine ultrasounds, the combined screening test and antenatal classes [2].
• You declare the birth within 3 days at the hospital or within 10 days at the Comune [3].
• A child born in Italy to two Australian parents is not Italian. Italian citizenship comes from an Italian parent, not the birthplace [4].
• To make your baby Australian, you apply for citizenship by descent with Home Affairs, then for a passport through the Australian Embassy in Rome [5][6].

Getting into the system early

The first thing to sort is SSN enrolment, because everything free flows from it. If you're already enrolled through work, you're set. If you're on a permit that normally means paying for voluntary enrolment, such as elective residence, pregnancy changes the picture: pregnant women are listed among the groups entitled to compulsory enrolment, running until six months after the birth [1]. Bring a pregnancy certificate from a public health facility to your ASL desk [1].

Our guide to joining the SSN in Rome walks through the enrolment step by step.

What about the Medicare deal? The Australia–Italy Reciprocal Health Care Agreement covers essential care you can't wait for during your first six months in Italy [7]. Smartraveller notes it doesn't cover conditions you already had when you arrived [8], and a pregnancy is planned care, not an emergency. Don't rely on it for antenatal checks or the birth.

Who looks after you

You have three main routes in Rome, and many women mix them:

• Your medico di base, who writes the referrals (impegnative) for tests.
• A consultorio familiare, the free community family clinic run by each ASL. They have gynaecologists, midwives (ostetriche) and psychologists, and run the corsi di accompagnamento alla nascita, the antenatal classes.
• A private gynaecologist, whom many Romans see for continuity, then deliver in a public hospital.

What's free during pregnancy

Italy's essential levels of care (Livelli Essenziali di Assistenza, or LEA) list the pregnancy services the SSN provides without a ticket. The Ministry of Health updated them in 2017 [2]. Your referral just needs the pregnancy exemption code; many regions use "M" plus your week of pregnancy, so you don't need a separate certificate [9].

Source: Istituto Superiore di Sanità summary of the LEA pregnancy package [2].

Things that cost extra: private gynaecologist visits, extra scans you choose yourself, NIPT blood tests outside the public pathway, and a private room. Prices vary a lot between clinics, so ask for a written quote.

A big difference from Australia: there's no Medicare rebate system. A service is either free under the SSN or you pay the full private fee.

Choosing a hospital and giving birth

Rome has several large public and university hospitals with maternity wards (punto nascita), including Policlinico Umberto I, Policlinico Gemelli, San Camillo-Forlanini, Ospedale Sant'Eugenio, San Giovanni Addolorata, and the Fatebenefratelli on Isola Tiberina. Some are religious foundations that are part of the public network, so SSN births there are covered just the same.

How to pick:

• Neonatal intensive care. If your pregnancy is high risk, choose a hospital with a level-two punto nascita and a NICU (TIN).
• Distance. Rome traffic is real. At 3am in labour, the Raccordo is not your friend.
• Epidural. Epidural pain relief (partoanalgesia) is part of the LEA, but availability around the clock differs between hospitals. Ask at the open evening or tour.
• Language. Midwives in big teaching hospitals often speak some English, but don't count on it. Learn the key words or bring someone who speaks Italian.

Around 36 weeks you usually start monitoring visits at the hospital where you'll deliver. Bring your full folder of results every time.

Stays are short by Australian standards for a straightforward birth, typically a couple of days. Partners can usually stay during labour; visiting rules on the ward vary.

Declaring the birth: 3 days or 10

Every birth in Italy has to be declared to the civil registry (stato civile).

1. Get the attestazione di nascita. The doctor or midwife who delivered your baby signs a birth attestation [3].
2. Choose where to declare. At the hospital's registry desk within 3 days of the birth, or at the Comune within 10 days, either where the baby was born or where the mother lives [3]. In Rome, that's the stato civile office of Roma Capitale.
3. Bring ID for both parents. Foreign parents bring passports and their permesso di soggiorno, or an Italian ID card if they're registered residents [3].
4. Know the parent rules. If you're married, one parent can declare. If you're not, both parents usually sign so the father is recognised [3].
5. Request the paperwork you'll need later. Ask for an estratto dell'atto di nascita (birth extract), ideally the multilingual EU version, for your Australian application.
6. Get the baby a codice fiscale and SSN enrolment. The codice fiscale is usually issued with the birth registration. Then enrol your baby at the ASL and choose a pediatra di libera scelta (family paediatrician).
7. Sort the baby's permesso. A non-Italian child needs to be added to a parent's permit. Ask at the Questura or the post office Sportello Amico when you renew yours.

Missing the 10-day window isn't the end of the world, but late declarations take more paperwork. Do it while you're still in hospital if you can.

Is my baby Italian? Usually not

This is where Australian parents get surprised. Italy's citizenship law is built on blood, not birthplace.

• Both parents Australian: your baby isn't Italian. A child born in Italy only gets Italian citizenship at birth if both parents are unknown or stateless [4].
• One parent is Italian (including Aussies who've been recognised by descent): your baby is Italian by birth through that parent.
• Raised in Italy: a foreign child born in Italy who lives there legally without a break until 18 can claim citizenship by declaring it within a year of turning 18 [4]. Keep your residenza continuous if that matters to you.

Italy's 2025 reform restricted citizenship by descent for people born abroad. If you or your partner are Italo-Australian, read our Italian citizenship by descent guide before assuming anything.

Making your baby Australian

A baby born overseas to an Australian parent isn't automatically on Australia's books. You apply for Australian citizenship by descent with the Department of Home Affairs, online through ImmiAccount [5]. You'll need the Italian birth extract, proof of the Australian parent's citizenship and photos of the baby.

Once citizenship is approved, apply for the baby's first passport through the Australian Embassy in Rome, at Via Antonio Bosio 5, where passport services are by appointment only [6]. Everyone with parental responsibility usually needs to consent.

Our citizenship by descent for babies born overseas guide has the forms, the current fee and the passport steps in detail.

Talk to parents who've done it

Which hospital let partners stay, which consultorio runs English-friendly classes, and how long the Comune took? Join Cooee Italy, our Facebook group for Australians in Italy, and ask the Rome parents. Join the community.

Sources

1. Iscrizione al SSN dei cittadini stranieri e comunitari – AUSL Modena
2. Novità per gli esami in gravidanza – Istituto Superiore di Sanità (EpiCentro)
3. Denuncia di nascita: informativa – ASST Mantova
4. Legge 5 febbraio 1992, n. 91, on Italian citizenship – Embassy of Italy in Chișinău
5. Become an Australian citizen by descent – Department of Home Affairs
6. About the Australian Embassy, Rome – DFAT
7. Reciprocal Health Care Agreement: visiting Italy – Services Australia
8. Italy travel advice – Smartraveller (DFAT)
9. Esenzioni in gravidanza, a cosa si ha diritto? – Orizzonte Scuola

Keep reading

• Joining the SSN in Rome: your medico di base and the tessera
• Italian citizenship by descent: what Australians need to know
• Babies born overseas: citizenship by descent
• Renewing your Australian passport overseas