Personally I don't think it's helpful to tell a PG woman that you can't think of anything scarier.
Lots of women do give birth without pain relief and are ok.
Nobody has even confirmed yet if this is actually what the OP will be facing either as most of the experienced MNers have said that their births in Italy were a while ago.
The OP also has some options:
She can find out what current practices are likely to be in the Hospital local to where she'll be.
They can both do cram learning Italian, they'll need to speak it anyway.
She can learn as many ways of dealing with any pain that she can, like Hypno Birthing and Tens machines
She can see if a Birth Doula are a thing in Italy and get one that is fluent in both English and Italian.
She can come home for the birth.
It's not all doom and gloom and the more anxious a Mother is about any potential pain, the more likely they are to feel the pain more acutely.