Russia plans to refer women who indicate they do not wish to have children to psychologists, according to new health guidelines aimed at addressing the country’s worsening demographic crisis. The move is part of broader efforts to boost the nation’s birth rate, which has been a persistent concern for President Vladimir Putin throughout his 25-year tenure.
The new guidelines, issued by the Health Ministry for reproductive health checks, instruct doctors to ask women how many children they plan to have. If a woman responds that she does not want any children, it is recommended that she be referred to a medical psychologist “with the goal of forming a positive attitude towards having children.” Although these recommendations were approved in late February, they only gained attention after being reported by state media this week.
Russia’s population challenges have intensified in recent years, particularly after the country mobilized hundreds of thousands of young men for military service in Ukraine, which has contributed to a decline in the number of potential parents. The birth rate currently stands at a 200-year low of approximately 1.4 children per woman, well below the 2.1 children per woman considered necessary for population stability.
The Kremlin has framed the declining birth rate as a matter of national survival. In 2024, President Putin warned that Russia could face “extinction” if measures were not taken to encourage higher fertility. State policies have increasingly promoted childbearing, including stricter abortion regulations, criminalization of so-called “child-free propaganda,” and incentives for large families, such as financial support and social recognition.
Experts say these measures reflect a broader strategy to cultivate a population growth culture in which raising children is both socially expected and financially encouraged. Large families are lauded as patriotic, and women are actively encouraged to embrace motherhood as a national duty.
While the guidelines have sparked debate over personal freedoms, the Russian government maintains that such interventions are necessary to counter demographic decline. With the population shrinking and birth rates at historic lows, officials are emphasizing psychological support as a tool to influence reproductive decisions and safeguard the country’s long-term survival.
