The legalization of abortion pills has emerged as a contentious issue once again. It has been six years since the Constitutional Court declared the abortion law unconstitutional, but the legal vacuum has resulted in problems with the illegal distribution of abortion pills. As the ruling party moves forward with the legislation of related bills, public opinions from the medical community, civic and religious organizations are sharply divided.
On the 6th, the Health and Welfare Committee of the National Assembly held a debate under the theme 'Six years after the Constitutional Court's unconstitutional ruling on the abortion law, should we leave it as it is?' In the previous month, lawmakers Nam In-soon and Lee Soo-jin from the Democratic Party of Korea each proposed amendments to the Maternal and Child Health Act to legalize abortion pills.
Both amendments removed provisions concerning the limits on permitted artificial abortions. They included provisions to allow artificial abortion through both surgery and medication, and to implement insurance coverage for it.
◇Ruling party: 'We must prevent legal and institutional vacuums and guarantee self-determination rights'
At the debate, lawmaker Nam In-soon stated, 'Despite the 2019 Constitutional Court ruling decriminalizing abortion, access to abortion medication has become clandestine,' revealing the legislative intent. Lawmaker Lee Soo-jin also argued, 'Safe abortion must be possible based on women's judgment and decision.'
Park Ju-min, chair of the Health and Welfare Committee from the same party, stressed, 'Due to the lack of law, women are forced into unsafe choices, and medical personnel are placed in a situation of uncertain legal risk.' Lee Dong-geun, secretary-general of the Health Society for Healthy Society, also noted, 'There are numerous research and evidence supporting the effectiveness and safety of abortion methods,' emphasizing the need for legalization.
Currently, prescribing or using abortion pills in Korea is illegal. The Constitutional Court decided on the unconstitutionality of the abortion law in 2019 and called for alternative legislation by the following year, but the legal vacuum has persisted until now. In 2020, the government announced a legislative proposal to allow abortion pills, but it was abolished due to the expiration of the deadline after much debate.
In the meantime, there have been ongoing cases of illegal distribution and transactions of the abortion pill Mifegyne through social media such as X (formerly Twitter). Mifegyne is an abortion-inducing agent used within the first 50 days of pregnancy and is legally prescribed in more than 90 countries, including the United States, France, the United Kingdom, and China.
Mifegyne cannot be used domestically. Hyundai Pharm holds the domestic rights for Mifegyne and applied for product approval from the Ministry of Food and Drug Safety in July 2021, but it withdrew the application voluntarily due to requests for supplementary safety data.
◇Medical community: 'Need for legal frameworks vs. concern over side effects and misconceptions'
Within the medical community, there are both supporting and opposing opinions. Supporters argue that the illegal use of drugs is increasing domestically and that we should consider the realities in other countries where it is permitted. Opponents counter that oral abortion medication could pose risks to women's health.
Kim Hee-seon, a professor of obstetrics and gynecology at National Health Insurance Ilsan Hospital, stated at the debate, 'As the legal vacuum persists, side effects such as arbitrary refusals by medical institutions, increased illegal drug use, and deepening economic burdens are emerging,' and urged, 'It is urgent to establish legal and institutional frameworks, including allowable criteria by gestational age, consulting procedures, and guidelines for medication use.' According to Professor Kim, the gestational age at which medical abortion is possible is before 9 weeks in Japan, France, Canada, and Australia, before 10 weeks in Germany, the United Kingdom, and New Zealand, and between 9-12 weeks in Ireland.
The Korean Medical Association Organization submitted an opinion opposing the amendment to the Maternal and Child Health Act to the National Assembly. They stated, 'Abortion medications can cause severe side effects such as massive bleeding and intense abdominal pain, and additional medical treatment is necessary in cases of incomplete abortion,' adding, 'The proposed amendment lacks preventive and integrated approaches.'
On the day of the debate, Choi Anna, director of Gangneung Medical Center (a specialist in obstetrics and gynecology), criticized the proposed amendment, saying, 'This bill misleads the public into thinking that using abortion pills is somehow safer than surgery.'
Choi also criticized the attempt to change the term "artificial abortion" to "artificial abortion cessation," stating, 'Once you use the term abortion cessation, the fetus is no longer a baby but a 'failed contraceptive outcome.'
Sixty-nine organizations affiliated with the National Union for the Protection of Fetus and Women called for the legislative withdrawal of the amendment to the Maternal and Child Health Act. The union includes members from the medical community, civic organizations, religious groups, and youth organizations. They criticized the amendment as 'a product of extreme anti-life thinking that treats fetal life as something disposable.'