Kyung Ae Cho

Korean Journal of Women Health Nursing

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Copyright © 2021 Korean Society of Women Health Nursing
http://kjwhn.org6
Issues and Perspectives
pISSN 2287-1640 · eISSN 2093-7695
Korean J Women Health Nurs 2021;27(1):6-9
https://doi.org/10.4069/kjwhn.2021.02.16
Received: February 15, 2021 
Accepted: February 16, 2021
Corresponding author: 
Kyung Ae Cho 
Korea Population, Health and 
Welfare Association, 20 
Beodeunaru-ro 14ga-gil, 
Yeongdeungpo-gu, Seoul 07230, 
Korea 
Tel: +82-02-2634-8212 
E-mail: choka3211@hanmail.net
Introduction 
In early 2021, the South Korean media poured out discouraging articles on the natural decrease in 
the nation’s population. The low birth phenomenon has continued for almost two decades since 
2002, when the total fertility rate (TFR)—defined as the average number of children that a wom-
an would bear during her reproductive lifespan between ages 19 and 49 years—dropped below 1.3 
[1]. In 2020, the number of births was surpassed by deaths, causing a natural population decline. 
To make the matter worse, young people are more likely to delay marriage or having children in the 
coronavirus disease 2019 (COVID-19) era, leading to an even lower number of expected births 
this year. It is a national task to slow the trend of low birth rates and an aging population by taking 
appropriate actions to bring about social, economic, cultural, and regional changes that can create 
a more sustainable society. In this paper, I would like to discuss the current status of low birth in 
South Korea (hereinafter, Korea) as well as the issues and future directions of the country’s popu-
lation policy. 
How serious is the birth issue in Korea? 
The number of births in Korea has declined dramatically on three occasions since the end of the 
Korean War. The country boasted high fertility rates from the end of the Korean War until 1982, 
where the number of annual births was maintained between 800,000 and 1 million. In 1983, the 
nation’s TFR dropped below the population replacement level of 2.1, thanks to the government’s 
strong fertility regulation policy, widespread use of contraception, and normalization of smaller 
family sizes [1]. This is referred to as the first population change in Korea. Between 1983 and 
2000, the number of annual births stayed at around 600,000; as such, this period has been labeled 
the low birth stage. In 2001, the number of births dropped dramatically to 400,000, with a TFR of 
1.3 [1], corresponding to the second population change. The 1997 Asian financial crisis seems to 
have had ripple effects on the trend of individuals delaying marriage and subsequently having chil-
dren. Low fertility continued through 2016, when the number of births further plunged to 300,000 
(the third population change). In 2019, Korea became the only country in the world where a woman 
is expected to give birth to less than one child in her life, with a TFR of 0.92 [1].  
The government has not been complacent regarding the issue of low birth. In 2005, the govern-
ment enacted the Framework Act on Low Birth Rate in an Aging Society and organized the Presi-
dential Committee on Ageing Society and Population Policy [2] which is led by the president and 
Korea’s low birth rate issue and policy directions
Kyung Ae Cho
Secretary (2018-2021), Korea Population, Health and Welfare Association, Seoul, Korea
Korean J Women Health Nurs 2021;27(1):6-9
https://doi.org/10.4069/kjwhn.2021.02.16 7
consists of ministers and experts, as very low birth rates have 
continued since 2001 with a TFR under 1.3. The government 
has renewed the Basic Plan for Aging Society and Population 
Policy every 5 years since 2006 and implemented policies across 
all walks of society. The first and second rounds of the plan in-
cluded policies and measures to support pregnancy and child-
birth, as well as childcare services to relieve couples’ financial 
burden of raising children. Starting in the third round, which 
came into effect in 2015, additional support was provided for 
job-seeking and housing for newlyweds to address the financial 
factors that contribute to getting married later and staying single 
longer. The government revised the third round in 2018, an-
nouncing the Policy Roadmap for an Inclusive Nation [3]. The 
new plan designed a transition to a policy aimed at improving 
the quality of life for all generations based on the criticism that 
previous plans have simply focused on the government’s role in 
encouraging childbirth without putting people at the center. 
Despite such efforts, the fertility rate seems far from ready to 
bounce back. 
Why aren’t young Koreans having 
children? 
When asked if they agreed with the statement “being a parent is 
an invaluable thing in life,” most Koreans (81.7%) agreed, in-
cluding 67.0% of people in their 20s [4]. All age groups, includ-
ing those in their 20s, reported thinking that having two chil-
dren is ideal. In reality, the younger generation in Korea make 
dark jokes about having to give up three things in life, i.e., so-
called “sam po”—dating, marriage, and having children. They 
feel like they do cannot afford to spare any time, energy, or emo-
tions that should go to surviving fierce competition in school 
and building qualifications to land a job in the tight job market. 
Korea has become a society where young people find it difficult 
to plan for a life where securing a job leads to getting married 
and having a family, because they are too anxious about obtain-
ing a secure job, a stable income, and a place to live.
Exploring differences between men and women in how they 
see marriage and family may also provide insights into this phe-
nomenon. The traditional gender roles of male breadwinners 
and female housekeepers are being challenged. A survey by the 
Korean Population, Health and Welfare Association [5] showed 
that six out of 10 single 30-somethings said they would like to 
get married. Two out of 10 responded they did not want to get 
married and the other two said they were not sure. Regarding 
the reason why they were hesitant to get married, 51.1% of male 
respondents said they found it difficult to agree on marriage 
terms such as housing and finances. Meanwhile, 25.3% of female 
respondents said they were “happy living alone,” and 24.7% said 
they were hesitant to tie the knot because of “the culture of pa-
triarchy and gender inequality.” Five out of 10 respondents were 
positive about having children, while negative opinions were ex-
pressed through responses of “not [being] confident if I can do 
well in parenting” (24.6%), and “the financial burden of child-
care” (24.3%). 
In a 2019 survey by the Korean Women’s Development Insti-
tute on the priority of developmental tasks in life among young 
women and men in their 20s-30s [6], female respondents placed 
a higher priority on work and personal life than partnership and 
children. The results were not markedly different from those of 
their male peers. This shows that today’s young women choose 
to prioritize their career throughout their life cycle, as do young 
men. 
A high percentage of young women also agreed that their 
partners’ participation in childcare, equal distribution of house-
hold chores, and partner’s maternity/paternity leave are prereq-
uisites for them to consider having children. This is sharply dis-
tinct from the responses of their male counterparts, who point-
ed to their own financial situation and stable job as the biggest 
factors. This means that today’s young women will not tolerate 
traditional gender roles or unequal treatment, and would only 
choose to have children if their partners actively share the bur-
den, allowing them to keep their careers without facing an exis-
tential crisis. These results provide a valuable perspective on 
what kind of environment is needed for today’s young women. 
How should we approach low birth 
policies? 
The international community has been discussing the most suit-
able way to approach population policies for a long time. In the 
1970s and 1980s, governments around the world implemented 
strong population policies focused on family planning. Discus-
sions were held about whether the population should be regu-
lated in light of how population growth seemed to deter eco-
nomic development. At the 1994 Cairo International Confer-
ence on Population and Development and the 1995 Beijing 
World Conference on Women, the paradigm for population 
policies shifted from controlling population size to acknowledg-
ing human rights [7]. 
The 1994 Cairo Conference confirmed that population poli-
cies should value the unique life of human beings rather than 
trying to regulate population size, acknowledging that reproduc-
tive rights are basic human rights. Governments committed to 
https://doi.org/10.4069/kjwhn.2021.02.16
Kyung Ae Cho • Korea’s low birth rate issue and policy directions
8
goals to be met by 2015 to ensure universal access to reproduc-
tive health services, such as reducing infant/child/maternity 
deaths, universal education, and family planning to help em-
power women and improve their social status. The 1995 Beijing 
Conference advised governments to protect women’s rights to 
reproductive health without unwanted pregnancy and birth, 
recognizing that women play a key role in socioeconomic devel-
opment. Reproductive health and rights refer to the state of 
physical, mental, psychological, and social well-being free from 
illness, malfunctions, and/or disabilities. This acknowledge-
ment helped the paradigm of population policy to move away 
from emphasizing economic development issues and to priori-
tize individual rights, health, and welfare. Since then, the global 
community has started to understand sexual and reproductive 
health and rights as part of human rights, and has protected 
comprehensive services that provide information, counseling, 
education, and healthcare.
How did this issue play out in Korea? The Korean govern-
ment continued to implement measures to control population 
growth for a considerable time even after reaching its goal of 
curbing population growth by 1983, earlier than it had planned. 
It was only in 1996 that the fertility regulation policy was re-
placed by the goal of “improving the quality of the population.” 
Concrete actions were taken to promote reproductive health 
such as providing sex education for teenagers and supporting 
mothers, infants, and children. With plummeting birth rates in 
the beginning of the 2000s, the government started to imple-
ment policies to encourage childbirth. Based on the diagnosis 
that the nation’s low birth and population aging trends will ag-
gravate social and economic crises, authorities put measures in 
place to promote childbirth and support childcare to achieve in-
creased fertility [8]. However, not enough efforts were made to 
enhance gender equality, understand childbirth as women’s in-
dividual right, and provide support for health and welfare. The 
younger generation saw this kind of policy as the government 
attempting to enforce traditional cultural norms by demanding 
that they have children. Korean women have expressed their re-
pulsion against recent initiatives like the disclosure of the “birth 
map” and conducting the National Survey on Fertility and Fam-
ily Health and Welfare, claiming that the government simply 
sees women as a tool for childbirth and is attempting to control 
population growth [9]. 
A paradigm shift is needed in low 
fertility policy 
The Korean government released the Fourth Basic Plan for Age-
ing Society and Population Policy for the 5-year period begin-
ning in 2021 [2]. The plan demonstrates a shift in paradigm in 
the government’s population policy compared to the previous 
rounds. The Fourth Basic Plan presents a vision of creating “a 
sustainable society where all generations are happy together,” 
acknowledging that current birth rates and demographic phe-
nomena are the outcomes of individual choices and adaptation, 
not of governmental regulation and control. This plan makes it 
clear that the focus will be on bringing about structural changes 
at the individual, family, regional, and social levels. This is in-
deed a shift in policy direction and will be a welcome shift new 
beginning, no matter how overdue the change is. 
The new plan envisions a society where we “work and care to-
gether” as a strategy to stop low birth [2]. Any woman who 
would like to work should be able to find employment, and not 
forced to discontinue their careers, endure job instability, or 
work in a low-paying job. Key strategies include creating gen-
der-equal labor conditions so that all genders can plan stable ca-
reers, as well as improving current maternity/paternity leave 
policies so that everyone can share the labor of work and parent-
ing. The COVID-19 crisis has shed light on the fact that the la-
bor of caregiving plays a key role in sustaining families and soci-
ety. Housekeeping, childcare, and elderly caregiving should not 
be underestimated or taken for granted as women’s tasks. 
Homes, businesses, and local communities should all contribute 
to transform Korean society into one where people truly “work 
and care together.” 
It is also notable that the new plan penciled in the tasks of 
“guaranteeing the rights to sex and reproduction over the life-
time” and “legally embracing various types of families” in its 
strategies [2]. The government should support healthcare ser-
vices from the point a woman gets pregnant, as well as providing 
health coverage for the entire life cycle, from adolescence to old 
age, covering sexual health, menstrual health, contraceptives, 
abortion, gender-based violence, sexually transmitted infections, 
and cancer control and prevention. Furthermore, Korean law 
only protects families that consist of “relationships based on 
marriage, blood, and adoption,” while France and Germany have 
expanded their legal boundaries of family to embrace unions 
that emotionally and financially support each other without of-
ficial marriage, through the Civil Solidarity Pact and the Life 
Companion Law, respectively [10]. In 2019, 2.3% births in Ko-
rea were out of wedlock [1], the highest percentage in the coun-
try’s history but the lowest among Organisation for Economic 
Co-operation and Development (OECD) nations—along with 
the lowest TFR. Korea should join the ranks of the global com-
munity in banning discrimination against diverse types of fami-
Korean J Women Health Nurs 2021;27(1):6-9
https://doi.org/10.4069/kjwhn.2021.02.16 9
lies and should create an environment where all types of families 
and their children are respected and embraced. 
The issue of low birth and aging population is caused by a 
combination of complex social issues that exist in Korean soci-
ety. It is true that this phenomenon may affect our country’s so-
cio-economic structure. As we see many countries overcoming 
the issue of low birth, Korea should restore trust within its soci-
ety, so that everyone is respected and able to choose their own 
lifestyle, rather than focusing on this crisis that fuels public anxi-
ety. Hopefully, Korea will evolve into a society where all resi-
dents can protect their own family and exercise reproductive 
rights with enhanced gender equality and quality of life. A stron-
ger focus on women’s health is needed within public health and 
health-related policy. Moreover, as the impact of sexual and re-
productive health on women’s lives and quality of life is para-
mount, active education, research, and policy development is 
more urgent than ever. 
ORCID
Kyung Ae Cho, https://orcid.org/0000-0003-3873-1565
Author’ contributions 
All work was done by Kyung Ae Cho. 
Conflict of interest 
The author declared no conflict of interest. 
Funding 
None. 
Data availability 
Please contact the corresponding author for data availability. 
Acknowledgments 
None. 
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