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KMID : 0614720160590060417
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Journal of Korean Medical Association
2016 Volume.59 No. 6 p.417 ~ p.423
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The collapse of infrastructure for childbirth: causes and consequences
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Oh Soo-Young
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Abstract
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Despite low childbirth rate in Korea, the number of women with high-risk pregnancies is steadily increasing, mostly
due to increased maternal age, multiple pregnancies, and obesity. In fact, one out of five Korean women is above 35
years old at childbirth. It is well known that high risk pregnancy is closely related with increased maternal mortality,
either by direct or indirect causes. Despite such problems, however, Korea’s health care infrastructure for childbirth has
deteriorated, leaving approximately 20% of the geographic area of the country medically underserved with regard to
optimal maternity care. Such a collapse has been caused by the decrease in the number of maternity hospitals and their
financial difficulties due to medical fee reimbursement for childbirth being too low. The problem is aggravated by a lack
of obstetricians who can provide skilled attendance at childbirth. In addition, extensive legal pressure has dissuaded
talented medical students from pursuing obstetrics and gynecology, thereby resulting in aging and severe gender
imbalance in such professions. The direct consequence of the collapse in infrastructure for childbirth is an increased
maternal mortality ratio, especially in underserved areas. Moreover, increased maternal death caused by postpartum
bleeding reflects an obvious sign of danger in the maternal health care system. Furthermore, the number of tertiary
hospitals that can provide optimal care to high risk pregnant women has decreased to two-thirds of what it once was,
and the training of competent obstetricians for the mothers of the future continues to be a difficulty.
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KEYWORD
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Parturition, Medically underserved area, Maternal mortality ratio, Obstetrics and gynecology department, hospital, Korea
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