No hospital, no hope: Maternal death highlights rural healthcare gap in N. Korea

A woman in Ryanggang province died from blood loss while giving birth at home after eight months of pregnancy. The tragedy occurred because, as a resident of a rural agricultural community, she had no easy access to a hospital.

According to a Daily NK source in the province recently, the woman began experiencing contractions at her home on the evening of March 25. She quickly called a neighbor with midwifery experience to help with the home delivery.

However, during childbirth, she lost an unexpectedly large amount of blood. The midwife was unable to handle the emergency, and the woman died.

“Hospitals aren’t easily accessible in agricultural communities,” the source explained. “In provincial capitals or downtown areas of cities and counties, people commonly go to hospitals to give birth, but in rural regions, hospitals are far away, and village clinics typically lack obstetrics and gynecology departments.”

Because of this, pregnant women in rural areas sometimes relocate to a relative’s home in town before their due date, but most end up giving birth at home with a midwife’s assistance.

“Transportation is scarce in these agricultural communities. If a woman wants to deliver in a hospital, she has to travel by ox cart,” the source said. “Tractors don’t run because there’s no fuel, and even using a cart requires permission from the official in charge.”

“There are taxis, but they rarely venture into rural areas, and they’re far too expensive for rural residents to even consider.”

Making matters worse, the woman who died went into labor prematurely, putting her at even greater risk.

In North Korea’s agricultural communities, women typically give birth at home rather than in medical facilities. Hospitals are inaccessible, and even available clinics rarely have obstetrics departments. Those that do often lack specialized equipment and medical supplies, making proper treatment or operations difficult.

Rural residents with little income also find hospital childbirth costs prohibitively expensive. For North Korean women in farming communities who would have to pay a fortune for obstetric care, calling a midwife and giving birth at home is often their only realistic option.

The source added that another factor increasing childbirth complications is the lack of basic knowledge about pregnancy and childbirth among rural residents. Since most rely on questionable information from neighbors or relatives rather than formal education, they’re often unprepared for the realities of pregnancy and delivery.

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