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J Korean Soc Matern Child Health > Volume 27(3); 2023 > Article
Choi: Let's Rescue Mothers and Babies From Postpartum Care Centers
South Korean society is stressful whether or not one is pregnant or not. As a result, South Korea has faced an unprecedentedly low birth rate (below 1.3 of the total fertility rate) for more than 20 years (Statistics Korea, 2023), forcing the entire country to imple ment pronatal policies. However, owing to widespread mis guided policies and prevailing perceptions, Korean women are having difficulty conceiving children. Urgent improvements are necessary for the unique culture of postpartum care centers found exclusively in Korea.
Many Korean women believe that breastfeeding can only be performed through specialized breast massages and that the community postpartum care culture is advantageous for vulnerable newborns with low immunity. This perception was raised from the shift from postpartum care within the home to postpartum care centers. According to a recent Survey on Postpartum Care by the Ministry of Health and Welfare in 2021, 81.2% of women have experienced postpartum care centers (Lee & Choi, 2021), and the costs of utilizing these facilities and receiving breast care massages are economically burdensome. Conse quently, local government entities have established “public postpartum care centers” and support programs for “breast care specialists.” Thus, Korea has developed a unique post par tum care and breastfeeding culture that is not found in other countries. However, it has also been criticized for making things harder for mothers and babies.
Previously, when extended families were the norm, Korean women learned about pregnancy, childbirth, breastfeeding, and childcare by observing family members. The term “Samchilil” refers to the traditional postpartum care period in Korea, which typically lasts 3 weeks. During this time, a birth rope known as ‘Geumjul’ was placed in front of a house gate to inform the neighbors about the birth news and restrict entry to protect the newborn with vulnerable immune system from the risk of infection (Encyclopedia of Korean Folk Culture, 2023).
Even during the nuclear family era, many women learned about early childcare practices, such as breastfeeding, from their mothers or female relatives while providing postpartum care. Newborns lived primarily with their families during this period.
Although the use of cloth diapers transitioned to disposable diapers and formula feeding became more common, most women learned from their mothers how to raise their babies. However, with the industrialization of postpartum care, Korean postpartum care culture has undergone significant changes.
With the transformation and upscale development of post partum care centers, even financially secure women now prefer to utilize them as a natural option after childbirth. The majority of the population now believe that postpartum care centers are better than home care.
However, several issues arise immediately after birth with babies living in group settings. First, newborns with weak immune systems are still infected, as they reside in group environments at postpartum care centers. Recently, a notable postpartum care center, known for its high prices (tens of millions of won), has experienced mass infection among newborns (Lina, 2023). The incident caused significant shock and concern.
Additionally, during the coronavirus disease 2019 pandemic, the baby's father was restricted from meeting the mother and baby, adding to the postpartum depression of mothers (Jang, 2020).
Furthermore, another significant issue is that the mothers prioritize postpartum care programs at centers, such as breast massages, over breastfeeding for their babies, establishing a strong connection with them. It is essential to initiate breastfeeding immediately after delivery by allowing the baby latch onto the mother's nipple because breast milk production relies on this stimulation. However, many women believe that milk must be produced before breastfeeding. Consequently, they diligently receive breast massages while feeding their babies with formula bottles instead of directly breastfeeding. Babies who start formula feeding find it even more challenging to adapt to breastfeeding.
Moreover, online advertisements promoting “specialized breast massage techniques for producing quality milk” make postpartum care fees a considerable burden for mothers, even after they return home. A survey conducted by Seoul Metropolitan Government in 2022 revealed that the support for breastfeeding management costs was the highest demand among women. In response, the Seoul Metropolitan Government will implement the “Happy Breastfeeding Support for Seoul Moms” program starting July 1st this year (Seoul Metropolitan Government, 2023). Other local governments may follow suit by implementing “breast care support programs” similar to “public postpartum care centers.”
Pregnancy and childbirth are significant experiences for women. The physical changes caused by pregnancy can be surprising and overwhelming, especially for first-time delivery mothers, who may also deal with emotional difficulties such as anxiety and depression.
Several new mothers have asked questions regarding child birth, postpartum care, and breastfeeding over the internet. While there are helpful answers for these mothers, a prevalence of misleading information portraying postpartum care and breastfeeding as if they require special skills, causing unnecessary anxiety and leading to the payment of unnecessary expenses. This makes it more challenging for Korean women to give birth and raise their babies.
The government should not implement policies that perpetuate this alarming trend of increasing infection risk in newborns (Korea Ministry of Government Legislation, 2022), making breastfeeding more difficult and burdening families with exorbitant postnatal care costs. Such detrimental practices further diminish the public's desire to have children, exacerbating the prevailing situation.
The best postpartum care for mothers and newborns is individual care at home, with the baby's father also present. Except for the time spent breastfeeding, mothers should ensure sufficient rest, sleep, and balanced nutrition. This can be achieved when the father takes responsibility for childcare and household chores, excluding breastfeeding, such as putting the baby to sleep or bathing the baby. The government should implement policies to support this by mandating paid paternity leave and making it the father's responsibility to take care of the mother during the postpartum period. Additionally, local authorities should monitor each household to ensure that mothers and newborns can safely and healthily undergo postpartum care and provide the necessary support.
Healthcare professionals should initiate the efforts to improve women's awareness and understanding of their bodies, giving them the confidence to manage pregnancy, childbirth, and breastfeeding processes. This is a path towards better health for women, babies, and society as a whole.

이해관계(CONFLICT OF INTEREST)

The authors have nothing to disclose.

REFERENCES

Encyclopedia of Korean Folk Culture. Samchilil [Internet] Seongnam (Korea), Academy of Korean Studies, [cited 2023 Jul 20]. Available from: https://encykorea.aks.ac.kr/Article/E0026905

Jang W. "I can't even see my baby's face"…Dads cry over access control to postpartum care centers. YonhapNews [Internet] 2020 Aug 20;[cited 2023 Jul 20]. Available from: https://www.yna.co.kr/view/AKR20200820126600004

Korea Ministry of Government Legislation. Maternal and Child Health Act, Article 15: Report of postpartum care business Sejong (Korea), Korea Ministry of Government Legislation, 2022.

Lee SY, Choi IS. Analysis of the status of postpartum care in 2021 Sejong (Korea), Korea Institute for Health and Social Affairs, 2021; 45-7.

Lina. RSV group infection of newborns at the top postpartum care center of "25 million won per two weeks.". MBN News [Internet] 2023 Mar 9;[cited 2023 Jul 20]. Available from: https://www.mbn.co.kr/news/society/4910514

Seoul Metropolitan Government. A guide to the Happy Breastfeeding Support for Seoul Moms [Internet] Seoul (Korea), Seoul Metropolitan Government, 2023;[cited 2023 Jul 20]. Available from: https://seoul-agi.seoul.go.kr/smom/info/download.do?boardId=bbs_0000000000000221&mode=view&cntId=13

Statistics Korea. 2022 Census of Birth and death statistics (tentative) [Internet] Daejeon (Korea), Statistics Korea, 2023;[cited 2023 Jul 20]. Available from: https://kostat.go.kr/board.es?mid=a10301020300&bid=204&act=view&list_no=423833

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