Russian women who express no desire to have children during routine medical appointments could be referred to psychological counselling under new health ministry guidelines, as President Vladimir Putin’s government intensifies efforts to reverse a historically low national birth rate.
The guidelines state that during medical examinations, women will be asked how many children they would like to have. Those who answer zero are to be referred to a medical psychologist “with the aim of developing a positive attitude towards the desire to have children,” according to the new rules. Men will not face the same line of questioning as part of their medical assessments.
Russia’s birth rate has fallen to 1.4 children per woman, with state statistics recording 600,000 more deaths than births across the country in 2024. Putin has previously described population growth as “a question of national importance,” stating that “the fate of Russia depends on how many of us there will be.”
The psychological referral policy is one of several measures introduced in recent years to address the demographic challenge. While abortion remains legal at the federal level, at least 31 of Russia’s 83 federal subjects have introduced full or partial restrictions on the procedure, with many regions banning what is described as “incitement” to abortion, according to Human Rights Watch and The Insider.
Authorities have also introduced fines for promoting a “child-free lifestyle” under the government’s Traditional Values framework, with penalties ranging from the equivalent of around £3,075 for individuals to approximately £3,835 for organisations including media companies and streaming services.
Financial incentives have also been deployed. Putin revived the Soviet-era Mother Heroine award in 2022, offering mothers a payment equivalent to around £13,500 on the first birthday of their tenth child. In some regions, pregnant students — including schoolgirls more than 12 weeks pregnant — are eligible for payments of 100,000 rubles, approximately £920, with no minimum age specified for eligibility.
Other proposals that have emerged from official discussions include allowing employees time during working hours for intimacy, and suggestions around restricting internet access during evening hours to encourage couples to spend more time together.
The measures reflect the scale of concern within the Russian government about long-term demographic trends and the pressure they place on the country’s workforce and social infrastructure.
