In an unsettling turn of events, North Korean authorities are reportedly cracking down on healthcare providers involved in abortions and those dispensing contraceptives. This is part of the regime’s push to increase the nation’s birth rate.
According to a recent report by Radio Free Asia, a medical source operating in the northern province of Ryanggang—an area that shares a border with China—revealed the harsh ramifications for doctors who defy the government’s directive. The source, who chose to remain anonymous for safety reasons, indicated that the head of the obstetrics and gynecology department at Paegam County Hospital faced a trial after conducting at-home abortions.
This doctor, who performed an abortion that tragically led to the death of the patient, was sentenced to five years in prison. Notably, the trial was conducted in an unusual setting: a conference room within a medical university hospital, rather than a traditional courtroom.
Current statistics reveal a concerning decline in North Korea’s fertility rate, which stood at 1.8 births per woman last year, according to estimates from the United Nations Population Fund. For context, a fertility rate of 2.1 is widely considered the minimum required for a population to maintain itself over time.
Another instance involved an OB-GYN in Unhung County, also within Ryanggang, who received a three-year sentence for her role in an illegal abortion back in 2021. Reports suggest these doctors conducted up to three clandestine abortions daily, with the procedures costing around 30,000 North Korean won (approximately $33) – the equivalent of a monthly salary or enough to purchase 10 pounds of rice.
The source disclosed that it is common practice for OB-GYNs in the region to visit patients’ homes for abortions to leave no evidence of the procedure. However, the two doctors in question had reportedly set up medical equipment in their residences.
Interestingly, the department head from Paegam County had reached retirement age this year, while the doctor from Unhung County is a mother of two middle school-aged girls.
In a broader crackdown on healthcare practices, reports also indicate that the North Korean government has significantly raised doctors’ salaries—up to 40 times—now averaging between $5 and $11 monthly. This change appears to be aimed at discouraging medical professionals from supplementing their income through unofficial means.
Additionally, vendors who sell contraceptives are also facing scrutiny. A source noted that two merchants in Hyesan had their stalls confiscated by authorities earlier in July, while three others faced hefty fines and were banned from the market permanently just last month.
The North Korean embassy in China has not responded to requests for comments regarding these developments.
The country had previously outlawed abortions during the “Arduous March,” a catastrophic period marked by extreme famine from 1994 to 1998, which resulted in millions of deaths.
North Korea’s demographic issues are not just an internal concern; they also alarm neighboring countries, many of which are grappling with their own declining birth rates. For instance, Russia, Japan, China, Taiwan, and South Korea have numbers ranging from 1.4 to a startling 0.72.
What’s particularly distressing for North Korea is how vulnerable the nation is to the effects of these trends, exacerbated by international sanctions on advanced technologies related to its missile and nuclear weapons programs. As a result, North Korea finds itself relying heavily on manual labor and outdated methods of production—further complicating these demographic challenges.
During the recent fifth National Congress of Mothers, North Korean leader Kim Jong Un acknowledged the dropping birth rate as a significant social issue, urging women across the nation to help counter this trend.