"There are not many people of childbearing age left around here. The young left looking for jobs in the big cities or abroad," paediatrician Bistra Kamburova, 68, told AFP.
Gabrovo, huddled at the foot of the Balkan mountains, is symbolic of the population decline in the European Union's poorest member.
Once known as the "Bulgarian Manchester" for its booming industry, the town has lost half its people since 1985.
It is a familiar story across the country.
Corruption, lack of prospects and a spiral of political crises have chased its disillusioned young people away.
The nation's fourth general election in 18 months was held in October, and it once again returned a fragmented parliament with no party able to cobble together a strong coalition so far.
Bulgaria has lost a tenth of its population in a decade, making it one of the world's fastest-shrinking nations.
It now has 6.52 million people compared with close to nine million inhabitants in 1989. And a quarter of the population is aged 65 or over.
'It's a desert'
Gabrovo's industries employed thousands of workers during communism, before bankruptcies and privatisations laid the factories bare.
Now, it has become the region with one of the lowest birth rates and the highest number of almost uninhabited villages in the country.
"I started working here in 1985. At that time, the number of births was still quite high -- around 1,000 babies per year," said Kamburova, whose two grown-up sons are among those who have left Gabrovo.
"But the factories were working, working, working," she added.
Last year, only 263 babies were born in the Gabrovo region and looked after by the energetic paediatrician, who works on long after her retirement age for "miserable pay".
"The explanation is simple -- no employment, no young people, no babies," said midwife Mariana Varbanova.
Many of those who remain are keen to leave.
"In Gabrovo, you enjoy the peace and quiet and the fresh air, but it's a desert where you only meet elderly people," said Hristiana Krasteva, a 23-year-old speech therapist, who recently gave birth to a baby girl.
Her husband, who works as a carpenter, is getting ready to leave for Britain in search of a better future for his family.
'Grandchildren for rent'
In front of the first public school in Bulgaria, founded in Gabrovo in 1835, high school student Ivo Dimitrov also wants to leave for western Europe to get a "quality education and new horizons.
"It's chaos here," he said, denouncing the negligence of the political class.
"It will take time to reverse the demographic trend," analyst Adrian Nikolov from the Sofia-based Institute for Market Economics told AFP.
Only 35 people live in the picturesque 17th-century village of Zaya around 25 kilometres (16 miles) from Gabrovo.
Apart from the locals, pensioners from France, Britain, Belgium, Russia, Italy and other countries have settled there, attracted by the cheaper cost of living.
There is no polling station, and the village grocery store shut years ago for lack of customers.
"We decided to get together to go shopping. We get by somehow," said Marin Krastev, a retired electrician, whose daughter long ago left for Germany.
Once a week, the 77-year-old drives three other retired women from the village to the nearest shop.
To brighten up their lives, the elderly joined a municipal programme over the summer called "Grandchildren for Rent" that brought young people to Zaya to discover village life.
"They enjoyed the rabbits, as well as the home-grown tomatoes and peppers," the village's cultural centre chairwoman Boyana Boneva, 75, smiled.
