South Korea to Approve Abortion Medication with Restrictions

South Korea is set to approve abortion medication, with restrictions, for the first time, officials announced this week. The decision comes seven years after the country's Constitutional Court declared a long-standing ban on most abortions unconstitutional, creating a legal vacuum that the government is now moving to fill.

President Lee Jae-myung acknowledged the gap on social media, stating that the phased introduction of abortion drugs will improve access to medically safe procedures for women. "During that time, women have been unable to obtain safe abortion drugs and have had to rely on overseas direct purchases or illegal transactions, taking risks in the process," Lee said. "Even while fixing a leaking roof, the floor gets wet. I believe that doing what we can now, rather than waiting for a perfect solution, is a slightly better decision."

Under the proposed plan, women up to nine weeks pregnant will be able to obtain the medication with a prescription, exclusively through hospitals or clinics. This initial rollout, slated to begin in the first quarter of 2027, is expected to last at least two years to allow for monitoring of safety issues and side effects, according to Won Min-kyung, Minister of Gender Equality and Family. "We expect this to serve as an opportunity to strengthen the policy foundation for overall women’s health, including pregnancy, childbirth, and contraception," Won added.

Drug and Global Context

The Ministry of Food and Drug Safety is reviewing an application for the import of a drug combination of mifepristone and misoprostol, a regimen commonly used for medical abortions. These medications are included on the World Health Organization's Model List of Essential Medicines. Mifepristone works by blocking progesterone, while misoprostol, taken afterward, empties the uterus. Misoprostol is also used for stomach ulcer treatment.

While the WHO recommends the drug combination for pregnancies up to 12 weeks, South Korean officials have set the limit at nine weeks, as the product seeking approval was tested on women within that gestational period. Globally, the WHO's Global Abortion Policies Database indicates that 84 nations have officially recognized mifepristone or a mifepristone-misoprostol combination. Misoprostol alone is approved in 123 countries, though some have restricted its use to non-gynecological purposes.

The United States approved mifepristone in 2000. In 2023, medication abortions accounted for 63% of abortions in U.S. states without total bans, according to the Guttmacher Institute. However, 28 states have policies restricting access to medication abortion.

Reactions and Concerns

The Korea Women’s Political Network welcomed the plan as a "significant step forward" that establishes a foundation for safe medical services. However, the group expressed concerns that the prescription requirement and dispensing exclusively through healthcare facilities could "excessively restrict women’s access" and urged extending the covered period to 10 weeks.

Conversely, the Catholic Bishops' Conference of Korea urged the government to focus on support systems for women in crisis rather than expanding abortion pill access. Medical professionals have also called for legal protections, highlighting concerns about potential criminal punishment due to the lack of comprehensive legislation. The Korean Association of Obstetricians and Gynecologists stated that while not opposed to the introduction of mifepristone in principle, they "will not accept any introduction that does not guarantee patient safety and the legal protection of medical professionals."