C-sections in Korea: Convenience or medical necessity?

Illustration depicting the first cesarean section performed in Latin America in 1844, by Enrique Graue / Courtesy of the International Museum of Surgical Science

According to the United Nations, the world welcomed approximately 132 million newborns in 2024. Of these, roughly 21 to 22 percent were born via cesarean section. In stark contrast, 67.4 percent of the 235,234 babies born in South Korea that year were delivered through the surgical procedure, which involves an incision into the mother's uterus.

The World Health Organization (WHO) recommends a C-section rate of 10 to 15 percent of all births, noting that the surgery should be performed only when necessary due to risks such as excessive bleeding, infection, organ damage and pulmonary embolism. The C-section rate is approximately 32 percent in the United States and 18 percent in Japan.

Korea's peculiarly high rate reflects the local perception that C-sections are safer than vaginal deliveries. Critics point out that the medical community often encourages defensive practices to avoid legal liability for complications that can occur during natural childbirth.

Other contributing factors include the desire to avoid labor pain, the cultural practice of selecting birth dates based on "saju" (fortune-telling), the aging population of mothers and the increase in fertility treatments. Some argue that the WHO's recommended standards fail to adequately reflect current realities, such as the prevalence of high-risk pregnancies among older women.

While patient self-determination is a crucial value in medical ethics, experts argue it is necessary to scrutinize whether these statistics result from genuine "self-determination" or pressure from the medical system.

There is a significant correlation between C-section rates and the incidence of massive maternal hemorrhages, hysterectomies and neonatal respiratory diseases. Experts question whether the possibility of long-term side effects, such as placenta accreta, is being sufficiently communicated to mothers.

The first cesarean section — excluding myths and legends such as those surrounding Julius Caesar — is said to have been performed in the early 16th century by a Swiss veterinarian named Jacob Nufer on his wife, who was suffering from a difficult labor.

However, modern medical history cites American obstetrician Jesse Bennett as the first official use of the surgery. On Jan. 14, 1794, Bennett operated on his wife, successfully saving both the mother and baby.

This article from the Hankook Ilbo, the sister publication of The Korea Times, is translated by a generative AI system and edited by The Korea Times.