Coincidentally, Korea, a country with declining birth rates, also happens to be the only country possessing such a unique culture of flourishing post-partum care centers. What could be the underlying reason for this strange phenomenon?

Post-partum care centers are almost mandatory in Korean culture despite declining birth rates. (Credit: Getty Images)
Post-partum care centers are almost mandatory in Korean culture despite declining birth rates. (Credit: Getty Images)

In an interview with Korea Biomedical Review, Lee Eun-ha, mother of a 19-month-old boy, said for Koreans, it’s never a question of if you’re going to a post-partum center but rather “how long” you are going to stay there.

Postpartum or postnatal care, as defined by the World Health Organization (WHO), refers to the care given to the mother and her newborn baby for the first six weeks of life immediately after birth. WHO recognizes this as a critical period for ensuring the survival of the mother and her newborn, in addition to supporting the healthy development of the baby alongside the physical and mental recovery of the mother.

Korean post-partum system vs those abroad

While post-partum care exists in other parts of the world, designated centers for this purpose seem to be exclusively Korean. Developed countries with low maternal mortality rates like Denmark, Netherlands Belgium, Sweden, and France, tend to perform routine home check-ins with mothers.

In Korea, a post-partum care survey from the Ministry of Health and Welfare (MOHW) revealed that 81.2 percent of mothers used this service in 2021, increasing from 75.1 percent in 2018. Also, the average post-partum care period is 30.2 days and the average cost of post-partum care is 2.49 million won (approximately $1844) for a two-week service.

According to Chairman Kim Hyung-sik of Korea’s Post-partum Association (KPA), the nation’s first center was established in Incheon in 1997 as families began transforming into nuclear households and could not receive help from other family members. Preceding this, traditional home recovery methods entailed reducing infection by limiting contact with others and eating seaweed soup for three weeks, locally referred to as the “saam-chil-il” which literally translates to three, seven days.

In comparison, Japan refers to this as the satogaeri bunben where mothers move back to their parent’s home from 32 to 35 weeks of pregnancy until a few months of postpartum. Mexico observes a 30-day rest period with a family called the cuarentena. Meanwhile, Latin American countries encourage secluded rest for the first month after birth with postpartum body massages and abdominal binding, or wrapping the belly several days after vaginal birth.

Chairman Kim noted the number of post-partum centers in Korea once peaked at 620 but drastically slumped to 520 in 2020 due to the declining number of newly born children. The number continued to fall to 492 in December 2021, government data showed.

A briefing from the Korea Institute of Child Care and Education (KICCE) reasoned that these centers were quickly established to facilitate a safer environment for Korean women whose first childbirth became gradually delayed over the years. However, Kim believes these centers exploded in popularity because of Korea’s unique culture of care and mothers’ positive recovery experiences.

Accordingly, Kim thinks these centers can become the next “Hallyu” movement in Korea as it has received global attention, particularly from next-door neighbors -- China and Japan -- that have emulated the Korean-style post-partum care centers to cater to its citizens who usually visit Korea for these services.

Low fertility rates endanger Korea’s post-partum centers

However, Korea’s low fertility rate is detrimental to these businesses. According to Statistics Korea, the country’s fertility rate hit a record low in 2021 at 0.81, down from 0.84 in the previous year. Since the 1960’s in Korea, fertility rates steeply dropped every decade, slowing down after the 1990s and dipping below 1 in 2018, exacerbated by the economic downturn and soaring house prices. While the same trends are observed worldwide, Korea particularly stands out as one of the three countries with a fertility rate below one, according to the World Bank.

A graph from the World Bank shows the declining fertility trend in Korea with similar trends also noted worldwide.
A graph from the World Bank shows the declining fertility trend in Korea with similar trends also noted worldwide.

Kim referenced Hungary’s policies to increase its fertility rate which has seen a 20 percent increase. The Hungarian government inf 2019 started providing a 40 million won interest-free loan to families. If you have two babies, 30 percent of this loan will be exempted. Furthermore, a third child cancels your debt to the government. Additionally, a fourth child guarantees you a lifetime exemption from income tax.

Comparatively, Korea has a maternity credit system allowing mothers with two children to be eligible for national pension 12 months earlier. Correspondingly, mothers with three children are credited with 30 months, four children with 48 months, and five or more children with 50 months. Additionally, Korea provides an allowance of 100,000 won monthly per child until the age of 8 years, with support for folic acid, iron supplements, diapers, and formula for low-income families. Overall, these policies fall short of addressing Korea’s current fertility crisis.

Housing, a major concern when starting a family, is not addressed in these policies. Notwithstanding these concerns, government support for post-partum care is also limited. Public post-partum centers offer vouchers, but a survey of these public facilities revealed that 35.8 percent of the surveyed mothers were not eligible due to exceeding the income standard, 11.6 percent cited additional costs as a deterrent, and 7.7 percent complained about a lack of professionalism in the program.

To address this issue, KICCE recommends a universal postnatal care voucher system for mothers and a postnatal care center evaluation system to enhance the safety, infection prevention, and quality of services of postnatal care centers.

‘Post-partum center’s service is better than husband’s help’

Lee revealed her reasons for going to a private center in Gyeonggi province. “I chose to stay at a post-partum center because I needed the help as it was my first time and it is difficult to take care of the baby by myself, especially right after labor.”

“As they are trained professionals, it's far better than getting assistance from your husband or any family member,” she commented.

As she used a center in the Gyeonggi province, she also received financial support of 500,000 won allocated by the local government for new mothers who are Gyeonggi residents.

Lee described her experience as a relaxing program entailing lessons for taking care of a newborn such as bathing, feeding, changing diapers, coping with situations like fever and crying, and basic information regarding the development and growth of the baby at each stage. Mothers can choose to stay in a room with the baby or in a separate room where they can see the baby at any time they wish, she explained.

Not only physical care but mental and emotional support is also provided to avoid or reduce post-partum depression. This is quite common in mothers and usually results from being overwhelmed with responsibilities from not having a proper adjustment period or support after the baby is born.

Beside postnatal care centers, women can also opt for government-supported in-home assistance or nanny service. Lee shared that she used this service for three weeks after exiting the post-partum care center and pointed out that partial government reimbursement is also available based on factors like family income and the number of children.

However, this service tends to be more popular from the second childbirth among Koreans as post-partum centers usually facilitate the mother and the baby and sometimes fathers, making it difficult to stay at the center if you have another child.

Lee noted that while her husband was allowed to stay with her during his ten days of paternity leave, he was not allowed to visit after returning to work, due to infection concerns exacerbated by the Covid-19 pandemic.

Public vs private post-partum care centers

Post-partum care services were initiated by private entities but due to the growing demand for these facilities, 11 public postnatal centers were established in Korea as of December 2020. Accordingly, prices vary based on their public or private status and whether they are located inside or outside of Seoul.

Naturally, as the Seoul and Gyeonggi regions are the most densely populated, most centers are situated in these provinces, accounting for more than half of the centers with the remainder scattered in other areas across the country. This is another issue that requires more government support to ensure greater access to these services.

The price of public postnatal care centers for a two-week stay is estimated to cost around 1.54 million won to 1.9 million won, compared to the 2.2 million won minimum cost of private postnatal facilities. Moreover, vulnerable, and multi-children households are entitled to an additional 50-to-70 percent discount. Both public and private centers offer similar services but public centers encourage mothers to stay with the baby in the same room.

Unaware of these public services, an expat mother of a 22-month-old girl, Adolat Nurullayeva, said the prices were too high for her to consider and opted out of these services.

However, she quickly added that thanks to the ten days of spousal leave granted to fathers, this short period still helped her adjust to her newborn. Perhaps because the public centers are new and fewer in number than private facilities, Lee also mentioned that she was unaware of these services.

Several YouTubers have also uploaded their experiences at these centers, all highlighting their satisfaction as it is quite a unique experience. Lee’s sister added, “Almost everyone that we know uses these centers. I don’t have a child but after hearing about my sister’s experience, I wish I could go now too.”

Despite the waning number of childbirths in Korea, the attraction and culture for using post-partum centers for Korean mothers appears to be strong as ever.

Copyright © KBR Unauthorized reproduction, redistribution prohibited