Russian for Wonks: Demographics and Childbirth

Russian Demographics child red square Russian demographics are declining again. What is the experience of a growing family in Russia?

Russian demographics have been a major policy issue for the Russian state since its formation in 1991. It has also been well covered in both the Western and Russian press. The following is a detailed primer looking at demographics and specifically at the experience of childbirth and infant care in Russia.

This bilingual resource hopes to build students’ vocabulary skills as well as provide them with a window onto this vital aspect of state policy in Russia and onto the experience of growing families within Russia.

Hover over the bold Russian to reveal its English translation.

Briefly on Russian Demographics

Much has been written on Russian демография over the past three decades.

In the 1990s, the population of Russia plummeted due to a высокая смертность, низкая рождаемость, and высокий уровень эмиграции. This perfect demographic storm was caused by the collapse of the Soviet government and the Russian economy, leaving citizens without социальное обеспечение, система социальной защиты, or уверенность в будущем.

Starting in 2000, however, Russian уровень рождаемости began to improve, eventually surpassing those of such countries as Germany, Canada, and Japan, and rivaling those of the United States. As Russia’s economy improved, it became the world’s second highest destination for иммиграция for many years, attracting mostly Russian speakers from former Soviet states that were still faring worse than it. Further, продолжительность жизни soared to historical highs for Russia, nearing 74 years of age in 2020.

These forces meant that Russia’s население росло from 2009-2019. In 2021, increased mortality from COVID, coupled with decreased immigration contributed to Russia’s first decrease in decade. Exacerbating this is a демографическое эхо; the generation born in the 1990s, one of Russia’s smallest on record, has now grown to adulthood. This means that there are simply fewer people in Russia able to have children, despite an improved fertility rate.

Given this, the Russia population is прогнозируется снижение. This decline will likely cost Russia a few hundred thousand in population per year, or a fraction of a percentage point decline each year. Russia may be able to mitigate this if it can continue to improve fertility rates, welcome immigration, and improve производительность труда работников.

Taking a more detailed look at the Russian policies and infrastructure affecting pregnancy, childbirth, and infant care can also elucidate the experience of families in Russia: the challenges they face and the support they receive.

Sex Education in Russia

There is no standard сексуальное образование in Russian public schools. In the 1980s, a class called “Ethics and Psychology of Family Life” was introduced, but the teachers were too embarrassed to explain “the birds and the bees,” which is known in Russian as “пестики и тычинки”. The class was therefore ineffective and soon cancelled.

In 1986, cross-sectional views of мужские и женские половые органы were added to the anatomy textbook for the first time. However, the textbook still does not mention “половой акт”, “контрацепция”, or even “планирование семьи”. There is no information on how to protect oneself from болезнь, передающаяся половым путём (also known in Russian by the acronym “ЗППП”) such as СПИД (in Russian, as in English, the disease is most often referred to by the acronym. It stands for синдром приобретённого иммунодефицита.

The Russian Orthodox Church actively opposes sex education in schools. Patriarch Kirill, the leader of the Russian Orthodox Church, and many conservative politicians have made public statements against sex education as well. In December 2019, Education Minister Olga Vasilieva stated that “parents, not teachers, should tell children about sex.” Some conservative public organizations such as Родительское всероссийское сопротивление and Всероссийское родительское собрание.

However, today, in some Russian schools, contraception is explained in special classes such as “Основы безопасности жизнедеятельности”. A few schools also offer a course called “Валеология” (the term is defined as “the scientific study of the structure, development, protection, and strengthening of human physical and moral health.” Some schools invite a гинеколог once a year to talk with female high school students about gynecology. Sometimes representatives of firms making прокладки will give lectures in schools, distributing brochures and samples of their products.

While most of the processes leading up to it are avoided in Russian schools, most Russian students are taught the basic process of оплодотворение wherein a сперматозоид penetrates the яйцеклетка, creating a зигота (also called “оплодотворенная яйцеклетка”). When the zygote divides the result is referred to as a зародыш.

Prenatal Care in Russia

Some health expectations for a беременная женщина are the same in Russia as in the West. In Russia, women are expected to бросить курить and не употреблять спиртных напитков for the length of the pregnancy.

Some expectations in Russia are different. Doctors generally recommend that pregnant women stop any exercise regime in favor of special гимнастика для беременных and light swimming.

Above: While free, state medical care is not universally liked. The state’s recent massive investment in clinics has not reached all clinics or fixed all problems. The above program (from 2017), titled “Check Up” visits a maternity clinic in Krasnoyarsk and finds several problems. The program is a long-running one covering many social services from local TV channel TVK.

During the вторая половина беременности, spicy food, chocolate, rich foods, and caffeine are considered potentially dangerous. Углеводы, мучное, and крахмал are restricted. After birth, during кормление грудью, the diet is often restricted further, ruling out red foods, most fruits, most fresh vegetables, and other restrictions based on the doctor’s advice.

Russia’s public health care system is especially concerned with the health of pregnant women. After an expectant mother registers with a женская консультация she receives the right to free prenatal vitamins as well as a small one-time payout of… This is done, in part, to encourage women to see their doctor as soon as possible after learning that they are pregnant. Providing early care has been instrumental in bringing down Russia’s младенческая смертность.

The woman is also immediately given анализы крови, анализ мочи, and often анализ кала. These tests look for the presence of diseases and, among other things, check hormone levels and sugar levels.

After this, the expectant mother undergoes a medical examination at least once a month during the first half of her pregnancy, then twice a month from the twentieth to the twenty-eighth week, and once a week thereafter. These examinations can include not only a general checkup, but also more tests such as those already described. She will additionally undergo an электрокардиограмма and УЗИ two or three times in the course of the pregnancy. Ultrasounds are believed to “disturb” the baby, and therefore are given in relative moderation.

All standard care at a state женская консультация is provided free of charge.

Pregnancy-Related Superstitions in Russia

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Russian people have a lot of superstitions related to literally every aspect of life, and pregnancy is not an exception. Not everyone follows them, but they are generally known. Females are generally advised to avoid becoming too cold, not lift heavy objects, and especially advised against sitting on cold surfaces. All of this is believed to cause possible бесплодие.

Once pregnant, a woman is often advised against playing with cats, sitting on the porch, sitting cross-legged, eating fish, getting haircuts, or telling people день родов. All of this is considered to bring bad luck to the pregnancy by some Russians.

Probably the most followed superstition in Russia is that one should not buy children’s items before the child is born. While most now consider this simply a superstition, it remains as a sort of right of passage for Russian fathers. Traditionally, the father, upon hearing that the baby has been born, will buy the детская кроватка, пустышки, погремушки, молочная смесь, clothing, and other needed items that day and begins assembling the детская комната at home. As Russian women will spend at least three days in the hospital after the birth, this theoretically gives the father enough time to do all this.

After the birth of the child, only the immediate family will be allowed contact with it for the first 40 days of its life. This is generally observed as a way to предотвратить инфекции, although it is also taken from folk belief.

The Maternity Clinic

Most births are performed in state-certified maternity clinics known individually as “родильный дом” or sometimes by the shortened роддом.

Women have a choice when deciding how and where to give birth to their child. Sometimes, for instance, women рожают дома с личной акушеркой.

Some chose to give birth in a частный родильный дом. The cost of this outside of Moscow currently ranges from about $300-1,000. Inside Moscow, costs generally range from $700 to $14,000, depending on the services ordered such as отдельная палата or присутствие отца при родах.

Роддом-8 is one Moscow’s largest maternity clinics

In state clinics, women can opt to have бесплатные роды, where all costs are covered by the state. Here, most costs are likely to be optimized and women can generally expect to give birth in a room with other women giving birth. The women will also sleep in a room with as many as six other women.

Most state clinics, however, now offer additional paid services such as private rooms similar to those offered by private clinics and at similar costs. Further, a woman may give birth in any state clinic she chooses.

The process of vetting clinics usually begins very early in the pregnancy by asking friends, researching online, and actually visiting clinics. This is important, first, as the physical states of clinics can vary widely. Although the state has spent millions of rubles on these clinics since 2000, not all have been upgraded or remodeled to the same level, and some may still be in conditions reminiscent of the 1990s, when most of Russia’s infrastructure decayed as the economy and government crumbled.

While it is now officially discouraged, expectant parents also sometimes come to an understanding with a doctor at a free clinic to make sure they have “хорошее отношение” during childbirth. This was once a more straightforward arrangement whereby the parents would agree that that doctor would oversee the birth and would receive some specific amount if everything went well. There are now regulations to discourage this – including preventing doctors from coming in on their day off (so it is not always certain who will perform the delivery). However, a tradition has remained of paying the doctor a large sum (in Moscow, $1000 is a fairly common amount) upon the delivery of the child. Today, even if a sum has not been agreed upon, it is still customary to gift the doctor something – often in cash along with something like chocolates or flowers – almost as a tip to show one’s благодарность – and knowledge that the state paychecks of doctors are quite low. Such cash gifts are still substantial and might range from $75-500.

In some state clinics, it is possible to sign a договор с личным доктором which will oblige the clinic or doctor to вести беременность and проводить необходимые исследования and to принимать роды.

However, these contracts are not considered by many doctors and patients to be an optimal arrangement, as the parents generally pay more and the doctor, in the end, receives less due to the administrative costs of the contract. An informal arrangement is preferred as it increases the doctor’s economic incentive to provide attentive and sympathetic care.

The mother should bring a few papers to the роддом. These include:

  • Обменная карта, which is given to the беременная on the 32nd week of pregnancy. This is considered the most important document for the future mother because it has all the information about her pregnancy and includes the результаты необходимых анализов. In the event of an emergency, the mother has a complete medical history of the pregnancy to hand to any doctor.
  • Страховой полис
  • Паспорт

The clinic generally has все необходимое для пребывания мамы и ребенка.

However, the mother usually arrives with предметы личной гигиены and many women prefer to arrive with certain items for themselves and their infant to ensure that they are of high quality and to her personal tastes. Each роддом has its own list of things which the молодая мама may bring.

These often can include:

  • Памперсы
  • Прокладки
  • Распашонка
  • Пеленка
  • Чепчик
  • Тапочки
  • Посуда – for the mother
  • Еда

Above: A woman discusses her prepations for entering a Russian maternity clinic.

There are also some restrictions for what can be brought in роддом. A lot of foodstuffs are prohibited, such as those which can spoil easily such as кондитерские изделия с кремом and мороженое, and foods that contain caffeine such as кофе and шоколад. Потенциальные аллергены such as цитрусы and клубника are also prohibited.

The woman usually stays at роддом at least three days after giving birth and sometimes for several days before giving birth. The father or others can bring things from home that she or the новорожденный may need or want, but is generally banned from actually entering the facility at any time, officially по санитарным причинам.

All items, whether brought by the mother or someone else, are inspected. Forbidden items can be confiscated.

After three days at the роддом the woman выписывается, and the father go through a ceremony of sorts where he meets the mother and the новорожденный (sometimes the more colloquial terms “малыш” or “младенец” are used). The baby передается to the father by two or three members of the clinic personnel and the whole process is usually captured in a фотосъемка and sometimes even a видеосъемка. The father is encouraged by the staff to purchase copies of these photos and the video – which are official paid services of the роддом. It is tradition to give gifts such as a bottle of champagne, a box of chocolates, or a small cash gift to each of the personnel present as a sign of gratitude for his/her service.

Baby’s First Documents

Once home from the роддом, the parents must do lot of paperwork to document the child with various государственные органы.

To do this, they need to obtain две справки из больницы. These are basically certificates of live birth, though they differ in terms of the form used, the chain of events they set off, and their final destinations.

The first certificate is taken to the ЗАГС, an acronym that stands for органы записи актов гражданского состояния, and pronounced “zaks.” It will often be the same place the parents got married in.

At ЗАГС, the parents obtain самый главный документ малышасвидетельство о рождении. The parents are required to obtain this certificate no later than one month after the child is born.

Russian demographics birth certificate

An example of a modern Russian birth certificate. The back will also have several stamps that are of importance. Note that this example has had some information replaced with fictionalized data. Source: Wikipedia.

After receiving the birth certificate, the parents must оформить гражданство for their child. Unlike in the US where being born on US soil automatically grants US citizenship, in Russia citizenship must always be applied for, even if both parents are Russian and the child is born in Russia. This child’s citizenship will be given в виде особого штампа на свидетельстве о рождении. This process is completed at the local offices of the Главное управление по вопросам миграции Министерства внутренних дел (usually referred to in Russian by the initialism “ГУВМ”).

At the ГУВМ, officials also вписывают родителям в паспорта данные ребенка. The stamp in the parents’ passports duplicates information from the свидетельство о рождении. The stamp used to be more frequently used, such as for checkups for the child with state-run clinics, enrolling the child in school, but increasingly these institutions are requiring the original свидетельство о рождении be shown. Modern Russian parents report that the stamp is used only infrequently now when traveling.

Next, as all people in Russia must obtain регистрация по месту жительства with the government, the child must also быть зарегистрированным. To do this, the parents must go to a Многофункциональный центр предоставления государственных и муниципальных услуг. These are branded, however, and are usually simply known as «Мои документы». These were founded to allow multiple government functions, once delivered under multiple roofs, to be offered in a single location. They are often located in newly renovated buildings and sometimes within shopping centers.

The fact that the child is registered is stamped on the свидетельство о рождении.

Russian demographics state insurance

An example of the Obligatory Medical Insurance Policy documentation, which comes with a paper certificate with QR code and a plastic, chipped card.

Lastly, a newborn, just like any other Russian citizen, имеет право на получение полиса обязательного медицинского страхования. This policy is often referred to be the acronym “ОМС”, and pronounced as “oh-em-es”. This ОМС gives Russians право бесплатно получать помощь в государственных медицинских учреждениях anywhere in the country.

This полис is issued as a small plastic card which looks something like a credit card.

At the same time the parent is applying for ОМС, they may also apply for полис добровольного медицинского страхования(most often referred to by the acronym “ДМС” and pronounced “deh-em-es”). ДМС is used at private clinics and often starts at $250 per year. The “insurance” often acts more like a subscription plan for the battery of examinations that the infant receives such as патронаж, диспансеризацию, and delivery of state-supplied прививки. Private insurance programs are appealing to those who can afford them, because often they provide doctors that pay house calls after the first month, saving parents the hassle of waiting in long lines at state clinics. Private clinics also often offer a wider variety of imported vaccines and even mobile laboratories.

The specifics on how all these procedures are carried out меняется почти каждый год. For example, the agency where вписывают родителям в паспорта данные ребенка has changed three times in the last 10 years or so. Procedures also often change. Parents often обращаются к государственным сайтам and also check unofficial форумы to see what to do and what to expect.

The other справка из больницы is used for получение единовременного пособия по рождению ребенка. This is part of a wider system of family social support services and will be discussed below.

State Medical Care for Infants

The day after the mother and her newborn check out of the maternity clinic, information on the child’s birth переданы в детскую районную поликлинику serving the district in which the family resides.

Conflict Studies banner PCON ICON After this, участковый врач и/или медсестра from the поликлиника visit or check in with the newborn on the second and third week after discharge. Медсестра is obliged to check in twice a week. This is known as патронаж новорожденного.

Следят за его состоянием, рассказывают родителям как ухаживать за малышом, including how to bathe him, feed him, чистить носик и ушки, обрабатывать пупочек, etc.

The medical workers also give общие рекомендации regarding the baby’s care and usually talk to the mother about the advantages of грудное вскармливание.

Патронаж continues for one month and then the mother and child go into the clinic for check-ups once per month thereafter. The clinic also has, once per week, a “грудничковый день”. Note that “грудник“, a word for “infant” comes from the word “грудь“, or “breast”, referring to breast feeding. On this day, pediatricians and other doctors проводят плановую диспансеризацию for children under one year of age.

This is considered both efficient and sanitary as it can then be done at the clinic without exposing the infants to older children. On these days, прием больных детей не осуществляется, so as not to infect the healthy children that are receiving routine check-ups.

When the baby is one month old, she is legally entitled to be seen, for free, by a neurologist, ophthalmologist, детский хирург, and детский ортопед in addition to monthly visits to a pediatrician (which are also free).

The pediatrician monitors the baby’s общее состояние and развитие. The specialists also evaluate the baby’s общее состояние and look for отклонений в развитии в своей области.

While visits to the pediatrician are monthly, visits to the specialists happen again at three, six, nine, and 12 months of age (although not all doctors are seen each time).

In addition, the child visits оториноларинголог at six months and детский стоматолог at nine and 12 months. These visits are, again, free.

Vaccination of Infants in Russia

During visits to the pediatrician, проводятся профилактические прививки according to a schedule as issued by Министерством Здравоохранения. Vaccinations are not mandatory, but they are free, and most Russians receive them.

Some Russians also pay for “upgraded” vaccinations – ones imported from abroad, rather than the free отечественные препараты. Imported vaccines are generally regarded as being of higher quality.

According to the recommended vaccination timetable, the baby’s first shots are given at the роддом in the first 24 hours after birth and then continued at one month of age, three months, etc.

Vaccinations are given for гепатита В, туберкулеза, дифтерии, коклюша, столбняка, полиомиелита, кори, краснухи, and паротита.

Family Social Support Services

In Russia, all mothers are eligible for особая социальная поддержка и защита государства. This starts from the moment she finds out she is pregnant, up until the time that her child reaches the age of three and sometimes longer.

First, Russia’s трудовое законодательство demands that employers retain лояльное отношение with mothers. For example, new employees are usually subject to a испытательный срок, during which time they may be let go for any reason. However, pregnant women and mothers of children under eighteen months are exempt from this rule and may not be terminated – including if they become pregnant during the probationary period. An employer may not dismiss a pregnant woman, a woman with a child under the age of three, or a мать-одиночка с ребенком до 14 лет. The woman can quit voluntarily, but will otherwise only legally lose her job if the company goes out of business.

These women also have the right to demand to shift to part-time work and to decline to go on business trips. They are prevented from working работа сверхурочно, ночные смены, weekends, or holidays. In addition to a regular lunch break, working women with children under the age of eighteen months must also be given перерывы на кормление ребенка. These are supposed to occur каждые три часа по тридцать минут and must be considered part of their paid working time. Unfortunately, the time it would take most women to travel home and return to her workplace is not subject to this same rule and it is generally unworkable to transport the child to the workplace every three hours. This makes the law a largely unworkable one for most women.

All workers in Russia are entitled to отпуск в двадцать восемь дней and to be paid for those vacation days. Pregnant women are additionally entitled to отпуск по беременности и родам (also commonly known as декретный отпуск) for семьдесят дней до родов и семьдесят дней после родов. В случае если женщина ожидает больше одного ребенка, she is entitled to eighty-four days leave prior to giving birth and 110 days after.

All benefits are revised every year. All numbers listed in this resource are current for 2021. One US dollar, as of November, 2021, is equal to about 70 rubles.

During her декретный отпуск, the woman is also entitled to a пособие по беременности и родам. This is paid в размере ста процентов среднемесячного заработка for each month she is on leave. The state is responsible for paying this benefit to the employer, who must then transfer it to the mother. However, the benefit is capped at 55,830 rubles per month.

If the expectant mother visits a prenatal clinic на раннем сроке беременности, she will additionally receive a one-time state benefit of 413 rubles and will be eligible for free лекарства и витамины from the state as prescribed by her doctor. Russia began these programs to encourage women to visit the doctor early, as this has been shown to reduce complications later in the pregnancy.

After the child is born, the parents receive a one-time пособие по рождению ребенка of 10,989 rubles. This benefit is provided by the state and delivered via one of the parent’s employers (or the Social Services Fund if neither parent is employed).

This one-time по рождению ребенка is paid for each child. In addition, women who give birth to their second or any subsequent children are entitled to receive материнский капитал. This is a certificate worth 343,278 rubles that may be spent on specific things. Up to 12,000 rubles may be spent at the mother’s discretion. The rest must be spent on улучшение жилищных условий, получение образования ребенком, or формирование накопительной части трудовой пенсии матери.

Above: a video blog on maternal capital and how it can be used.

There are also special benefits доступные только москвичам which are provided by the Moscow city government. While some other cities and regions offer programs of their own, none compare to the size and diversity of Moscow’s programs.

If both parents hold (or the мать-одиночка holds) постоянная регистрация in Moscow, they may receive 5,500 rubles for the birth of their first child and 14,500 rubles for their second and any additional child. This постоянная регистрация is also commonly referred to as “прописка” and is held only by Russian citizens. If these Russian parents have тройня or more children born at one time, they receive an additional 50,000 rubles.

There is also the “лужковская выплата”, which is paid to молодым семьям who have a child while both parents are (or the мать-одиночка is) under 30. This “payout” is calculated via the official прожиточный минимум calculated by the city each year. For 2010, the official “living wage” is 5790 rubles per month. Young families receive пятикратная величина прожиточного минимума for their first child, seven times for the second child, and ten times for the third and any child thereafter. This is a one-time payout.

Various cities also offer натуральная помощь. In Moscow, for instance, it is available for all children, regardless of economic circumstances, who are under three years of age. The program provides, at various stages, молочные смеси, молоко, творог, and кефир. Parents can claim these products by obtaining a рецепт from their local pediatrician. Based on the рецепт, the parents receive their ration from local молочно-раздаточныe пункты (also known as “молочные кухни”,) every two days.

After her maternity leave ends, the new mother has the right to take additional leave known as отпуск по уходу за ребенком. This leave is divided into two time frames with differing benefits. While the child is less than eighteen months old, the mother receives a пособие по уходу за ребенком of 40% of her average salary, but not more than 29,600 rubles per month.

For low-income families, the пособие may continue after 18 months. If the new mother is unemployed, a new first-time mother, for instance, will still receive 6,752 rubles per month and unemployed mothers of two or more children receive 3,000 rubles per month until the children turn 18. If she is officially still employed, benifits for children of 3-7 years old amount to half the прожиточный минимум (in Moscow, that amount in 2021 is currently 18,029 rubles). After three years of age, low income families are still eligible for amounts ranging from 4,300 to 16,400 rubles until the age of 18.

Thus, in total, new mothers in Russia can expect about $19,000 in monetary benefits from the state to be paid from the time of conception to the time that their first child turns eighteen months old. Mothers of a second child can expect about $25,000. Muscovites can additionally expect about $1300 for their first child and $1750 for a second child. These figures are not including the value of any натуральная помощь they may receive.

Conclusion and Further Information

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While Russia’s population was growing, President Vladimir Putin and other government officials were quick to emphasize childbirths as the source, and to credit government programs investing in дородовой уход and уход за новорожденными and especially to new programs such as материнский капитал.

These investments have been substantial and Russia’s programs supporting families are quite generous. However, much of the improvement in fertility rates likely came from the removal of the negative impacts of the 1990s. Russia’s economy improved, crime rates lowered, стабильность returned to the country, and life in Russia’s cities improved substantially. This gave prospective parents the confidence that they could give a new child достойная жизнь.

If to maintain its fertility rates, which are relatively high when compared to other European and “Western” states, continued to investments into city infrastructure, health care, education, and the economy will likely be needed to hold the confidence of prospective parents.

It is also undeniable that without immigration, demographic growth would have been impossible. If to return to growth, Russia will also have to do more to support immigration if it desires population growth. This is especially true as its демографическое эхо deepens.

None of these issues are easy or simple. Future installments of Russian for Wonks will look more deeply into other aspects of life in Russia to provide windows on these issues for those that take them seriously.

 

About the Author

Andrei Nesterov

Andrei Nesterov has reported on political and social issues for the Russian press as well as American outlets such as Russian Life, Worldpress.org, and Triangle Free Press. He has travelled Russia extensively and penned many stories on the "real Russia" which lies beyond the capital and major cities. Andrei graduated from Ural State University (journalism) and Irkutsk State Linguistic University (English). He studied public policy and journalism at Duke University on a Muskie Fellowship and went on to study TESOL and teach Russian at West Virginia University. He is currently working on an MA from St. Petersburg State in International Relations. Andrei contributes news, feature stories, and language resources to the SRAS site, and is an overall linguistics and research resource. He additionally helps coordinate activities for our students in Moscow.

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Josh Wilson

Josh Wilson is the Assistant Director for The School of Russian and Asian Studies (SRAS) and Communications Director for Alinga Consulting Group. In those capacities, he has been managing publications and informative websites covering geopolitics, history, business, economy, and politics in Eurasia since 2003. He is based in Moscow, Russia. For SRAS, he also assists in program development and leads the Home and Abroad and Challenge Grant scholarship writing programs.

Program attended: All Programs

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