A woman gets counseling about abortion with the doctor at an obstetrics and gynecology clinic.CHATGPT
More than five years after the Constitutional Court of Korea ruled the country's abortion ban unconstitutional, legislation governing abortion remains stalled, leaving women who cannot legally obtain mifepristone, best known as the "abortion pill," to turn to less certain alternatives for terminating pregnancies.
One such alternative is methotrexate (MTX), an immunosuppressant typically used for cancer therapy.
“I learned about medical abortion while searching online communities, and received an MTX injection, but the pregnancy has not yet been completely terminated," said Choi, a woman in her 30s who received the MTX shot on July 14 to terminate her pregnancy at four weeks.
Using the MTX injection as a method of pregnancy termination typically takes two to four weeks, as it works by inhibiting the synthesis of dividing cells' DNA. Still, she resorted to the method because this was her second abortion and she wanted to limit the damage to her body. Five years ago, Choi had undergone a vacuum aspiration abortion at six weeks of pregnancy. This time, she realized she was pregnant sooner after experiencing physical changes, including breast pain and a fever.
“I would have chosen mifepristone if that was an option, instead of a drug whose outcome is uncertain or surgery that puts a lot of strain on my body," she said.
MTX is primarily used to treat ectopic pregnancies — a pregnancy in which the fetus develops outside the uterus, typically in a fallopian tube — immune disorders and cancer. Some doctors, however, have also begun promoting it as a method of terminating early pregnancies after finding that it can be effective in such cases.
Mifepristone is an oral medication used to terminate early pregnancies. First approved in France and other countries in 1988, it is now legally used in about 100 countries, including the United States and countries across Europe and China. The World Health Organization designated it an essential medicine in 2005.
The drug, however, has not been approved in Korea and cannot be purchased legally.
Members of civic groups embrace outside the Constitutional Court in Jongno District, central Seoul, on April 11, 2019, after the court’s ruling that the Criminal Act provisions penalizing abortion were unconstitutional.NEWS1
The onlineforum thatChoiconsulted categorizes clinics offering MTX injections under "medical abortion." Posts from people who received the injections appear on the site almost daily, and on other sites, posts from people seeking mifepristone continue to surface — some as recently as early this month.
Legislation on abortion has remained stalled since the Constitutional Court of Korea ruled the abortion ban unconstitutional in 2019. Women seeking abortions have faced difficulties, with some attempting to obtain mifepristone through illegal channels and others choosing medication such as MTX despite concerns over the outcome.
President Lee Jae Myung raised the need to approve mifepristone during a Cabinet meeting on July 14.
“Even if it creates some difficulties for the government, women should be able to receive mifepristone appropriately,” Lee said. “Leaving the situation as it is now is irresponsible.”
President Lee Jae Myung speaks during a Cabinet meeting at the Blue House in Jongno District, central Seoul, on July 14.BLUE HOUSE
Efforts to introduce mifepristone formally began five years ago. Hyundai Pharm first applied for approval of Mifegymiso in July 2021. The medication contains one 200-milligram tablet of mifepristone and four 200-microgram tablets of misoprostol, a drug used in conjunction with mifepristone to induce an abortion.
But Hyundai Pharm withdrew the application in 2022 after the Ministry of Food and Drug Safety requested additional data. The company later refiled an application, only to withdraw once again over the same roadblock. It reapplied a third time in 2024 and is still awaiting the ministry’s decision.
“There are practical difficulties in reviewing the drug’s efficacy and risk management plan because the legal scope and permitted period for medical abortion have not been clearly established,” an official from the Ministry of Food and Drug Safety said on July 15. “As calls for its introduction continue, we plan to hold further discussions with related ministries, including the Ministry of Health and Welfare and the Ministry of Gender Equality and Family.”
“Working-level discussions on the introduction of mifepristone began on July 15 among the Ministry of Food and Drug Safety, the Ministry of Health and Welfare and the Ministry of Gender Equality and Family,” an official from the Gender Ministry said on July 16.
Medical groups remain divided over the proposal.
The Korean Association of Obstetricians and Gynecologists expressed concern on July 14 over “the early approval of mifepristone before safety guidelines and a distribution system have been established.”
People walk past an obstetrics and gynecology clinic in Seoul on Feb. 23, 2023.NEWS1
On the other hand, the Association of Physicians for Humanism issued a statement welcoming the president's call for introducing the abortion pill in Korea on July 15.
“Mifepristone’s safety has already been established,” said Oh Jung-won, an obstetrician-gynecologist at Soon Chun Hyang University Hospital Seoul, who has performed abortions through methods including vacuum aspiration in the hospital. “It is ironic that MTX injections, which cannot guarantee the termination of a pregnancy, are being used instead, along with procedures such as curettage that place a greater burden on women’s bodies.”
“To protect medical professionals, the industry should develop guidelines for abortion procedures rather than oppose the introduction of mifepristone,” Oh said.
This article was originally written in Korean and translated by a bilingual reporter with the help of generative AI tools. It was then edited by a native English-speaking editor. All AI-assisted translations are reviewed and refined by our newsroom.
