Kenneth Glad
Russia’s demographic slowdown is no longer confined to policy debates or financial incentives. It is starting to surface in routine medical care, where conversations about family plans are handled a bit differently.
The country has faced years of declining births, with about 1.22 million recorded in 2024, writes The Moscow Times. Projections from Rosstat suggest the population could continue shrinking for decades, keeping officials under pressure to respond.
That pressure is beginning to shape what happens during appointments.
Health Ministry guidance, cited by the Moscow-based news outlet, advises doctors to suggest psychological consultations when a woman says she does not plan to have children. Men are not subject to the same step.
Their questionnaires are shorter, framed around personal circumstances, and their answers do not lead to referrals. Two patients might give similar answers and still leave with different recommendations.
The distinction is built into the system from the start.
How it plays out
This comes up during standard checkups, often once a year. Patients sit down, fill out forms, move through the usual questions. Then one stands out.
“How many children would you like to have, including those already born?” reports 20 Minutos.
If the answer is none, a consultation with a psychologist is suggested.
Elsewhere, countries facing similar demographic declines, including Japan and parts of Europe, have focused more on childcare access or workplace flexibility.
Russia’s approach leans more toward addressing personal decisions within a medical setting.
Wider implications
The guidance comes alongside other measures linked to family policy. Russia has tightened abortion-related rules and restricted the promotion of “childfree” lifestyles, according to 20 Minutos.
Sergei Leonov, head of the State Duma’s Health Committee, defended the approach:
“A woman has the right to decide how to live her life. However, if for some reason she does not wish to have children, a psychologist can help her understand the reasons.”
Officials describe the measure as supportive. Others point to questions about medical ethics and patient autonomy, particularly when personal decisions become part of a clinical process.
Sources: The Moscow Times, 20 Minutos
