November , 2021 Issue 19

Public Postnatal Care Service for Mothers and

Newborns in South Korea: Demands and Challenges

Background In this brief, we would look at demand, current status, and

improvement tasks focusing on South Korea's post-birth
The general timing of women’s first childbirth is postponed in public maternal policy.
line with the low birth rate phenomenon in South Korea.
Public Postnatal Care Services for
• According to the “2019 Birth Statistics” from the National
Statistical Office, the proportion of mothers aged 35 or older
Mothers and Newborns in South Korea
was 33.4%, which was more than double from 15.4% in 2009.
Postnatal voucher services for women and infants
As the age of the first childbirth increases, the probability • The healthcare support project for mothers and newborns is a
of premature delivery and Caesarean section increases,
system that involves assigning health managers to families of
along with the possibility of prenatal complications.1
women who have given birth to support their postnatal
• Therefore, the importance of prenatal and postnatal care has
recovery and the raising of newborns.
increased remarkably to secure the health of mothers and
- Voucher Recipient: The voucher is received by families
newborns.
where the mother or spouse is living, medical, residential,
Mothers and newborns who did not receive proper educational benefit recipients, next-higher class, or the total
prenatal and postnatal care were observed to have lower amount of the household's health insurance premium, is
health levels than those who received it.2 120% or less of the standard median income.
- Service timing and duration: Vouchers are valid for up to 60
In South Korea, pre-birth support policies, such as those
days from the date of birth of the child and are supported for
that target pregnancy medical expenses and iron and folic
up to 5 to 25 days depending on the type of fetus (single,
acid intake, are systematically well designed, while
after-birth support policy(e.g., support with childbirth twin, three or more) and birth rank (first, second, third, or
medical expenses) is insufficient.3 more) (for 8 hours a day, except holidays).

1. Kirz, D. S., Dorchester, W., & Freeman, R. K. (1985). Advanced maternal age: the mature gravida. American Journal of Obstetrics and Gynecology, 152(1), 7-12.
2. Song, Y., Shin, J., Yoon, Y., Jung, H., Im, H., Choi, B., Lee, J., Kim., H., Hong., Y., & Song., J. (2010). Perinatal complications of mothers and neonates resulting from
inadequate prenatal Care. Korean Journal of Perinatology, 21(4), 347-355.
3. Lee, S. (2014). Policy challenges for pregnancy after the age of 35 years. Health and Welfare Policy Forum, 213, 24-35.
02 KICCE POLICY BRIEF

- Service contents: Standardized services provided by the Seoul Healthy First Step Program
government to users are maternal health care, neonatal • The Seoul Baby Health First Step Project was introduced by
health care, maternal information provision, domestic the Seoul Metropolitan Government by benchmarking
activities support, and emotional support. Australia's Maternal and Early Childhood Sustained Home
Visiting (MECSH) program.
- Service Cost: The user is required to pay the difference from
the service price minus the government subsidy, which is - Target: Families who reside in the Seoul Autonomous
Region and are 20 or more weeks pregnant and/or have
differentiated according to the fetal type, birth order,
infants under two years of age can apply for the program
income range, and service period selected by the user (e.g.,
after registering.
87,000 won per day standard service, 29,000 won).
- Services are divided into universal and continuous visits.
∘ Universal visits take place within four weeks of childbirth.
Public postnatal care center
In this type of visit, a nurse with a professional degree and
• In South Korea, local governments can establish public postnatal experience visits the home of mothers and newborns to
care centers based on the Mother and Child Health Act. examine their health and provide counseling on baby care.
• Since the Seogwipo Public Postnatal Care Center was first ∘ Continuous visits are made to families with children with a
opened in March 2013, a total of 11 public postnatal care vulnerable health development. At least 25 home visits are
centers (as of December 2020) have been installed and are provided by nurses during pregnancy and two years after
operating. Other local governments are preparing to establish childbirth to educate the families regarding child care and

public postnatal care centers. monitoring and counseling on the health of children.

• The establishment and management of public postnatal care

centers is jointly funded by the South Korean central and local Current Status and Demands of the
governments. Postnatal Care Services
- Period of use: Mothers can use public postnatal care centers
To check the use of the above-mentioned postnatal care
for one to two weeks after childbirth. services and demands from mothers and newborns after
- Service content: There are no differences between public childbirth, 426 women within a year of childbirth were
and private postnatal care centers regarding services. They surveyed.

both offer maternal and newborn healthcare services. • A total of 79.0% and 83% of mothers and newborns were
However, the public postnatal care center encourages examined within three months after childbirth, respectively.

mothers to keep rooming-in(staying mother and baby • The average postnatal care period for mothers was 4.25
together). weeks, and the average response to the reasonable postnatal
care period was 6.37 weeks.
- Service costs vary by local government, but the cost range of
- A total of 49.8% of mothers, answered that their preferred
public postnatal care centers is 1.54 million to 1.9 million
and a reasonable place for help regarding postnatal care for
won, which is less than three -quarters of the 2.2 million
two weeks after giving birth is a postnatal care.
won(based on two weeks) of the private postnatal care
- A total of 48.3% of mothers, answered that their preferred
centers. Furthermore, vulnerable and multi-child
and a reasonable place for help regarding postnatal care
households can receive 50 to 70% additional discounts.
from three weeks to four weeks after giving birth is their
home.
 ISSUE 19 03

• The utilization rate of mothers' postnatal health care workers Health care support services for mothers and newborns
was 5.6% in the first week, 5.4% in the second week, 11.6% in need to improve the overall quality of services provided
the third week, and 10.0% in the fourth week. by improving the evaluation system of training and
consignees.
- According to a survey to comprehend the reasons for not
using the healthcare support service for mothers and • Major postnatal care services, such as maternal and newborn
newborns, 35.8% of the total sample replied they were not health care support services and postnatal care centers, need
eligible due to exceeding the income standard, 11.6% due to to provide vouchers that can be commonly used for
additional costs, and 7.7% due to lack of professionalism in households with women who gave birth. This will expand the
the program. country's postnatal care support and strengthen the rights of

- According to survey on the improvement of maternal and service users.

healthcare support services, 31.0% of healthcare providers, • To improve the overall quality of the mother and newborn
27.8% of service extension, 21.6% of service improvement, health management project, it is necessary to consider
14.1% of service cost, and 5.5% of resident health care introducing a certification system and strengthening job
providers. education. This will improve professionalism for managers.

• Postnatal care center utilization rate was 53.0% in the first

week and 38.3% in the second week of the postnatal period. Since the utilization rate of postnatal care centers has
- The average number of days that the postnatal care centers increased and the use of postnatal care centers has been
were used was 14.5 days. established, a universal postnatal care voucher system for
maternity households is needed.
- The average financial amount of postnatal care center use
was 2.54 million won.
- Postnatal care education, such as care for newborns and A postnatal care center evaluation system needs to be
health care for mothers was found to be the most received established to enhance the safety, infection prevention, and
at postnatal care centers. quality of services of postnatal care centers.

- A total of 89.8% of mothers replied that postnatal care

centers need to be evaluated to enhance the level of
infection and quality of service in postnatal care centers.

Policy Suggestions

The registration of pregnant women must be established

to build a systematic policy framework of government
support for maternal and newborn health care and to
strengthen the connection between various maternal and
postnatal management policies.
• Based on the registration of pregnant women, health care in Jaehee Lee Ph. D.
the initial stages of their lives (the first step in the health of Research fellow
babies in Seoul) should be developed into national projects. leejaehee@kicce.re.kr
 Korea Institute of Child Care and Education
Post Tower, 9F, 70, Sogong-ro, Jung-gu, Seoul, Korea
Tel 82-2-398-7700 Ⅰ Fax 82-2-398-7798 Ⅰ www.kicce.re.kr/eng