ROME >> One ad pictured a woman holding an hourglass next to the words: “Beauty has no age limit. Fertility does.” Another portrayed a pair of baby shoes wrapped in a ribbon of the Italian flag. Yet another showed a man holding a half-burned cigarette: “Don’t let your sperm go up in smoke,” it read.

They were part of a government effort to promote “Fertility Day” on Sept. 22, a campaign intended to encourage Italians to have more babies. Instead, the ads set off a furor, were denounced as being offensive and within days were withdrawn.

What they did succeed in doing, however, was to ignite a deeper and lasting debate about why it is that Italy has one of the lowest birthrates in the world, and what can be done about it.

The problem is not a lack of desire to have children, critics of the campaign say, but rather the lack of meaningful support provided by the government and many employers in a country where the family remains the primary source of child care.

“I should be a model for their campaign, and I still feel very offended,” said Vittoria Iacovella, 37, a journalist and mother of two girls, ages 10 and 8. “The government encourages us to have babies and then the main welfare system in Italy is still the grandparents.”

Many working women, without an extended family to care for a child face a dilemma, as private child care is expensive. Some also worry that their job security may be undermined by missing workdays because of child care issues. Many companies do not offer flexible hours for working mothers.

Not surprisingly, Italy’s long slowdown in childbirth has coincided with its recent economic slump. But Italian families have been shrinking for decades.

In 2015, 488,000 babies were born in Italy, the fewest since the country first unified in 1861. It has one of the lowest birthrates in Europe, with 1.37 children per woman, compared with a European average of 1.6, according to Eurostat figures.

By contrast, in France, the economy has been flat, too, but a family-oriented system provides a far more generous social safety net that includes day care and subsidies for families to have children. There, women have two children each on average.

“On paper, Italian women have equal rights,” said Tiziana Bartolini, editor of Noi Donne, one of Italy’s most prominent feminist magazines. “But reality tells us a different story. Women are expected to care for children. If they live in regions where services are good, or in small towns, they keep their job. If they live in big, chaotic cities and have no family nearby, they are very prudent about becoming pregnant.”

“Or they stop working,” she added.

The Ministry of Health began the fertility campaign on Aug. 31 with a group of online advertisements and a hashtag on Twitter. The goal was to publicize a series of public meetings on Fertility Day and encourage Italians to have more children.

Yeah, sure, thought Maria Scioli, 41, a teacher who depends on her family to care for her 15-month-old boy, when she spotted the debate on her Facebook page.

“I’d love to have a second child,” Scioli said, “but my job situation worries me. And I even feel lucky. I think about all those women my age or younger that couldn’t have babies and had to watch that offensive ad.”

Even Prime Minister Matteo Renzi, whose own health minister started the campaign, distanced himself from the ads in a radio interview, noting ironically that none of his friends “had their kids after seeing an advert.”

Renzi said that to increase the birthrate, structural issues like day care and services needed to be addressed.

Under Renzi, Italy’s government has tried to help families with a so-called baby bonus of 80 to 160 euros (about $90 to $180) for low- and middle-income households, and has approved labor laws giving more flexibility on parental leave. But Italy allocates only 1 percent of its gross domestic product to social protection benefits — half the European average. One child out of three here is at risk of relative poverty.

“Italy has a terrible combination: low birthrate, low women’s employment and high risk of child poverty,” said Alessandro Rosina, a professor of demography at Universita Cattolica del Sacro Cuore in Milan. “On this path, Italy can only but have increasing costs for aging people, and increased public debt.”

“We defend our present, but can’t design the future,” he said.

Figures from Istat, the national statistics agency, show that Italian women with children are far less likely to work than mothers in other European countries, which provide greater social services.

In much of northern Europe, where social services are greater, about 70 percent of women work — and almost all of them continue to work after having children. By comparison, according to Eurostat, Italy has the second-lowest female employment rate in Europe, especially in the south.

“So many young women are even asked to pre-sign a resignation letter here, especially in small companies,” said Teresa Potenza, a longtime women’s advocate in Naples, referring to a practice in which some women are asked to sign a resignation letter in case of pregnancy before they are hired. “Even to all those women, that campaign is a punch to the gut.”

“Without the ‘family welfare,’ I would have never been able to have children myself,” Potenza said.

Iacovella, the journalist, said her child’s kindergarten closed two hours before she got off work, and noted that working mothers “are frustrated by the little help that Italy gives to women.”

She was so offended by the government ads that she vented her anger on Facebook soon after they started appearing, and her comments went viral online.

Italy’s health minister, Beatrice Lorenzin, responding on Facebook, wrote that the Fertility Day campaign was not a “call to reproduction” but a day to discuss “the fertility issues that 15 percent of Italians deal with.” She promptly canceled the campaign.

“I am saddened that the launch of the advertising campaign misled many people,” Lorenzin said. “I withdrew it to change it.”

© 2016 The New York Times Company