SEOUL — The death of a newborn in a clinic in Jeonju last month has drawn attention to a growing crisis in South Korea’s emergency neonatal care system. The infant, who began turning blue shortly after birth, was rushed to a neonatal intensive care unit (NICU) nearly 30 minutes away after two closer hospitals were unable to provide immediate care—one due to the recent resignation of a specialist and the other because of a lack of available beds. Despite efforts to seek emergency treatment, the baby did not survive.

This tragic incident highlights wider systemic challenges across South Korea, where a shortage of neonatal specialists has become a pressing concern. The country currently operates 77 NICUs staffed by approximately 240 physicians, but the distribution of these professionals is uneven, with facilities outside the greater Seoul metropolitan area particularly underserved. Some regional hospitals reportedly have only one neonatal specialist responsible for over 30 critically ill infants, underscoring the strain on medical resources.

The shortage is part of a broader decline linked to demographic shifts. Since South Korea’s birthrate fell below replacement levels in the 1980s, the nation has witnessed significant social changes, including closures of thousands of schools and reductions in daycare centers. Pediatric care infrastructure, including delivery wards and neonatal specialists, has also diminished steadily. While the government has invested heavily—amounting to hundreds of billions of dollars—in policies and incentives aimed at boosting the birthrate, such as cash allowances for parents and medical procedures related to fertility, experts say these efforts have not prioritized the expansion or support of neonatal medical services.

Medical professionals cite difficult working conditions as a primary factor deterring new doctors from entering neonatal specialties. Long work hours, low compensation, and the pressures of a litigious environment have contributed to a dramatic 94 percent decrease in the number of residents in NICUs in recent years, according to government figures. Young-Ah Youn, a neonatal teaching physician at Seoul St. Mary’s Hospital, shared that throughout her 16-year career she has frequently worked more than 100 hours per week, especially during her early years. Currently, her department has no residents, and staffing increasingly relies on contract physicians and nurse practitioners.

Critics argue that government policy has been heavily skewed towards encouraging family formation without adequately addressing the critical gaps in neonatal emergency care. “There is still an imbalance in incentives to ensure adequacy in trained medical specialists,” said Prof. Tan Poh Lin, a pediatric and public policy expert at the National University of Singapore. The Korean Society of Neonatology has labeled the situation outside Seoul as approaching “a state of catastrophe,” describing it as paradoxical for the government to promote childbirth while emergency medical infrastructure remains insufficient.

In response, authorities have announced plans to increase delivery fees and payments for high-risk procedures to improve doctors’ compensation. Additionally, the government aims to enhance emergency transfer systems by increasing the number of dispatchers at the National Medical Center's Central Mother and Child Medical Center. Nevertheless, medical professionals remain concerned about the sustainability of neonatal care. As Youn remarked, “I’ve worked tirelessly out of a sense of duty. But I fear that if things continue this way, there will soon be no one left to care for these babies.”