"Childbirth as a Planned Choice"... 7 Out of 10 First-Time Mothers Opt for Cesarean Section

Seoul National University Research Team Analyzes 6.63 Million Births in South Korea
Cesarean Section Rate Nearly Doubles in 17 Years: 36.4% to 67.4%
"Cesarean rate remains excessively high"

Two out of every three births in South Korea are now delivered by cesarean section, and the rate surpasses 70% for first-time mothers.

Pregnant woman image to aid article understanding. Photo by Yonhap News.

According to Yonhap News on September 11, a research team led by Professor Kang Young-ho from the Department of Preventive Medicine at Seoul National University College of Medicine analyzed 6,635,390 childbirths by women aged 15 to 44 in South Korea between 2007 and 2024. The findings were published in the latest issue of the international journal "Birth."

Higher Cesarean Section Likelihood Among Mothers Born in the Late 1990s

The cesarean section rate among all births rose from 36.4% in 2007 to 67.4% in 2024, marking a 1.9-fold increase. Until 2014, the rate was below 40%, but it has since increased rapidly. The rise was even steeper among first-time mothers; the cesarean section rate for this group jumped from 35.6% to 72.4% over the same period, more than doubling. For mothers with previous births, the rate increased from 37.2% to 58.8%.

The research team also identified a "birth cohort effect," meaning the likelihood of having a cesarean section varied by generation. This suggests that even for mothers of the same age—for example, those who gave birth at age 30 in 2010 versus 2024—the broader social environment, beyond just age, has influenced the probability of cesarean delivery. According to the analysis, women born between 1992 and 2002, especially those born in the late 1990s, showed a relatively higher probability of cesarean section.

The research team explained, "This may be due to later marriage and childbirth, the growing importance of women's participation in the workforce and career maintenance, and the trend of viewing childbirth as a planned, predictable event beyond just a medical occurrence." They added, "Fear of labor pain and risk avoidance may also have influenced the choice of cesarean section."

Far Above Global Averages...Multiple Factors Including Defensive Medical Practice

South Korea’s cesarean section rate is high even by international standards. According to a study published by the World Health Organization (WHO) in the journal "BMJ Global Health" in 2021, the average cesarean section rate across 154 countries between 2010 and 2018 was 21.1%. By region, East Asia was 33.7%, and Latin America & the Caribbean recorded the highest at 42.8%. The WHO projected that the East Asia cesarean section rate would reach 63.4% by 2030, but South Korea had already surpassed this figure in 2024.

There are several factors involved in the rise of cesarean section deliveries, including not only the increasing age of mothers but also changes in the medical environment. Hospital-specific cesarean section rate disclosure and incentive policies, which were introduced to bring down cesarean rates, have weakened. Due to the falling birth rate, the number of delivery centers and obstetricians has also decreased. Other contributing factors include the increase in multiple births, the burdens of natural delivery which requires standby for 24-hour labor and emergencies, and defensive medical practice driven by fear of medical disputes and lawsuits.

The cesarean section rate could continue to rise. With the proportion of first-time mothers increasing due to the low birth rate, those who have their first child by cesarean are likely to have subsequent births by surgery as well. An obstetrics professor told Yonhap News, "During last year’s medical conflict, obstetricians and gynecologists tasked with births faced excessive workloads due to a strike by resident doctors. This led to recommendations for daytime cesarean sections even to women who could have given birth naturally. If such delivery data are included, the current cesarean section rate would be even higher." According to the National Health Insurance Service’s "2025 Statistical Yearbook of Major Surgeries," the number of cesarean section surgeries last year rose by 10.2% from the previous year.

Image of a pregnant woman to aid article understanding. Pixabay

There are certainly cases where cesarean sections are medically necessary. For fetal distress, difficult labor, or abnormal fetal positioning, cesarean delivery is essential for protecting the lives of both mother and child. However, problems can arise when the surgery is performed without valid medical necessity. The WHO notes, "There is no evidence that cesarean section brings more benefit to mothers and babies when it is not medically indicated," adding that, "As with any surgery, risks such as bleeding, infection, anesthesia complications, thromboembolism, and organ injury exist, and recovery can take longer than with vaginal birth."

Professor Park Joongshin of the Department of Obstetrics and Gynecology at Seoul National University Hospital told Yonhap News, "The rise in high-risk pregnancies combined with structural problems in the medical system appears to have increased cesarean births, but the current cesarean rate remains excessively high." He added, "Policymaking to ease the burden of medical disputes and resolve obstetrics human resource issues, as well as efforts to create an environment where mothers are given a balanced explanation of the pros and cons of both vaginal birth and cesarean section, are needed to encourage natural birth."

This content was produced with the assistance of AI translation services.