Russian health authorities have introduced new guidelines that recommend women who say they do not want children be referred to a psychologist, part of a broader effort to address the country’s declining birth rate.
Under the updated rules, doctors are instructed to ask women during routine medical exams how many children they plan to have. If a patient answers zero, the guidance states: “It is recommended that the patient be sent for counselling with a medical psychologist with the aim of developing a positive attitude towards the desire to have children.”
The policy comes as Russia faces a significant demographic downturn. Official figures show that in 2024, deaths exceeded births by approximately 600,000, while the country’s birth rate has dropped to about 1.4 children per woman.
The numbers are stark, and officials have been rolling out multiple measures to try to reverse the trend.
President Vladimir Putin has previously framed population growth as a national priority, stating that “the fate of Russia depends on how many of us there will be,” and describing efforts to increase birth rates as a “question of national importance.”
Other policies have been introduced across Russia in recent years aimed at encouraging childbirth. While abortion remains legal, restrictions have expanded in several regions, including measures that limit what authorities describe as “incitement” to abortion.
At least 31 regions have implemented partial or near-total restrictions, according to reports.
Authorities have also moved to limit public messaging around remaining child-free. Under policies promoting what officials call “traditional values,” the promotion of a “child-free lifestyle” has been restricted, with fines applied to individuals and organizations. Additional initiatives include financial incentives.
Under the updated rules, doctors are instructed to ask women during routine medical exams how many children they plan to have. If a patient answers zero, the guidance states: “It is recommended that the patient be sent for counselling with a medical psychologist with the aim of developing a positive attitude towards the desire to have children.”
The policy comes as Russia faces a significant demographic downturn. Official figures show that in 2024, deaths exceeded births by approximately 600,000, while the country’s birth rate has dropped to about 1.4 children per woman.
The numbers are stark, and officials have been rolling out multiple measures to try to reverse the trend.
President Vladimir Putin has previously framed population growth as a national priority, stating that “the fate of Russia depends on how many of us there will be,” and describing efforts to increase birth rates as a “question of national importance.”
Other policies have been introduced across Russia in recent years aimed at encouraging childbirth. While abortion remains legal, restrictions have expanded in several regions, including measures that limit what authorities describe as “incitement” to abortion.
At least 31 regions have implemented partial or near-total restrictions, according to reports.
Authorities have also moved to limit public messaging around remaining child-free. Under policies promoting what officials call “traditional values,” the promotion of a “child-free lifestyle” has been restricted, with fines applied to individuals and organizations. Additional initiatives include financial incentives.
