From Home to Hospital: The Decline of Midwives and the Surge in Hospital Births in the 1960s and 1970s

Antenatal care and facility-based delivery have become essential contemporary health services for pregnancy and childbirth. While the medical concept of antenatal care was emerging in the early 20th century with the development of technologies for diagnosing pregnancy and managing its related complications, most women in modern Korea gave birth at home. As Korea moved through its colonial period and on to the Korean War, the number of medical professionals, midwives, and hospitals increased, leading to a gradual rise in facility-based deliveries. Notably, Korea stands out among industrialized nations in that nearly all its antenatal care and deliveries are conducted by obstetricians in hospitals. This study examines the literature of the time to explain this rapid shift from home-centered to hospital-centered and obstetrician-led childbirth due to three interconnected factors: (1) the national family planning program centered around obstetricians; (2) the revision of medical laws restricting the role of midwives and physicians’ exclusive control of modern antenatal diagnostic technologies, such as obstetric ultrasound; and (3) the increased accessibility to hospitals due to the introduction of the National Health Insurance system. This study seeks to improve our understanding of the primary driving forces behind the transition of pregnancy and childbirth from homes and non-medical professionals to hospitals and specialized medical professionals.