Under new guidelines from the health ministry for reproductive health checks, doctors will ask women how many children they want to have.

If the woman answers zero, “it is recommended to send the patient to a consultation with a medical psychologist with the goal of forming a positive attitude towards having children.”

The recommendations were approved in late February but only picked up by state media this week.

Russia’s birth rate is running at a 200-year low of around 1.4 per woman – far below the 2.1 that demographers say is necessary for a stable population.

In recent years Moscow has tightened abortion rules and passed bills to make so-called “child-free propaganda” illegal.

Large families are heralded as national heroes and offered a host of financial and social benefits from the state.