By the time she is one, more than 200,000 Russians will have died of unnatural causes; almost seven times the estimated civilian deaths in Iraq since the war began.

By her 50th birthday, Russia’s population could have halved, based on current trends. Little does she know it as she lies next to her mother, Masha, in a Moscow maternity ward, but Lisa is on the front line of a national fight for survival. By Russian standards, she is lucky to have made it even this far: last year, there were 1.6 million registered abortions in Russia and 1.5 million births.

“The situation is critical,” said Vladimir Kulakov, deputy head of the Russian Academy of Medical Sciences and an adviser to President Putin on the demographic crisis. “The most important thing for every nation is to have confidence in its future.”

Russia’s population has been in decline since 1992 due to poor medical care, one of the world’s least healthy diets, and a national weakness for vodka.

Experts say the crisis is reaching a critical level that threatens not only its economic development, but its very existence.

According to the Federal Statistics Service, the population of 143 million could plummet to 77 million by the middle of this century. It dropped by almost half a million in the last year alone.

Mr Putin raised the issue in April, calling it a “national crisis”, but the Government has yet to respond. Mr Putin is now under pressure to dip into the Stabilisation Fund, designed to save excess oil revenues, to arrest the population decline.

“Everyone says they agree with me and we have to do something, but they have yet to take action,” said Professor Kulakov. He was among the first to highlight the issue in Pravda, the Communist Party newspaper, in 1986, but his article fell on deaf ears.

After the collapse of the Soviet Union, he tried to get the Duma to provide incentives for families to procreate but conservative politicians blocked his proposals. Only now is the Kremlin sitting up and listening. Life expectancy for Russian men has dropped to 58.8, which is 20 years below the average in Iceland. The main killer is heart disease but death by unnatural causes — industrial accidents, car crashes, military conflict — comes second, killing 200,000 people every year.

“This looks like a battlefield loss rate,” said Irina Sbarskaya, head of the Federal Statistics Service population department.

Russia’s birth rate, meanwhile, has risen slightly as baby-boomers from the 1980s reach reproductive age. But it is still way below the levels needed to keep the population stable. The result is that Russia will not have enough workers to drive its economy by around 2020.

Natalya Rimashevskaya, a population analyst, said: “We have reached a point of no return. In terms of numbers there will never be more of us than before. But this is not the worst of it. The danger is that we are reaching another point of no return, in terms of the quality of the population.”

That much is already clear from the number of Russian schoolchildren, which has dropped by one million a year since 1999, according to the Education Ministry.

There are now 5,604 schools in Russia with only ten pupils each. The short-term solution is to attract immigrants, especially ethnic Russians from former Soviet republics. But an influx of immigrants in the 1990s has already triggered a violent xenophobic backlash which threatens Russia’s social stability.

Over the long term, life expectancy in Russia will gradually improve if the Government maintains political stability and economic growth.

The problem comes in trying to increase the birth rate.

According to Professor Kulakov, 10 million Russians are sterile due to botched abortions, venereal diseases and exposure to radiation or harmful chemicals. Among those who are fertile, as in the West, couples are choosing to have fewer children, and later, because of the cost of raising them.

The Russian Government pays new mothers a one-off stipend of 8,000 roubles (£150) and then 500 roubles a month after the first year. But that barely covers basic costs.

Masha Petrachkova, 26, and her husband, Aleksei, delayed having children in order to finish their studies and save enough money to move out of her parents’ apartment. She would like a second child, but is worried about supporting Lisa.

“We’ll see how life goes and we’ll try to give Lisa everything she wants but it will be hard,” she said. “If you don’t have the financial resources in Russia, then you shouldn’t give birth.”

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