Navigating women’s health in South Korea.
I have to admit that when I heard about Park Geun-Hye’s pledge to become the first female president of South Korea, I was flabbergasted: here was a woman running for president in a nation where women have the lowest labor participation rate in the OECD, abortion is still illegal, and the overwhelming majority of men firmly believe that a woman’s place is in the home.
That being said, while Obamacare recently forced American health insurance companies to merely subsidize the cost of birth control pills (which still remain prescription-only), The Pill has remained an over-the-counter, inexpensive medication in South Korea for more than 40 years. When it comes to issues like abortion and contraception, no matter how conservative South Koreans sway (an ever-increasing number of citizens are converting to the Christian faith), birth control pills, condoms, and pregnancy tests have always been accessible and affordable – condoms available only the next subway vending machine away. It’s a fascinating twist in how a society that poo-poohs premarital sex and lacks any government-mandated sex-ed programs has seemed to come to terms with the inevitable occurrence of the act.
However, Korean women who had previously relied on birth control pills were thrown for a loop in May when the country’s Food & Drug Administration suddenly decided to give contraceptive pills and the “morning after” pill a role reversal, making emergency contraceptive OTC and monthly-dosage pills prescription-only. This was, no doubt, more than partially fueled by the government’s cry for more births, as the nation’s rapid gentrification and stagnant desire of families to bear babies have prompted even the United States to give a hoot (only because it threatens economic relations, of course).
Fortunately, after complaints from women’s rights groups and the explosions of netizens, the FDA responded with a proverbial “Gotcha!” and claimed it would stave off the decision for another three years, encouraging more research into the effects of the pills and consideration for their misuse. I’m not really sure how birth control pills can be “misused” – I don’t personally know anyone looking to get high or OD on Yasmin – but it’s possible that with the aforementioned reluctance to teach young girls and women alike about the use and effects of the pills, there could be some women out there who might assume that taking three pills in a row can make up for one day missed (or not…there ARE instructions included, after all).
Nevertheless, laws are only one of many factors that come into play when women take charge of their bodies and their decisions about sexual health. What about their overall disposition towards contraception, their knowledge about it, or their comfort in discussing such issues with family, a boyfriend, or their doctor? How would requiring a doctor’s visit to get The Pill impact the birth rate…or the abortion rate? While various forms of birth control are widely available in pharmacies, visiting a gynecologist is an entirely different ordeal, and the awkwardness and discomfort women feel in the waiting room are compounded by outside pressures from a society that makes contraceptives commodities that are seen but seldom spoken of.
“Well…isn’t going to a gyno awkward in anycountry?” you might think. This is true, but in South Korea it seemed that there were far more situational influences that contributed to women’s discomfort — primarily if they were not there to actually get pregnant or care for a child. In other words, most women go into a gynecological office with their own premeditated reservations or anxieties, but there is not much about the experience itself that works to dispel that apprehension.
I can only speak of my own experiences, having visited a gynecologist in the United States and a few different ones in Seoul, and I’ve no doubt that being a foreigner probably intensified an already mortifying situation. However, for those who may be planning a visit or extended stay in South Korea – or in any other country that may hold similar views on abortion and premarital sex – here are a few words of advice on what you’ll be getting yourself into.
First of all, do everything you can to secure a visit with a female gynecologist. This has nothing to do with sexual abuse or inappropriateness, and everything to do with the mere fact that a male gyno already has enough trouble speaking to a Korean woman, let alone a foreigner. Within Seoul and most of its suburbs, the language barrier will not be an issue in an OB/GYN clinic. Most Korean doctors in general study from English textbooks, as very few textbooks for Western medicine have been translated into Korean. So even though the doctor may not be able to string together full sentences, he/she will be familiar with terms such as “Yeast Infection,” “Ovulation,” or “Menstruation”.*
That being said, the day that I walked into my female gynecologist’s office for a scheduled appointment, only to find that she was out sick and had been replaced by a male cohort (assumedly, not that type of cohort), was the day I left a grown man speechless for the first time. Though I could tell that he could communicate in English, he stumbled over his words, could not bear to make eye contact with me, and gave me the privilege of the shortest vaginal examination ever. I suppose he accomplished what needed to be done, but not without nearly bringing himself to tears and leaving me to obtain a more clear-cut explanation of my test results the following week with my calm and collected femMD.
Age also plays an important role in how you will be judged based on the reasoning for your visit. A medical issue such as a UTI, infection, or more serious issue like cancer will be of genuine concern no matter what generation your doctor, but those who hail from the postwar era will likely be far less understanding of sexual and contraceptive issues that have arisen out of wedlock, perhaps to the extent that they will outright refuse to write you a prescription. Before I became wizened enough to learn that monthly contraceptive pills were available over-the-counter, I rushed to a nearby gyno in desperate need of the morning-after pill (which is still prescription-only), thinking I was well-armed with my Korean-speaking boyfriend in tow. American sex-ed had beat into my head that one could get pregnant at “virtually any time” of the month, but granny gyno prohibited me – with a look of utter disdain – from a prescription because, based on my last period, “there was no possible way I could be pregnant.” Fortunately, she was right, but that didn’t stop me from gripping my pillow in distress every single night until my next period. I can’t imagine what it would be like if I had to go to this same gynecologist having to request a monthly contraceptive pill. Would she have nixed that proposition as well? I could have just gone to another clinic – no need for a referral under national healthcare – but this would make a new law requiring a prescription for The Pill about as useful as the ban on abortion….which is to say, not much.
When I did finally obtain a morning-after pill (again, all this before I knew I could get a box of Minivlar for 6,000W – about US $4 – from a pharmacy with no questions asked), the pharmacist told me that since it had taken me so long to obtain it that day, I needed to take it “right now”. Yes, right there in a crowded pharmacy with people watching, who probably knew what it was, because what other pill would I be taking so urgently if I did not otherwise look disastrously ill? He also made a point of telling me aloud, and in detail, all of the side effects, in front of the other patrons, so I’m sure that helped identify my “affliction” for those who couldn’t have already guessed.
Lastly, the physical atmosphere of obstetrics offices does not offer solace to unmarried visitors. When I arrived at one, a series of videos played on the screen to try and placate women facing issues with their husbands. All of the videos were cartoon shorts, the first documenting the story of a woman whose husband was just “never in the mood.” Another clip displayed the same woman chatting with her (married) girlfriends about her and her husband’s sex life. Near the door stood a cardboard cutout of a pregnant woman with a thought bubble that asked, “What kind of prenatal care should I consider?” Not a single advertisement for a contraceptive method graced the lavender walls.
Even my young, female gynecologist felt that limiting my contraceptive options was in my best interest, especially since I wasn’t married. When I finally mustered the courage to discuss birth control options (I was hesitant about going on a monthly pill in a foreign country because I did not know what was available, only to later learn that all contraceptive pills in South Korea are foreign-brand), she first recommended that I take Yaz. When I told her repeatedly that I did not prefer this pill because I’d read up on several lawsuits about its side effects (one of which included death), she insisted that it was “the best pill on the market and this was not disputed.” A week-and-a-half later I returned to her with a half-used box, explaining that the side effects had been so bad that the benefits did not outweigh the costs. She then claimed that my “only other option” was an IUD, which posed the slight but horrifying possibility of “tearing through my uterus.” It was only through a close Korean friend that I discovered several brands of mini-pills which could be purchased at my local pharmacy**, simply by asking for them by name. Was it that my doctor was actually unaware of other contraceptive options, or that she thought that, as a foreigner, I was too daft to know she was up-selling me the most expensive ones? (Yaz is the most expensive pill available in South Korea and one of the few that is prescription-only; don’t even get me started on the cost of an IUD.) Either way, I couldn’t help but feel I’d been screwed, and not in the good way.
I was lucky to have a female Korean friend who had studied in Canada, became perfectly fluent in English, and was able to bridge the divide between East and West when it came to sexual matters, but not many Korean women are that open to discussing the subject. Most expats resort to what they believe to be more “foreigner-friendly” clinics in areas like Itaewon or in International Health Care Centers such as the one at Yonsei Severance Hospital. For what it’s worth, I’ve gone down that route as well, and not only was it twice as expensive and three times the wait, but the foreign-born doctor there sent me in circles through various departments for the same tests that took a matter of minutes at a regular obstetrics clinic.
In conclusion, my best advice would be to visit a few clinics in your area until you find a doctor that you feel comfortable with, and keep going back to the same doctor. I found this to be assuaging for both my gynecologist and the generalist I visited, for once they knew who I was (not difficult as I was probably the only foreigner in their clinic), it became easier to build a trusting relationship with them and discuss my ailments with less judgment involved. After all, a doctor whom you are continually willing to pay is far less likely to shame you. Should you encounter a language barrier, here are some useful Korean terms:
Gynecologist office -산부인과
Birth control pills – 피임약
Emergency contraception (“morning after pill”) -사후 피임약
Pregnant -임신 한
Pregnancy test -임신 테스트
Urinary tract infection – 요로 감염
Yeast infection – 효모 감염
Menstruation – 월경
Be strong, fearless foreign female. Believe it or not, sexual health is a universal concern, and while every country confronts it in a different way, researching how obstetrics operate in your “adopted” country is time well-spent.
If you are ever in a dire situation in South Korea, you can call the 24-hour Medical Referral Service at the Seoul Global Center for English information on the clinics and hospitals in your area.
*Always use as many technical terms as you know. Unless your gyno has studied abroad and partied hard on campus, “get laid”, “come,” and even “period” will be gibberish.
** Click here for a comprehensive list of all available pills.