🇰🇷 How Excessive Use of C-Sections is Hurting Fertility in Korea and Around the World

In Korea, an incredible 59% of deliveries are by C-section. This is one cause of South Korea's low birthrates since C-sections significantly lower the number of births a woman will have.

These rates in Korea and other countries are far above international guidelines for best maternal and neonatal outcomes (around 10-15 C-sections per 100 births).

Where rates of C-section are high, fertility tends to be much lower, by ~ 1/3 birth/woman in advanced countries.

The same relationship holds for US states. Although the variation in the rate of C-sections is just 23% to 38%, we still see that a higher rate of C-sections is linked to fewer births.

Numerous studies have confirmed this relationship. But why?

Demographer Lyman Stone explains how C-sections reduce future fertility

First, studies find the ability to conceive is reduced after a C-section, likely because of scar tissue in the uterus.

Second, doctors advise women to avoid becoming pregnant again after 2-3 C-sections

But what is going on with Korea? Why are doctors performing so many C-sections in South Korea when they are so damaging to a woman's future fertility?

Is this medically necessary? Mostly no. The prevalence of C-sections in South Korea looks random.

The reason for excessive C-sections is money.

In Korea, doctors are compensated very little for vaginal delivery (one fifth to one third of similar countries). Combined with lawsuit risk, profitability for obstetricians was low.

Many OBs went out of business. Many others increased profitability through C-sections.

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