May 5, 2025
SEOUL – When 33-year-old Lee, who is due to give birth in four weeks, made her birth plan, she had no medical complications, no known risks and no family history of difficult pregnancies. But she had already decided: her first child would be delivered by cesarean section.
“Soon-to-be mothers around me choose C-section as natural birth comes with a lot of pain,” she said. “People say it’s a matter of choice. If you go with natural birth, you recover faster. But with C-section, it’s less painful at the moment, though it comes with more recovery.”
Lee’s decision reflects a growing trend among expectant mothers in South Korea, where cesarean deliveries — once a procedure reserved for medically necessary cases — have now become the norm.
According to data submitted to the National Assembly, 67.4 percent of all 235,234 births in South Korea in 2024 were by C-section, the highest rate on record. That’s a sharp rise from 51.1 percent in 2019, and significantly above the global norm: more than twice the rate in the United States at 32.1 percent, over three times that of Japan at 18.6 percent, and nearly four times the World Health Organization’s recommended rate of 10 to 15 percent.
Behind this rapid shift lies a combination of social, medical and legal forces — from mothers’ desire to avoid labor pain to fears among doctors of legal liability.
In online communities, especially those known as mom cafes, stories of childbirth are frequently shared.
These posts often emphasize the trauma of labor pains and the relative comfort of planned C-sections, helping to shape public perception of cesarean delivery as a more controllable and less stressful choice.
“Definitely, C-section,” a comment read a post asking what to choose between C-section and natural birth in an online forum for mothers. “There are higher chances to ‘fail’ with natural birth. Rather than suffering all that pain and then going for a C-section, it’s better to go for the ‘safe choice.'”
“Many pregnant women now ask for it even when it’s not medically required,” said a professor of obstetrics at a university hospital.
Doctors say another driver is the rising age of mothers.
In 2024, the average maternal age in South Korea was 33.7 years — up from 32.0 just a decade ago. The older the mother, the more likely a C-section becomes: 59 percent of births among women in their 20s were by cesarean, rising to 64 percent in their 30s and 75.3 percent in their 40s.
“As maternal age increases, uterine contraction becomes weaker and the risk of complications rises, making natural birth more difficult,” said Kim Jae-yeon, chair of the Korean Association of Obstetricians and Gynecologists.
But it’s not just patient preference. Legal risks play a critical role in doctors’ decisions.
In 2023, a South Korean court ordered an obstetrician to pay 1.2 billion won ($845,000) in damages after a baby was left with cerebral palsy following a natural delivery. Since then, doctors have increasingly opted for C-sections, fearing lawsuits or criminal charges in the event of complications.
“Even when natural birth might be feasible, many physicians now preemptively choose cesarean delivery,” said Yoo Jung-hyun, an obstetrician at Bundang Jesaeng Hospital.
This “defensive medicine” culture is further fueled by ongoing tensions between doctors and the government. With junior doctors stepping away from hospitals amid lengthy medical standoff, some clinics have found themselves less equipped to handle complicated deliveries. As a result, doctors at smaller clinics tend to err on the side of caution, opting for surgery when even minor risks are perceived.
However, medical experts warn that unnecessary C-sections come with their own dangers.
A professor of obstetrics at a university hospital cautioned that cesarean deliveries carry greater health risks for mothers compared to vaginal births. “Women who undergo C-sections are more likely to experience complications in future pregnancies and are considered high-risk,” the professor said.
The maternal mortality rate for cesarean births is 2.2 per 100,000 — 11 times higher than for vaginal deliveries. Recovery tends to take longer, and women who undergo cesarean deliveries face increased risks in future pregnancies.
“Natural birth, even when converted to a C-section mid-delivery, often results in better outcomes than a planned surgical delivery,” the professor explained.
Yet the real issue, many experts argue, lies in the ineffective legal safeguards for unavoidable birth-related accidents.
Since 2013, the government has operated a compensation system under Article 46 of the Medical Dispute Mediation Act, which is intended to cover damages in cases where doctors exercised due diligence but a delivery-related accident occurred nonetheless.
Recently, the Ministry of Health and Welfare announced that the maximum compensation cap would be raised from 30 million won to 300 million won, effective July 1.
However, questions remain over how often these cases are actually recognized and compensated. Data submitted by Rep. Seo Myung-ok shows that between 2021 and March 2025, a total of 101 claims related to unavoidable birth accidents entered the mediation process — but only about half received compensation.
The government has acknowledged this gap and proposed expanding legal protections for essential medical fields like obstetrics as part of broader healthcare reforms.
Yet progress has stalled due to ongoing conflicts between the medical community and policymakers. “The rise in cesarean births shows how defensive medicine is becoming the norm,” Rep. Seo said.
“We urgently need legal reforms that reduce or eliminate liability risks when physicians make medically sound decisions.”