In Korea, which had even been labeled "the country that could disappear first in the world" due to low birthrates, the sound of babies crying is growing louder again. The number of births in the first quarter (January–March) this year was 75,013, up 14.8% from a year earlier. But delivery rooms to receive those babies are in short supply. Mothers are facing a reservation crush, and hospitals are struggling with staffing shortages. We examined the problems in Korea's delivery infrastructure. [Editor's note]
A person surnamed Lee (28), who is due at the end of this year, said this. Lee barely managed to secure a reservation at a delivery hospital in May. After enlisting a spouse, parents, and acquaintances, Lee finally got through to the hospital after making about 400 calls. It took about 40 more minutes to proceed to the reservation consultation.
Lee did not insist on that hospital from the start. In early pregnancy, Lee went to a nearby obstetrics and gynecology clinic but ultimately chose to transfer to a larger hospital. The reason was that it runs an integrated nursing and caregiving service with specialized nursing staff on duty 24 hours a day and has a system in place for immediate surgery in emergencies. Lee said, "Finding a hospital to give birth is as hard as the saying about plucking a star from the sky."
Although the number of births in Korea has risen for two straight years, the country's delivery infrastructure is not keeping up. As the average age at childbirth increases, the number of high-risk mothers is rising, while obstetricians and specialized wards dedicated to them have decreased. With pregnant patients flocking to certain hospitals, there is even a "reservation crush."
◇ 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 visit at a delivery hospital only after about 300–400 call attempts. Among pregnant patients, "press connect to an operator, not appointment reservations" and "start calling from 8:54 a.m." are among the tips being shared.
A person identified as A, who booked an initial visit at a delivery hospital in March, also succeeded in getting through to an operator after about an hour. This hospital takes reservations on the morning of the last Tuesday of each month, and you must book two months before the visit date. To reserve a highly popular doctor among pregnant patients, "the competition is as fierce as getting tickets for an idol concert," A said.
That's because many mothers try to switch hospitals during pregnancy. In early pregnancy, they get prenatal checkups and ultrasounds at neighborhood obstetrics and gynecology clinics where reservations are relatively easy, then after mid-pregnancy, they move to large delivery-specialty hospitals or general hospitals with strong facilities such as neonatal intensive care units (NICU). Among pregnant patients, this is described as switching from a "sub hospital" to a "main hospital."
A pregnant patient living in Paju, Gyeonggi Province, said, "In early pregnancy, I went to an obstetrics and gynecology clinic close to my residence," and added, "From mid-pregnancy, as the risks grow, I try to move to a large delivery hospital, but it's hard to book, so you have to reserve 2–3 months before delivery."
◇ More high-risk mothers, but dedicated beds are in dire short supply
Because the number of medical institutions capable of deliveries has continued to decline, the system has not kept pace with the rebound in births. Over the past 10 years, domestic medical institutions capable of deliveries have fallen more than 40%, from around 700 to around 400.
Conversely, as the number of high-risk mothers grows, reservation bottlenecks are worsening at large hospitals with dedicated facilities. Last year, the average age at childbirth for women was 33.7, up 5.8 years from 10 years earlier. The share of mothers age 35 or older also expanded from 4.8% in 1995 to 35.9% last year.
There are only about 80 neonatal intensive care units (NICU) nationwide. According to data submitted by Democratic Party of Korea lawmaker Seo Mi-hwa to the Ministry of Health and Welfare, over the four years since 2020, the number of NICU admissions exceeded 460,000 annually every year except 2023. This is the effect of a continued rise in the number of premature infants, such as low-birthweight and preterm babies. Meanwhile, dedicated medical staff fell 31.2% over the same period.
◇ Experts say "urgent to improve the fee structure and expand state support"
On the ground, many say it will be hard to expand delivery infrastructure without dramatic measures such as a large increase in financial support. In the case of NICUs in particular, the government provides annual operating funds of 600 million won per regional maternal and neonatal care center and 10 million won per bed in maintenance support, but the structure is said to be in the red.
Ewha Medical Center Director Yoo Kyung-ha noted, "Gynecology professors are taking delivery duty together, or we are holding out by assigning nurses as midwives," but pointed out, "After adding staff and operating the NICU at 100%, we are posting an annual deficit of 2.5 billion won."
There is also analysis that a joint delivery system between obstetrics and pediatrics is needed. Korea Society of Obstetrics and Gynecology Deputy Secretary-General Kim Hee-seon said, "We need to establish a system where treatment for mothers and newborns happens at the same time."