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4) Inadequate maternity protection measures: From unwanted
pregnancies to ‘livelihood-type’ abortions
In cases of pregnancy or childbirth, having a sufficient period of rest before and after
giving birth is a condition difficult to realize due to women’s livelihood activities. State
support of free health services relating to pregnancy and childbirth continue to be in a
poor state. According to the testimonies of North Korean refugee women, medical
drugs have already been scarce since the 1990s, so that people have no choice but to
buy medicine at markets for money or bribe the doctor, or to obtain medical drugs and
then go to hospital. With regard to illnesses related to women, many have had the
experience of receiving only an examination at hospital and having to obtain medicines
themselves or of dealing with illness by themselves without any medical examination.
At the same time, due to the aggravation of the economic crisis in the 1990s and
livelihood activities becoming more urgent, abortions (curettage) are carried out
openly yet unofficially as the state turns a blind eye. Reasons for these abortions are
complex: from unmarried women’s unwanted pregnancies (caused by premarital
sexual relations, sexual violence, ‘sexual bribery’) to abortions motivated by livelihood
considerations. What is important is that these abortions occur mostly because of
violence induced by the social structure, because of sexual violence carried out by men,
because of sexual bribery as abuse of power, economic difficulties to sustain
livelihoods, husbands evading livelihood responsibility, state inactivity, etc.; which
means that abortions are carried out not based on individual choice but rather within a
structural dynamic.
Furthermore, the point that requires attention is not whether abortions do really
happen but, rather, that the physical and psychological wounds inflicted through
abortions are becoming increasingly generalized to women. This point refers to men’s
avoidance of responsibility in the decision-making process leading up to the abortion,
the physical after-effects of abortion, ‘feelings of guilt’ about the abortion, etc., i.e. to
the fact that abortions leave deep wounds on women’s lives. Consider the experience
of a woman who had an abortion after bribing a doctor with 10 kg of red beans and