Would you like to know more about pregnancy and childbirth in South Korea? The following blog post provides a descriptive analysis of the data gathered in the SOS Public Health Maternal Health Survey (2022 SOS PHMHS).
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Purpose of the Maternal Health Survey Data
The following data may do such things as 1) provide support and information for people considering childbirth in South Korea, 2) support additional research into the lived pregnancy and childbirth experiences of international residents living in South Korea, and 3) contribute to a better understanding of how international residents experience pregnancy and childbirth in South Korea.
About the Data
South of Seoul Public Health (SOSPH) implemented the SOS Public Health Maternal Health Survey (2022 SOS PHMHS) in March of 2022 to learn about the pregnancy and childbirth experiences among the multinational community who lived in South Korea from 2018 – 2022. The 2022 SOS PHMHS examined such experiences associated with prenatal care, childbirth, postnatal care, and pregnancy and childbirth complications in the descriptive analysis below.
Eighty-nine individuals participated in the 2022 SOS PHMHS. Survey respondents reported living in 15 of the 17 South Korean administrative provinces. Additionally, the SOS PHMHS respondents included individuals who moved to Korea from 6 of the 7 continents. Read more about the SOS Public Health Maternal Health Survey demographics here.
How Data is Used
South of Seoul Public Health uses the data provided within surveys such as the 2022 SOS PHMHS to better understand how to advocate for the international community and to create increasingly relevant public health initiatives. The data is also shared publicly to promote awareness of international healthcare needs in South Korea. All 2022 SOS PHMHS survey responses are anonymous.
International Residents’ Prenatal Care Responses
The following section reviews the 2022 SOS PHMHS international residents’ responses regarding prenatal care. The following section includes five questions specifically focused on prenatal care.
The Start of Prenatal Care
In the 2022 SOS PHMHS, all (100%) respondents reported receiving prenatal care at some point during their pregnancy in South Korea. Figure 1 shows the responses to the question, “When did you begin prenatal care during your most recent pregnancy between 2018-2022 in South Korea?
About 70% of respondents began prenatal care during the first trimester of their most recent pregnancy. Twenty-two percent began prenatal care before pregnancy. Approximately four percent began prenatal care during the second or third trimesters.
Type of Medical Facility Utilized by International Residents for Prenatal Care
The majority of 2022 SOS PHMHS respondents received their prenatal care at a Specialized Maternity Clinic in Korea. Figure 2 breaks down the responses to the question, “Where did you primarily receive prenatal care for your most recent pregnancy in South Korea?”
A total of 59% of respondents received prenatal care from a Specialized Maternity Clinic. Following Specialized Maternity Clinics, 19.8% of respondents utilized a Private Hospital. Next, 13.6% of respondents utilized a University Hospital for prenatal care visits. Fewer than 5% of respondents reported utilizing a U.S. Military Medical Facility (3.7%), a Local Medical Center (2.5%), and a General Hospital (1.2%).
Frequency of Prenatal Care Visits During Each Trimester
The majority of 2022 SOS PHMHS respondents went for prenatal care once a month for the first and second trimesters, however, for the third trimester the majority of women went for prenatal care every two weeks. Figure 3 provides a visual overlay of respondents’ answers regarding the first, second, and third trimesters.
First Trimester Prenatal Visit Frequency
During the first trimester of their most recent pregnancy, about 59.3% of respondents attended prenatal care appointments in South Korea once a month. About 24.7% of respondents attended prenatal care appointments once every two weeks and 6.2% attended once a week. Ten percent of respondents were categorized as “other.” Such respondents reported attending prenatal appointments only once throughout the entire first trimester (1.2%) or not at all (2.5%). The remaining respondents in the “other” category selected “not applicable” as their response due to being out of the country during the first trimester (Figure 3).
Second Trimester Prenatal Visit Frequency
During the second trimester of their most recent pregnancy, 75% of respondents attended prenatal care appointments in South Korea once a month while 13% attended once every two weeks. In the “other” category for the second trimester, respondents also reported making prenatal visits once overall (1.2%), not at all (2.5%), and once every 6-8 weeks (2.5%). The remaining 4.9% selected “not applicable” due to being out of the country during their second trimester (Figure 3).
Third Trimester Prenatal Visit Frequency
In the third trimester of their most recent pregnancy, 51% of respondents attended prenatal care appointments in Korea once every 2 weeks. About 21% of respondents attended once a week, and 16% attended once a month. In the “other” category for the third trimester, respondents reported attending prenatal visits more than once a week (2.5%), not at all (2.5%), and on a varied schedule (2.5%). About 3.7% of respondents selected “not applicable” due to being out of the country for their third trimester. (Figure 3).
For perspective, such findings are in line with the U.S. recommended frequency of prenatal check-ups but may differ from your country of origin.
Types of Prenatal Care Received During the First Prenatal Appointment
During their first prenatal appointment, over 50% of the 2022 SOS PHMHS respondents reported receiving such care as 1) an ultrasound, 2) an established due date, 3) general lab tests, 4) taking their medical history, 5) a physical, 6) prescribed prenatal vitamins, or 7) a medical exam. Figure 4 shows respondents’ answers to the question, “What care did you receive in your first prenatal appointment during your most recent pregnancy between the years 2018-2022 in South Korea?”
Roughly 96.3% of respondents established their due dates and received an ultrasound scan at their first prenatal appointment. About 72.8% and 71.60% had a general lab test and medical history check completed at their first prenatal appointment, respectively. Sixty-five percent of respondents received a physical examination. About 53% and 51.8% were prescribed prenatal vitamins or received a pelvic exam, respectively. Thirty-eight percent of respondents had a pap smear. Approximately 29.6% of respondents received a genetic abnormality test and around 19.8% received vaccinations (Figure 4).
Additional data on which medical facilities provide the most comprehensive prenatal care services based on the 2022 SOS PHMHS responses will be explored in a future research blog post.
Types of Prenatal Care Received at Follow-Up Prenatal Appointments
During follow-up prenatal appointments, the majority of 2022 SOS PHMHS respondents reported receiving: 1) a blood pressure check, 2) a weight check, 3) an ultrasound, and 4) a urine test. Figure 5 shows the responses to, “What care did you receive during ROUTINE PRENATAL visit(s) of your most recent pregnancy between 2018 – 2022 in South Korea?”
All (100%) respondents reported having their blood pressure checked at follow-up prenatal appointments. About 98.7% and 97.5% of respondents had their weight checked and received an ultrasound scan, respectively. Urine tests (71.6%), blood tests (59.2%), vaccinations (40.7%), and pelvic exams (39.5%) were also administered at follow-up appointments. Additionally, non-stress test (2.5%) and gestational hypertension monitoring (1.2%) were conducted at follow-up prenatal appointments (Figure 5).
It is also important to note that the majority of women reported that they understood the care they received during their follow-up prenatal appointments. Only a small percentage of women reported they were unsure of the care they received.
International Residents’ Childbirth Responses
This section will review the 2022 SOS Public Health Maternal Health Survey international residents’ responses regarding childbirth. Of the respondents who were pregnant and received prenatal care while living in South Korea, approximately 11.1% did not give birth in the country. As a result, the data has been adjusted to include only respondents who gave birth in South Korea from 2018 – 2022 for the following section.
Childbirth Education Courses Attended by International Residents
The majority of 2022 SOS PHMHS respondents did not receive childbirth education courses during their pregnancy in South Korea. Such information can be seen in Figure 6.
When asked “Did you attend any childbirth Education courses,” 38.9% of respondents reported attending a childbirth education course prior to giving birth and 61.1% responded that they had not.
Days Spent in the Hospital After Giving Birth
The majority of 2022 SOS PHMHS respondents reported spending at least one night in the hospital after giving birth. Figure 7 shows the total number of days such respondents reported staying in the hospital after giving birth.
When asked “How many days did you stay in the hospital after giving birth for your most recent pregnancy between 2018 – 2022 in South Korea,” the majority of respondents (roughly 60%) reported spending between 2 to 3 days spent in the hospital after giving birth (Figure 7).
Type of Medical Facility Utilized by International Residents for Childbirth
The majority of 2022 SOS PHMHS respondents reported they gave birth at a Specialized Maternity Clinic in Korea. When asked “Where did you give BIRTH for your most recent pregnancy between 2018 – 2022 in South Korea,” respondents reported the following which can be seen in Figure 8.
Specialized Maternity Clinics (52.8% of respondents), Private Hospitals (22.2%), and University Hospitals (15.3%) were most utilized by international residents for childbirth. Following these three medical facilities, US Military Medical Facilities (4.2%), Local Medical Centers (1.4%), and General Hospitals (1.3%) were also utilized for childbirth. Additionally, roughly 2.8% of respondents gave birth at home (Figure 8).
International Residents’ Preferred Childbirth Delivery Method
The majority of 2022 SOS PHMHS respondents preferred natural childbirth while 8.3% preferred a scheduled c-section. When asked “What was your preferred childbirth delivery method that you planned for,” respondents reported the following in Figure 10.
A majority (76.4%) of respondents reported a preference for Natural Childbirth. Following Natural Childbirth, respondents also reported having a preference for Assisted Vaginal Delivery (12.5%) and Scheduled C-Section (8.3%). Additionally, 2.8% of respondents who had previously given birth via C-Section reported that they preferred their most recent pregnancy to be conducted via a Vaginal Delivery method (Figure 10).
International Residents’ Actual Childbirth Delivery Method
The majority of 2022 SOS PHMHS respondents gave birth naturally while only 12.5% gave birth via a scheduled C-section. When asked “How did you DELIVER your child for your most recent pregnancy between 2018 – 2022 in South Korea,” respondents reported the following represented in Figure 9.
About 50% of respondents gave birth naturally. Eighteen percent of respondents gave birth via assisted vaginal delivery method and via an unplanned C-section. Twelve and a half percent had a scheduled C-section. Roughly 1.4% of respondents who had a previous pregnancy where they gave birth by C-section, gave birth by vaginal delivery (Figure 9).
More in-depth comparison analysis on ‘actual’ versus ‘preferred’ methods of childbirth delivery will be addressed in a later research analysis.
International Residents’ Postpartum Care Responses
This section will review the 2022 SOS Public Health Maternal Health Survey international residents’ responses regarding postpartum care. Of the respondents who gave birth in Korea, 86.1% reported receiving postpartum care in South Korea. The data below has been adjusted to include only those who received postpartum care while in Korea.
First Postpartum Check-Up Appointment
The majority of 2022 SOS PHMHS respondents went for a postpartum check-up one week after giving birth. When asked “When did you go for the first POSTPARTUM check-up after your most recent pregnancy between 2018 – 2022 in South Korea? (in weeks),” respondents reported the following shown in Figure 11.
The majority (52%) of respondents attended their first postpartum appointment one week after giving birth. The remaining respondents reported attending their first postpartum appointment at varying rates (2% – 10%) from 2 weeks to 12 weeks. Two outliers reported going to their first postpartum appointment at weeks 35 and 40 (Figure 11).
Types of Postpartum Care Received
The two most common types of care received by 2022 SOS PHMHS respondents during their postpartum check-ups included Physical Examinations and Pelvic Exams. Figure 12 shows the responses to “What care did you receive during your POSTPARTUM exam after your most recent birth between 2018 – 2022 in South Korea.”
Roughly 83.9% of respondents received a physical examination at their postpartum appointment. About 77.4% of respondents had a pelvic exam. Forty percent reported that their doctors conducted a health check to monitor health conditions experienced during pregnancy. About 30.7% and 25.8% of respondents spoke with their doctors about birth control and breastfeeding support, respectively. Nearly 19.4% of respondents completed a mental health assessment and about 17.7% received vaccinations (Figure 12).
* Other postpartum care services not included in Figure 10 above include a leg bone density check, an ultrasound to check uterus healing progress, and Joriwon (specific post-natal care center) visit.
Types of Breastfeeding or Baby Formula Resources Provided Postpartum by the Hospital
The 2022 SOS PHMHS respondents reported receiving a variety of different breastfeeding or baby formula resources postpartum. Figure 13 reflects the answer to the question, “Which of the resources on BREASTFEEDING or FORMULA were you provided with postpartum from your hospital/clinic.”
Approximately 58.3% of respondents reported receiving Pamphlets/Information on Breastfeeding from the hospital. Forty-seven percent received Support for their Preferred Choice on Breastfeeding vs. Formula. About 44.4% were provided a Breastfeeding/Lactation Expert by their hospital and 18.1% were provided a Privately-Hired Breastfeeding/Lactation Expert. Forty-two percent received recommendations on Formula Milk and 29.7% received Pamphlets/Information on Formula Milk. About 19% received their Preferred Choice of Formula Milk (Figure 13).
Respondents (1.4%) also reported receiving resources and information from their Doula (non-hospital provided).
International Residents’ Pregnancy and Childbirth Complications Responses
The following section reviews the 2022 SOS Public Health Maternal Health Survey international residents’ responses regarding pregnancy and childbirth complications.
Pregnancy Complications Reported by International Residents
High blood pressure, miscarriage, anemia, and premature delivery existed as the most common pregnancy and childbirth complications for 2022 SOS PHMHS respondents. About 39.5% of respondents responded “YES” to the question, “Did you experience complications during your pregnancy or childbirth.” The next section will discuss the types of pregnancy complications the majority of respondents (39.5%) experienced during their most recent pregnancy between 2018 – 2022. Figure 14 documents the responses to the question, “Did you have any PREGNANCY COMPLICATIONS during your most recent pregnancy between 2018 – 2022 in South Korea.”
Of the 39.5% who experienced pregnancy complications, the top complications reported by respondents included High Blood Pressure (28.1%), Miscarriage (25%), Anaemia (21.9%) and Premature Delivery (21.9%). Respondents also reported pregnancy complications involving General Risk due to Medical Background (15.6%), Gestational Diabetes (12.5%), Preeclampsia (9.4%), Infection (6.3%), and Stillbirth (3.13%) (Figure 14).
Additional pregnancy complications affecting 3.13% of respondents that were reported as “other” include:
- low amniotic fluid
- struggle to gain an appropriate amount of weight
- prenatal depression
- placenta previa
- water in the baby’s heart
- weak cervix
- leaking of amniotic fluid
- high CRP levels
- hyperemesis gravidarium
- uterine fibroid growth
- intrahepatic cholestasis of pregnancy.
Managing potential health challenges during pregnancy may help mitigate the risk of complications. If you are pregnant or planning to give birth and are worried you may be at risk for complications, speak with your doctor about risk management strategies.
A deeper dive into the correlation between pregnancy complications and other maternal health factors will be explored in a future analysis.
Childbirth Complications Reported by Respondents
When asked “Did you experience any BIRTH COMPLICATIONS during your most recent pregnancy between 2018 – 2022 in South Korea,” of those who gave birth in Korea, approximately 37.5% of respondents responded “YES.” The next section will discuss the types of birth complications these respondents (37.5%) experienced during their most recent pregnancy between 2018 – 2022.
Of the 37.5% of respondents who experienced childbirth complications, the top childbirth complications reported included Issues with the Baby’s Position (22.2%), Preterm Labor (22.2%), Labor Not Progressing (18.5%), and Excessive Bleeding (18.5%) (Figure 15).
Additional childbirth complications reported in the 2022 SOS PHMHS include:
- Meconium Aspiration (14.8%)
- Shoulder Dystocia (7.41%)
- Premature Membrane Rupture (3.7%)
- Placenta Issues (3.7%)
- Perinatal Asphyxia (3.7%)
- Pre-Labor Drop in Amniotic Fluid (3.7%)
- Not Having Labor Pains (3.7%)
No respondents reported Umbilical Cord Issues (0%) in the 2022 SOS Public Health Maternal Health Survey.
A deeper dive into childbirth complications will be explored in future analysis.
International Residents’ Likert Scale Ratings of their Maternal Health Care Experience in Korea
The following section reviews the 2022 SOS Public Health Maternal Health Survey international residents’ responses regarding their perception of access to resources on pregnancy and childbirth.
Resources International Residents Utilized for Maternal Health Information Access
The majority of 2022 SOS PMHS respondents reported Social Groups such as those on Facebook and their family or friends as their primary sources for maternal health information. When prompted “I was able to find most INFORMATION on pregnancy and childbirth in South Korea through the following RESOURCES,” respondents reported the following as shown in Figure 16.
The most utilized resource (84% – of those who selected Agree or Strongly Agree) reported by respondents was Social Groups (Facebook. etc.). Respondents also reported high utilization of Family and Friends (46.9% total), Healthcare Centers (42%), and Blogs (34.5%) to access maternal health information (Figure 16).
International Residents’ Perception of Difficulty in Accessing Maternal Health Care Resources
The 2022 SOS PMHS respondents reported having the most trouble accessing 1) mental health support, 2) childbirth options, 3) childbirth education classes, 4) breastfeeding information, and 5) birth registration/other government documentation. When asked to rate their difficulty level for the statement “I experienced challenges when accessing maternal health care due to the following reasons,” respondents reported the following:
The top 3 easiest resources to access according to respondents included Prenatal Care (53%), Health Care Centers (35.8%), and Postpartum Care (32.1%). The top 3 most difficult resources to access included Mental Health Support (65.5%), Information on Childbirth Options (53.1%), and Childbirth Education Courses (51.9%) (Figure 17).
Perceived Causes of Pregnancy Support Challenges Experienced by International Residents
The SOS PMHS respondents reported the language barrier and lack of a support network as the two biggest challenges faced in meeting their pregnancy support needs. When asked to rate the statement “I experienced challenges when accessing PREGNANCY SUPPORT due to the following reasons,” based on their personal experience with accessing pregnancy support, respondents reported the following as shown in Figure 18.
The majority of respondents (64.2%) who selected the options Agree or Strongly Agree perceived a Language Barrier as the primary challenge to accessing pregnancy support. Respondents perceived a Lack of a Support Network (38.3%) as the second leading cause of pregnancy support challenges. Lack of Relevant Information (24.7%) came in third among perceived causes of support challenges in this survey (Figure 18).
Perceived Causes of Overall Maternal Health Care Access Challenges Experienced by International Residents
The SOS PMHS respondents reported many challenges to accessing maternal health care in Korea. When prompted with the statement “I experienced challenges when accessing OVERALL MATERNAL HEALTH CARE due to the following reasons,” respondents reported their perceptions on the cause of their maternal health care access challenges as reflected in Figure 19.
The majority of respondents perceived Cultural Differences (76.5%) as the primary cause of their maternal healthcare access challenges. Respondents also perceived a Lack of Access to Social Benefits (48.2%) and Not Understanding How Insurance Works (42%) as top maternal health access challenges (Figure 19).
Satisfaction of Maternal Health Services in Korea
This section will review respondents’ satisfaction levels based on their experience accessing maternal healthcare services.
The SOS PMHS respondents reported the highest level of satisfaction with prenatal care services in South Korea and the lowest satisfaction with the breastfeeding support received in South Korea. Figure 20 shows the responses to, “How SATISFIED were you with the following maternal health services and care in South Korea.”
Regarding Prenatal Care Services, about 75.4% of respondents reported they were Neutral to Very Satisfied with the care provided while 24.7% reported being dissatisfied or very dissatisfied with the care.
About 60.6% of respondents reported being Neutral to Very Satisfied with Childbirth Care services. Roughly 28.4% responded that they were Dissatisfied or Very Dissatisfied with services. Eleven percent of respondents selected not applicable due to not giving birth in Korea.
Fifty-eight percent of respondents reported that they were Neutral to Very Satisfied with Postpartum Care Services. Almost 31% of respondents reported being Dissatisfied to Very Dissatisfied with Postpartum Care Services. Eleven percent of respondents selected Not Applicable due to not giving birth and not receiving postpartum care in Korea.
About 35.8% of respondents rated their satisfaction between Neutral to Very Satisfied regarding Childbirth Education Courses. Thirty-five percent of respondents selected Dissatisfied or Very Dissatisfied. Roughly 30% of respondents did not attend Childbirth Education Courses and selected Not Applicable.
For Breastfeeding Support, 37.1% of respondents selected Neutral to Very Satisfied while 46.9% selected Dissatisfied or Very Dissatisfied. About 16.1% selected Not Applicable for varying reasons. One reason included having a preference for formula over breastfeeding (Figure 20).
Conclusion
In conclusion, this comprehensive descriptive analysis of the 2022 SOS Public Health Maternal Health Survey provided valuable insights into maternal healthcare access among international residents in Korea.
Future research will be conducted to better understand how these factors correlate with one another, which will provide a more nuanced understanding of the complex issues at play. The results of such analyses will be shared in a future blog post, so stay tuned for more research updates!
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Research Design & Implementation Team
Survey UX/UI Supervisor & Editor
Lanae Rivers-Woods moved to Korea in 2011 where she lives in the countryside with her family, friends, and puppies. She holds a BSSW (Bachelor’s of Science in Social Work), a MAIT (Master’s of Arts in International Teaching), and registered by the Pyeongtaek Korean Times with the Korean government as a Cultural Expert.
Ms. Rivers-Woods used her 15 years experience as a social architect, UX/UI designer, and technology consultant to found South of Seoul in 2015. South of Seoul is a volunteer organization that leverages technological tools to mitigate cultural dissonance in multi-cultural communities.
Through South of Seoul, Ms. Rivers-Woods works with independent volunteers, non-profit organizations, businesses, local & federal government, universities, and US military organizations to develop solutions to support English speaking international residents in rural South Korea.
Additionally, Ms. Rivers-Woods founded the South of Seoul smart phone app available for Google Play and iPhone. The app provides information a resources for those living and traveling in South Korea.
When she isn’t in South of Seoul development meetings or working her day job, Ms. Rivers-Woods loves to be outside at skate parks, the beach, or playing in the mountains.
Research Compliance Supervisor, Editor & Co-Author
Ms. Peck graduated from the University of Utah Asia Campus (UAC) in Incheon with a Master’s in Public Health and her Certification in Public Health (CPH). Ms. Peck also holds a Bachelor’s Degrees in Linguistics and one in International Studies with a Global Health emphasis.
Ms. Peck is Korean American and speaks both English and Korean. She has moved between the US and Korea since childhood, finally settling in Korea after graduating from UAC.
In 2021 Ms. Peck founded the South of Seoul Public Health Program which focuses on research and initiatives regarding the health and wellness of multinational residents in South Korea.
Additionally, Ms. Peck oversees the SOS Public Health Graduate Student Practicum Program which provides mentorship and training for Master’s in Public Health students. The program works with two students a semester with a focus on ethical UX research design, survey development, and initiative implementation.
Primary Researcher & Author
Denise Feurer holds a Master’s of Science in Public Health and a Bachelor’s in Nursing. Ms. Feurer is a public health researcher and advisor living and working in South Korea. Mrs. Feurer founded the Maternal Health Initiative for the South of Seoul Public Health Program in 2021. Her first research project or SOS Public Health launched in 2022.
Prior to joining the South of Seoul Public Health Program, Ms. Feurer volunteered for the London School of Hygiene and Tropical Medicine’s (LSHTM) award-winning endeavor, the “Rapid Data Project”, to code and organize worldwide Covid-19 policies for WHO decision makers, student ambassador program representative, and UK Model WHO Academy.