Debate reignites in South Korea over legalisation of abortion pills

SEOUL - South Korea’s Constitutional Court declared the criminalisation of pregnancy termination unconstitutional in 2019, but the country remains mired in legal and medical limbo, leaving women to deal with uncertainty, stigma and unsafe alternatives.

Without follow-up legislation to regulate and guarantee safe access, women seeking abortions are forced into what advocates call a “blind spot”.

Hospitals often refuse to perform procedures without clear legal guidelines. Women are then left to scour online forums or underground markets to buy smuggled drugs at exorbitant prices, raising risks of counterfeit pills and severe health complications.

For many women, especially minors, low-income individuals and those living outside metropolitan areas, the barriers are even higher. What was celebrated as a legal victory has, paradoxically, left many stranded.

Now the debate has reignited, as the government of South Korean President Lee Jae Myung recently included the legalisation of abortion medication in its five-year national policy agenda.

At the centre of the debate is mifepristone, a medication primarily used to terminate early pregnancies.

Taken in combination with misoprostol, it enables early pregnancy termination without surgery and has been widely used worldwide for decades by more than 90 countries.

The World Health Organisation has included mifepristone on its list of essential medicines since 2005, describing it as a proven, low-risk method of care.

Despite international recognition of its safety and efficacy, the pill is currently banned in South Korea. The health authorities have long argued that regulatory and legal frameworks must come first.

In 2024, the National Human Rights Commission of Korea recommended its formal introduction and classification as an essential medicine, but progress stalled.

This summer, both ruling and opposition lawmakers began pushing Bills that explicitly recognise abortion by medication as a legal medical procedure.

Representative Nam In-soon of the Democratic Party of Korea and 10 co-sponsors introduced the first such Bill of the 22nd National Assembly in July, amending the Maternal and Child Health Act to define abortion as “termination of pregnancy by surgical or pharmaceutical methods”.

The Bill calls for coverage under the national health insurance system, while removing outdated requirements such as spousal consent or restrictions tied to sexual assault.

International voices are also amplifying the urgency.

At a roundtable at the National Assembly in Seoul on Sept 2, Dr Suzanne Veldhuis, a physician affiliated with Women on Web, urged that pregnancy termination should not be treated as a crime, but rather as “a fundamental right for women’s safety”.

Women on Web is an international non-profit organisation that provides access to abortion pills for women living in countries where safe services remain restricted.

“Of the 73 million abortions performed annually worldwide, 25 million are carried out through unsafe methods,” she said.

“Abortion pills are the first step to ensure women do not have to rely on clandestine and dangerous procedures.”

According to data shared at the discussion, the risk of serious side effects such as heavy bleeding from abortion medication is less than 0.5 per cent.

Dr Veldhuis cautioned that in societies where abortion is criminalised, inequality tends to deepen.

“Those who need abortion services are often among the most vulnerable,” she said, pointing to survivors of domestic and sexual violence, adolescents and unemployed women.

“Without a proper system, people who lack access to information, education or financial resources are pushed toward unsafe abortions,” she warned.

Echoing her concerns, Dr Yoon Jung-won, an obstetrician at the National Medical Centre, said abortion services have effectively become a “luxury” for women excluded from mainstream systems, such as migrant women and women with disabilities.

She also voiced concerns about a growing gap between demand and medical capacity, especially after

a wave of trainee doctor resignations

reduced gynaecological services earlier in 2025.

According to a 2025 issue paper by the Korean Women’s Development Institute, the cost of abortion surgery continues to climb, with 40 per cent of patients reporting they paid over 1 million won (S$930).

Health Minister Chung Eun-kyung has also said that the government will review the introduction of abortion medication.

The Constitutional Court’s ruling in 2019 declared that criminalising abortion violated women’s bodily autonomy and ordered lawmakers to craft a replacement law by the end of 2020.

The Parliament, however, failed to act, leaving the country in limbo for six years, where abortion is neither explicitly legal nor illegal.

In 2023, more than 1,800 pharmacists, doctors and citizens petitioned the Ministry of Food and Drug Safety to allow and classify such drugs as essential, but regulators rejected the request, citing a lack of social consensus.

As the government frames safe abortion access as part of its broader women’s health and rights agenda, expectations are rising that legal recognition of abortion medication may finally end South Korea’s long limbo.

But until lawmakers translate policy pledges into enforceable law, experts say women continue to bear the risks of a system that recognises their right to choose in theory, but withholds the tools to exercise it safely in practice. THE KOREA HERALD/ASIA NEWS NETWORK