Russia is taking an unusual step to tackle its falling birth rate, as new health guidelines now recommend psychological counseling for women who say they do not want children.
Under fresh directives from the health ministry, doctors conducting reproductive health checks will ask women how many children they intend to have. If a patient responds with zero, officials advise referring her to a medical psychologist “with the goal of forming a positive attitude towards having children.”
The move comes as Vladimir Putin intensifies efforts to reverse what he has repeatedly described as a national emergency.
Russia’s population decline has been a long-standing concern throughout his 25-year rule, now worsened by the loss of hundreds of thousands of young men sent to fight in Russia-Ukraine War.
Although the guidelines were approved in late February, they only gained widespread attention this week after being reported by state media.
The Kremlin has framed the demographic slump as a matter of survival. In 2024, Putin warned that Russia risked “extinction” if birth rates did not improve.
Currently, the country’s fertility rate stands at about 1.4 children per woman, a 200-year low and well below the 2.1 level experts say is needed to maintain population stability.
In response, authorities have rolled out increasingly aggressive pro-natalist policies. These include tightening ab+rtion laws, banning so-called “child-free propaganda,” and rewarding large families with financial incentives and social benefits.
While officials argue the measures are necessary, critics say they raise serious questions about personal freedom and state interference in private life.
