South Korea’s Abortion Pill Gap: 3,000 Illegal Sales and Zero Approved Drugs
South Korea currently has no government-approved medical abortion pills, leaving thousands of women to rely on unregulated online markets. According to data from the Ministry of Food and Drug Safety (MFDS), authorities detected 3,189 cases of illegal online sales of abortion medications over the last five years, yet only seven of those cases resulted in actual police investigations.
The Enforcement Gap in Online Drug Sales
The gap between detection and prosecution is stark. Between 2021 and early 2025, the MFDS identified thousands of illegal advertisements and sales posts. The breakdown of detected cases includes 414 in 2021, 643 in 2022, 491 in 2023, 741 in 2024, 682 in 2025, and 218 in the first five months of this year, according to reporting by Kyunghyang Shinmun.
Most of these actions involve requesting the blocking of websites. The MFDS stated that initiating criminal investigations is difficult because many sellers use servers located outside of South Korea or employ strict anonymity to hide their identities. Because the act of purchasing these drugs is not currently criminalized, the government lacks the legal leverage to track users or deter the trade.
Legal Vacuum Following the 2019 Constitutional Ruling
The current state of “legal limbo” stems from a 2019 ruling by the Constitutional Court of Korea, which found the ban on abortion unconstitutional. By January 1, 2021, Article 269, Paragraph 1 of the Criminal Act—which punished women for performing their own abortions—lost its effect. However, the National Assembly failed to pass replacement legislation by the court’s deadline.
This legislative failure created a double blind spot:
- Medical Blind Spot: Since no drugs are approved, there are no official prescriptions or dispensing records, making it impossible for health authorities to track how many women are using these medications.
- Legal Blind Spot: Under the current Pharmaceutical Affairs Act, mifepristone (the primary ingredient in medical abortion pills) is not included in the regulation that imposes fines on buyers of certain designated drugs. The Mother and Child Health Act also lacks provisions to punish those who purchase or use these medications.
The Struggle for Drug Approval: Mifepristone and ‘Mifegymiso’
While the World Health Organization (WHO) added mifepristone to its list of essential medicines in 2005 and over 100 countries have legalized its use, South Korea remains an outlier. Hyundai Pharmaceutical applied for approval of “Mifegymiso” three separate times—in July 2021, March 2023, and December 2024—but the process remains unresolved.
The MFDS has argued that it cannot finalize the review of efficacy, effects, and risk management plans until the National Assembly defines the legal scope and allowable gestational age for medical abortions through the Mother and Child Health Act. This has resulted in a “responsibility ping-pong” where the agency waits for law and the legislature avoids the debate.
Health Risks of Unregulated Procurement
With no legal pharmacy route, many women turn to Telegram or overseas websites to acquire pills. Kang Kyung-young, Secretary General of the Pharmaceutical Association for a Healthy Society, told Kyunghyang Shinmun that the primary danger is the lack of verification regarding the dosage and safety of these smuggled drugs. Without official product approval, there is no national system to manage distribution or ensure the purity of the medication.
| Metric | Status in South Korea | Global Standard (WHO/International) |
|---|---|---|
| Approved Medication | None (Mifegymiso pending) | Approved in 100+ countries |
| Legal Status of Buyer | Not punishable | Regulated medical access |
| Tracking Mechanism | None (Unregulated/Online) | Prescription and medical records |
Legislative Stagnation in the National Assembly
Reports indicate that the National Assembly has avoided the issue due to political pressure. One official cited by Kyunghyang Shinmun noted that when the government requested laws to punish buyers, lawmakers feared backlash from women’s rights groups. Conversely, when asked to legalize and regulate the drugs, lawmakers feared opposition from religious organizations. As a result, multiple bills to amend the Criminal Act and the Mother and Child Health Act were discarded at the end of the 21st National Assembly’s term and remain pending in the 22nd.