Under the updated reproductive health directives, Russian doctors are instructed to ask women how many children they plan to have. Those who indicate they do not intend to give birth are now “recommended” to attend consultations with medical psychologists aimed at fostering a positive attitude toward motherhood. Men who choose not to have children are exempt from this policy. The measures follow President Vladimir Putin’s December 2024 law outlawing the promotion of child-free lifestyles, which the Kremlin brands as a Western-imported threat to Russia’s future.
The move comes against a backdrop of a deepening demographic crisis exacerbated by the war in Ukraine. Official statistics show that in 2024 there were 600,000 more deaths than births, with birth rates at their lowest since Putin assumed power in 2000. Analysts warn that Russia’s population, currently reported at 146 million, could decline to 90 million or fewer by the end of the century. Independent demographers have faced increasing restrictions on publishing data, and Rosstat, the state statistics agency, has limited access to demographic information.
Previous Kremlin attempts to reverse the trend—including restricting abortions, promoting “traditional values,” offering financial incentives for women with multiple children, and even reviving the Mother Heroine award for women who bear ten children—have so far failed to raise birth rates significantly. Some regions have introduced one-off payments to pregnant schoolgirls, while educational institutions have organized excursions to marriage registration offices, sometimes involving mock weddings for students. In some cases, teenagers under the legal marriage age of 18 have participated in these events, drawing international condemnation.
The Times UK reports that critics view these measures as part of a broader authoritarian push to control women’s reproductive choices. The policy also intersects with the Kremlin’s ongoing actions in occupied Ukrainian territories, including plans to resettle nearly 114,000 Russian citizens and allegations of deporting thousands of Ukrainian children, for which Putin and Kremlin official Maria Lvova-Belova are wanted by the International Criminal Court. A UN inquiry has described the deportations as a crime against humanity, highlighting the regime’s increasingly aggressive domestic and international policies amid its demographic emergency.
This unprecedented step to medicalize childlessness underscores both the severity of Russia’s population decline and the Kremlin’s willingness to intervene directly in citizens’ private reproductive decisions, raising human rights concerns across the globe.
