South Korea Remains Among Five OECD Nations Blocking Abortion Pill Access as 101 Countries Adopt WHO-Essential Medication
核心洞察
Oral abortion medications containing mifepristone and misoprostol are now approved in 101 countries worldwide, including 33 of 38 OECD member states, with South Korea among the five holdouts alongside Poland, Turkey, Slovakia, and Costa Rica.
The WHO added both mifepristone and misoprostol to its Model List of Essential Medicines in 2005, noting that medication abortion can reduce deaths from unsafe procedures which account for 45% of abortions globally.
South Korea's Hyundai Pharm (搜索) has applied three times since July 2021 for MFDS approval of Mifegyne, but regulators maintain a legal basis is required amid a six-year legislative vacuum following the 2019 Constitutional Court ruling.
South Korea stands among a shrinking minority of nations that continue to block access to oral abortion medication, even as 101 countries worldwide—including 33 of 38 OECD member states—now permit its use, according to data released by the Ministry of Gender Equality and Family as of 2024.
The medication, commonly known under the brand name Mifegyne, combines mifepristone, which blocks hormones necessary to maintain pregnancy, with misoprostol, which induces uterine contractions. Both substances were added to the World Health Organization (WHO) Model List of Essential Medicines in 2005, underscoring their recognized role in reproductive healthcare.
The global adoption of abortion medication began in France in 1988, followed by the United Kingdom in 1991 and Sweden in 1992. By 1999, 15 countries including Austria, Belgium, Denmark, Germany, the Netherlands, Russia, Spain, and Switzerland had introduced the regimen. The United States approved its use in 2000, with the FDA now permitting pharmacy purchase without a doctor's prescription and mail delivery. Australia followed in 2012, Canada in 2015, and Japan in 2023. In June 2024, the U.S. Supreme Court unanimously rejected a lawsuit by anti-abortion groups seeking to restrict access to the medication.
Only five OECD nations maintain a ban: South Korea, Poland, Turkey, Slovakia, and Costa Rica.
WHO Endorsement and Public Health Rationale
The WHO estimates that 45% of abortions worldwide are performed in unsafe ways, contributing to preventable deaths and infectious diseases. The organization states that "ensuring access to abortion care reduces maternal mortality and protects the dignity of pregnant individuals and girls," positioning medication abortion as a critical public health intervention.
Regulatory Stalemate in South Korea
Hyundai Pharm (搜索), which holds domestic distribution rights for Mifegyne, has submitted three applications for product approval to the Ministry of Food and Drug Safety (搜索) (MFDS) since July 2021. None have been approved. The MFDS maintains that product approval requires a clear legal basis—a position that has drawn criticism from advocacy groups.
The legal impasse traces back to April 2019, when South Korea's Constitutional Court issued a decision of non-conformity regarding the criminalization of abortion. Substitute legislation was required by the end of 2020, but no law was enacted, resulting in a six-year legal vacuum.
The Korea Women's Associations United argued in a July 15 commentary that "the Ministry of Food and Drug Safety (搜索) claims it cannot grant sales approval because the relevant law has not been revised, but it has actually delayed the introduction while hiding the fact that it received multiple legal opinions stating there are no issues with introduction under current law."
Presidential Intervention and Inter-Ministerial Talks
At a cabinet meeting on July 14, President Lee Jae-myung directed the government to examine ways to allow the use of abortion drugs based on medical professionals' judgment, even before the relevant laws are revised. Minister of Gender Equality Won Min-kyung subsequently confirmed that "following the President's remarks, discussions among relevant ministries will be held more actively under the leadership of the Office for Government Policy Coordination."
The outcome of these inter-ministerial discussions may determine whether South Korea joins the 101 nations that have integrated medication abortion into their healthcare systems, or remains among the five OECD outliers.