Russia, the sick man of Europe

Public Interest, Wntr, 2005 by Nicholas Eberstadt

Since 2001, there have been some indications of a resurgence of fertility in the Russian Federation. For the year 2002, according to Goskomstat, the country's total fertility rate has risen to 1.32. And for the year 2003, according to Russian Federation President Vladimir V. Putin in his 2004 New Year's Day address, an "especially joyous" auspice was the absolute increase in births over the previous year. According to Goskomstat, Russia's total births rose in 2003 to 1.48 million--by that report, a 6 percent increase over the previous year. Birth figures for the first half of 2004, for their part, are 2 percent higher than for the first half of 2003.

These signs of improvement raise the question: If Russian fertility fell suddenly and sharply with the demise of the Soviet Union, might it not also rebound vigorously in an auspicious political and economic environment? That possibility cannot be entirely ruled out. Demographic science, after all, lacks any robust techniques for accurately predicting future fertility patterns. But even supposing an improvement in social conditions and an increase in general levels of confidence (improvements, it should be pointed out, not entirely independent from the demographic trends under discussion here), there are a number of factors weighing against a significant upsurge in the Russian birthrate--much less a return to earlier, Soviet-era, levels of fertility.

First, Russia's poor and declining overall health patterns extend to the area of reproductive health. Notably, involuntary infertility is a more significant problem for Russia than for any other Western country. And the problem is getting worse, not better. To be sure, data on infertility for contemporary Russia are not entirely reliable. According to some recent reports, however, 13 percent of Russia's married couples of childbearing age are infertile--nearly twice the 7 percent for the United States in 1995 as reported by the National Center for Health Statistics. Other Russian sources point to an even greater prevalence of infertility today, with numbers ranging as high as 30 percent of all males and females of childbearing age. Whatever the true level, medical diagnoses of infertility in Russia are clearly on the rise--suggesting that the 13 percent estimate and others of its ilk are more than just a statistical fluke.

With respect more specifically to female infertility, Russia suffers today from two pronounced and highly unusual risks. For one thing, Russian womanhood has, quite literally, been scarred by the country's extraordinary popular reliance on abortion as a primary means of contraception--with the abortions in question conducted under the less-than-exemplary standards of Soviet and post-Soviet medicine. A Russian woman nowadays can expect to have more abortions than births over the course of her child-bearing years. In 1988, at the end of the Soviet era, Russian women underwent an officially tabulated 4.6 million abortions--two for every live birth. In 2002, the country officially reported 1.7 million abortions--over 120 for every 100 live births.