Russia has introduced new health guidelines recommending psychological evaluation for women who say they do not want to have children, as authorities intensify efforts to address the country’s declining birth rate.
Under the directive issued by the Ministry of Health, doctors conducting routine reproductive health assessments are now required to ask women about their desired number of children. Women who indicate they do not intend to have any children may be referred to a medical psychologist, with the stated aim of encouraging a “positive attitude towards having children.”
Speaking on the policy, a Ministry of Health official said, “Our goal is to provide support and guidance to women who may be unsure about starting a family. This is about encouraging a healthy outlook on parenthood.”
The policy is part of a broader push by President Vladimir Putin to reverse what he has repeatedly described as a demographic crisis threatening the nation’s future. Putin has warned in previous speeches, “Russia risks extinction if we do not address our falling birth rate. The survival of our nation depends on our families.”
Russia’s population decline has been a persistent concern throughout Putin’s more than two decades in power, but the situation has worsened in recent years. The ongoing Russia-Ukraine War has significantly impacted the country’s working-age population, with hundreds of thousands of young men reportedly lost to the conflict.
Although the new guidelines were approved in late February, they only drew widespread attention after being highlighted by state media this week.
A Kremlin spokesperson told reporters, “These measures are designed to safeguard the future of Russia by promoting family growth and supporting our citizens.”
Currently, Russia’s fertility rate stands at approximately 1.4 children per woman one of the lowest levels recorded in the country’s history and well below the 2.1 replacement rate required to maintain population stability.
Authorities have also introduced a range of pro-natalist policies aimed at encouraging larger families, including stricter abortion laws, a ban on “child-free propaganda,” and expanded financial incentives for families with multiple children.
Critics, however, have expressed concern. Anna Kuznetsova, a human rights advocate, said, “Forcing or pressuring women to have children under the guise of psychological counseling is a violation of personal freedom. Reproductive choices are deeply personal, and the state should not interfere.”
The development highlights the growing tension between national demographic goals and individual autonomy, as Russia confronts one of the most significant population challenges in its modern history.