‘Abortion pills’ uncovered in more than 3,000 cases, yet only 7 referred for investigation··· cannot block them or punish, yet indiscriminately labeled ‘illegal’ - 경향신문

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On April 9, 2023, activists from the Network for the Guarantee of Safe Abortion for All held a rally at Yongsan Station Plaza in Seoul, calling for abortion to be guaranteed as a health right on the second anniversary of the decriminalization of abortion. Han Su-bin

Over the past five years, the government uncovered more than 3,000 cases of online sales of abortion medications (abortifacients), but only seven of them were actually referred for investigation. Because there is no provision that penalizes the act of purchasing abortion pills in the first place, crackdowns have clear limits in their effectiveness. Critics say the government is labeling as ‘illegal’ drugs that it can neither effectively block nor has grounds to punish, which in turn makes it impossible to grasp the realities of purchase·use and leaves the health rights of women in a blind spot.

According to Kyunghyang Shinmun reporting compiled on the 20th, the Ministry of Food and Drug Safety detected the following numbers of abortion medication sales cases: 414 in 2021, 643 in 2022, 491 in 2023, 741 in 2024, 682 in 2025, and 218 from January to May this year, for a total of 3,189.

Most of the detections involved finding simple online sales·advertising posts and requesting relevant agencies to block access. Among these, the number of cases in which a seller was identified and the matter was referred to investigative authorities such as the police was only seven, about 0.2 percent of the total. The Ministry of Food and Drug Safety said, “To request an investigation, information that identifies an illegal seller is needed, but in online transactions, servers are located overseas or identities are thoroughly concealed, which limits the ability to confirm sellers.”

While the government has relied on requests to block access to sales·advertising posts, there is no grasp of how many people actually purchase and take this drug. Because there is no approved product in the country, no prescription·dispensing records exist, and because there is no clause penalizing the act of purchase, such cases do not appear in investigation·crackdown statistics. In effect, they are in a dual blind spot, caught neither by the lawful medical system nor by systems that investigate illegal acts.

There is no basis to punish medication abortion because, following the Constitutional Court’s 2019 decision of constitutional nonconformity, Article 269 Paragraph 1 of the Criminal Act (self abortion) lost effect as of January 1, 2021. A provision of the Pharmaceutical Affairs Act imposes fines on buyers who purchase certain designated medicines such as steroid·ephedrine injection formulations from unqualified persons, but mifepristone, an ingredient in abortion pills, is not included. The current Mother and Child Health Act also has no clause that punishes medication abortion or buyers of abortion pills.

Although a situation in which authorities can neither stop distribution nor punish has continued, there is still no approved abortion pill in the country. As of 2024, oral abortion medications are permitted in more than 100 countries worldwide, and the World Health Organization placed this drug on its Essential Medicines List in 2005. In Korea, Hyundai Pharm applied for approval of the product Mifegymiso three times, in July 2021, March 2023, and December 2024, but no conclusion has been reached. The background to this situation includes negligence by the National Assembly.

Mifepristone is a primary medication used for medication abortion. The drug is prepared at the Alamo Women Clinic in Carbondale, Illinois, United States. Reuters/Yonhap News

An official well acquainted with government and National Assembly affairs said, “Because crackdowns on abortion pills lack effectiveness, the government asked the National Assembly to create a provision to punish buyers. At that time, lawmakers were very reluctant,” and added, “So when we asked to legalize them outright, there was also complete silence on that.” Observers point out that the National Assembly is putting off discussion itself, finding it burdensome to face opposition from women activist groups if it creates punitive provisions and to face opposition from religious groups if it legalizes abortion pills.

The five years during which the National Assembly stood idle are evident in the record as well. It was the National Assembly in 1953 that stipulated in Article 269 Paragraph 1 of the Criminal Act that a woman who had an abortion ‘by medication or other means’ would be punished. It was the only clause that explicitly designated abortion by medication as a crime.

The Constitutional Court in 2019 issued a decision of constitutional nonconformity on the provision and ordered revisions by the end of 2020, but the National Assembly missed the deadline. As a result, the provision entirely lost effect the following year without substitute legislation. In the 21st National Assembly, several amendments to the Criminal Act and the Mother and Child Health Act, including a government bill, were introduced but were discarded upon term expiration without deliberation, and bills introduced in the 22nd National Assembly are also pending. For five years, neither a basis to bring medication abortion into the system nor rules to replace it have been established.

The Ministry of Food and Drug Safety has also used the legislative vacuum as grounds to delay the marketing authorization review. The rationale is that the scope of permitted medication abortion and the gestational age for use must first be set by laws such as the Mother and Child Health Act before efficacy·indications and a risk management plan can be reviewed. While the government has maintained a lukewarm stance, drugs with unverified ingredients and strengths have been traded domestically through overseas websites and Telegram.

Kang Kyung-yeon, secretary general of the Association of Pharmacists for a Healthy Society, said, “The biggest problem with abortion pills distributed in Korea is that there is nowhere to verify their content and safety,” and added, “Only when marketing authorization is granted will the distribution and use of abortion pills finally enter the national management system.”