In Korea, which had been labeled "the first country in the world that could disappear" because of low birthrates, the sound of babies crying is growing louder again. In the first quarter (January–March) of this year, 75,013 babies were born, up 14.8% from a year earlier. But delivery rooms to receive those babies are in short supply. Expectant mothers are struggling with booking chaos, and hospitals are groaning under staffing shortages. We examined the problems in Korea's delivery infrastructure. [Editor's note]
A woman surnamed Lee, 28, who is due at the end of this year, said as much. Lee barely managed to secure a booking at a delivery hospital in May. It took more than 400 calls, mobilizing her spouse, parents, and acquaintances, before they finally got through to the hospital. It took about another 40 minutes to proceed with the booking consultation.
Lee did not insist on that hospital from the start. In early pregnancy, Lee went to an ob-gyn clinic near the residence, but ultimately chose to transfer to a larger hospital. The decision was because it runs an integrated nursing and care service with professional nursing staff on site 24 hours a day and has a system that enables immediate surgery in emergencies. Lee said, "Finding a hospital to give birth is as hard as picking stars from the sky, just like having a baby."
Although the number of births in Korea has risen for two straight years, the country's delivery infrastructure is failing to keep up. As the average age of childbirth climbs, the number of high-risk expectant mothers is increasing, while obstetric specialists and dedicated wards to care for them are actually decreasing. With pregnant patients flocking to a few hospitals, even "booking chaos" is unfolding.
◇ A one-hour wait on the phone is standard
On the 22nd, multiple posts on social media (SNS) said they were able to book an initial appointment at a delivery hospital only after about 300 to 400 call attempts. Among pregnant patients, booking hacks are being shared, such as "press connect to an agent instead of appointment booking" and "start calling from 8:54 a.m."
A person identified as A, who booked an initial appointment at a delivery hospital in March, also managed to connect to an agent after about an hour. This hospital takes bookings on the morning of the last Tuesday of every month, and reservations must be made two months before the visit date. "The competition is as fierce as trying to get idol concert tickets" if you want to book a physician popular among pregnant patients, A said.
That is because many prepare for a transfer during pregnancy. In early pregnancy, they first visit a small ob-gyn clinic where booking is easier, then move to a large hospital specializing in delivery for childbirth. It is the so-called switch from a "sub hospital" to a "main hospital."
A pregnant patient living in Paju, Gyeonggi, said, "In early pregnancy, I first went to an ob-gyn close to my residence," and added, "From mid-pregnancy, as the risks rise, I plan to move to a large delivery hospital."
◇ More high-risk expectant mothers, but far too few dedicated beds
Because the number of medical institutions capable of delivery has been steadily declining, the system cannot keep pace with the rebound in births. Over the past 10 years, domestic institutions capable of delivery have fallen by more than 40%, from a little over 700 to a little over 400.
Conversely, as the number of high-risk expectant mothers rises, the booking crunch centered on large hospitals with dedicated facilities is getting worse. Last year, the average age at childbirth for women was 33.7, up 5.8 years from 10 years earlier. The share of mothers 35 and older also expanded from 4.8% in 1995 to 35.9% last year.
There are only about 80 neonatal intensive care units (NICUs) nationwide in Korea. According to data submitted by Seo Mi-hwa, a lawmaker from the Democratic Party of Korea, to the Ministry of Health and Welfare, from 2020 over four years the number of NICU hospitalizations topped 460,000 every year except 2023. That is due to a continued increase in premature infants, including low-birthweight and preterm babies. Meanwhile, dedicated medical staff fell 31.2% over the same period.
◇ Experts: "Urgent need to reform reimbursement structure and strengthen state support"
On the ground, many say it will be difficult to expand delivery infrastructure without breakthrough measures such as significantly increasing financial support. In particular for NICUs, although the government provides annual operating costs of 600 million won per regional maternal and child health center and 10 million won per bed in maintenance support, the structure is said to be in the red.
Yoo Kyung-ha, head of Ewha Medical Center, said, "Gynecology professors are taking delivery duty together, or we are holding on by deploying nurses as midwives," but also noted, "After staffing up and running the NICU at 100% capacity, we are incurring an annual loss of 2.5 billion won."
There is also analysis that establishing a joint delivery system between obstetrics and pediatrics is necessary. Kim Hee-seon, deputy secretary-general of the Korean Society of Obstetrics and Gynecology, said, "We need to put in place a system in which treatment for the mother and the newborn is carried out at the same time."