When Population Policy Meets ART

• In Event: Reproductive Governance in East Asia

Abstract

South Korea features the lowest total fertility rate (1.17 in 2016 and 1.08 in 2005) in the world and advanced assisted reproductive technology (ART) as well, meaning that not only is there a general tendency to have fewer children but still a strong desire for them even through surrogacy and/or egg donations as well as in vitro fertilization (IVF). I’d like to talk about the negative effects of the policies coming out of concern about low fertility on the governance on ART.
Korea began to support ART through coverage under the national health insurance scheme in October 2017, the first to do so in East Asia. Public financing of ART differs by country in terms of implementation and coverage. European countries expanded this financing in step with tightening ART regulations. A good example is the regulations on the number of embryos transferred (e.g. single embryo policy) with the aim of reducing multiple births like twins or triplets.
In Korea, public financing for ART began as an aspect of the policy against low fertility in 2006. Recently, however, the occurrence of premature birth and babies with low birth weight has risen drastically along with an explosion in multiple births. Furthermore, with public financing, total cycles of IVF have risen and more recently, cases of surrogacy and egg donation have also increased.
Korean governance of ART was initiated not out of consideration for the health of mothers or babies but by the fears of the consequences of low fertility. What is more concerning is that “more NHI benefits” are being proposed by the new “candle revolution” government and an increasing number of infertile couples are requesting “wider NHI coverage.” I propose that it is about the time for governance on ART to separate from population policy.

Author

• Jung-Ok Ha, National Museum of Korean Contemporary History