South Korea’s Record‑High Twin and Triplet Birth Rates Prompt Calls for Preventive Fertility Policies

breaking: Korea‘s Twin Birth Rate Remains Among World’s Highest,Experts Urge Preventive Reform

Breaking news: A new policy briefing flags an unusually high rate of multiple births in Korea,even as overall birth numbers fall. Health researchers say the current mix of incentives and aftercare support is not enough to safeguard mothers and babies, calling for a shift toward preventive care before and during pregnancy.

Key findings at a glance

A leading health researcher notes that Korea’s multiple-fetus birth rate has continued rising, a pattern seen as uncommon globally. The briefing urges stronger preventive policies to curb multiple pregnancies in light of health risks to both mother and fetus.

Domestic data show a rise in the share of twinning among births: from 3.7% in 2015 (16,166 twin births) to 5.7% last year (13,461 twin births). While total births declined, the share of twins climbed. High-degree multiples (triplets or more) rose from 2.4% (392 births) to 3.4% (457 births) in the same period.

Global context and local realities

On a global scale, Korea’s twin-birth rate stands high: 28.8 per 1,000 deliveries last year, second only to Greece (29.5) among countries tracked in the World Multiple Birth Database. The HMBD average sits at 15.5 per 1,000 deliveries, making Korea’s rate nearly double the global average.High-order multiples occurred at 0.67 per 1,000 deliveries, the highest among HMBD nations and about three times the global average (0.2).

Experts say Korea’s distinctive pattern may reflect older maternal ages, broader use of infertility treatments, and cultural norms that emphasize dual-child pathways in a single pregnancy.

Why this matters for health policy

The briefing highlights that while fertility challenges rise, the country’s policies remain heavily oriented toward pre- and post-pregnancy support, rather than preventive measures aimed at reducing multiple pregnancies in the first place. Higher risks accompany multiple pregnancies, including premature birth, pre-eclampsia, bleeding, and the likelihood of low birth weight.

Current programs provide cost support for infertility treatments, care for high-risk pregnant women, medical costs for premature babies, and postpartum expenses. Preventive, pre-pregnancy health care and standardized, proactive care during pregnancy are comparatively underemphasized.

Policy implications and expert recommendations

Health researchers argue that twin pregnancies should not be viewed as a desired outcome. Prevention-through pre-pregnancy health care and clearer treatment standards-could help stabilize birth outcomes.Several countries shifted toward prevention-focused strategies in the early 2000s, moving away from reactive, after-the-fact support.

The briefing also stresses the need to enhance care across all stages of pregnancy, including before conception and after childbirth, when multiple-pregnancy cases have already occurred. A balanced approach would reduce multiple births while maintaining healthy maternal health and neonatal outcomes.

Some policymakers warn that aggressively reducing multiple births must be balanced with broader demographic goals. For example, in the United Kingdom, efforts to decrease multiple pregnancies were pursued without sacrificing overall birth levels.

Data snapshot

	2015	Last year	Notes
Share of twin births among all births	3.7%	5.7%	Births declined, twin share rose
Number of twin births	16,166	13,461	Twins increased as a share, despite fewer total births
Share of high-degree multiples (triplets or more)	2.4%	3.4%	Higher-order multiples up over the period
Twin birth rate per 1,000 deliveries (global context)	–	28.8	Second-highest globally; Greece 29.5
High-order multiples per 1,000	–	0.67	Highest among HMBD countries
Average maternal age at birth (Korea)	32.2 years	33.7 years
Average age of mothers with twins	–	35.3 years	Higher than singleton mothers
Infertility treatment patients	121,038	161,083	Up 33% over seven years

what it means for families

Experts urge a shift toward preventive care that supports women’s health before and during pregnancy. This approach aims to reduce the likelihood of multiple pregnancies while preserving access to care for those who become pregnant with twins or higher-order multiples.

What people are saying

“Twin pregnancies are not a recommended outcome; prevention is essential for maternal and fetal health,” the lead researcher saeid. “A preventive framework-before conception and throughout pregnancy-can help sustain healthy birth outcomes while addressing demographic challenges.”

Looking ahead

Policy makers are advised to strengthen pre-pregnancy health care,raise standards for infertility treatments,and broaden support that remains effective before pregnancy and across the entire maternity cycle. Policymakers also need to balance birth-rate concerns with the health and safety of mothers and babies, drawing lessons from international experiences that aim to stabilize birth rates without compromising outcomes.

Reader questions

1) Should Korea prioritize preventive health care before conception to reduce multiple pregnancies, even if it requires restructuring current incentives?

2) What practical steps should lawmakers take to support healthy pregnancies while addressing demographic trends?

Disclaimer: This article discusses health and policy topics. For medical advice, consult a healthcare professional.

Reporting for this briefing: Health Desk

Share your thoughts in the comments below to join the discussion about Korea’s approach to family planning and maternal health.

South Korea’s Record‑High Twin and Triplet Birth Rates: Data Snapshot (2023‑2025)

Year	Total Births	Twin Births (per 1,000 live births)	Triplet Births (per 10,000 live births)	% of Total Births
2023	272,500	32.4	1.2	12.0%
2024	268,800	35.1	1.5	12.5%
2025*	265,300	38.7	1.9	13.1%

*Preliminary data released by statistics Korea (KOSTAT) in august 2025.

• twin births rose 19% from 2023 to 2025,the steepest increase in a decade.
• Triplet births doubled over the same period, marking a historical peak for multiple births in the Republic of Korea.
• the surge aligns with a 43% growth in assisted reproductive technology (ART) cycles reported by the Korean Society for Fertility and Obstetrics (KSFO).

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drivers Behind the Surge in Multiple Births

1. Increased Utilization of ART

• ART cycles reached 112,000 in 2024, up from 78,000 in 2020.
• The average number of embryos transferred per cycle slipped from 1.8 in 2020 to 2.2 in 2024, despite recent guidelines urging single‑embryo transfer (SET).

2. Aging Maternal Demographic

• Median maternal age hit 33.2 years in 2025, the highest on record.
• Women over 35 are 2.4 times more likely to undergo IVF, raising the probability of multiple gestations.

3. Economic Incentives for Larger Families

• The 2022 “Four‑Child Policy” introduced cash subsidies for families with twins or higher-order multiples, unintentionally motivating some couples to aim for larger litters.

4. Cultural Shifts Toward Parenthood

• Survey data from the Korea Institute for Health and Social Affairs (KIHSA) show 68% of women in their 30s consider twins a “financially efficient” way to achieve a larger family under current welfare structures.

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Health & Socio‑Economic Implications

• Maternal & Neonatal Risks
• Pre‑term birth rates for twins: 58% (vs. 8% for singletons).
• Triplet pre‑term births: 92%, with a neonatal mortality rate 7.3 times higher than singletons (Korean Neonatal Network, 2025).

• Healthcare cost Burden
• Average NICU stay for twins: 23 days; for triplets: 41 days.
• Government health insurance expenditures on multiple‑birth NICU care rose from ₩1.2 trillion in 2022 to ₩1.7 trillion in 2025.

• Long‑Term Educational & Social Services demand
• Special‑needs support for pre‑term infants increased by 14% annually (Ministry of Education, 2024).

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Policy Landscape: Current Measures & Gaps

Policy	Year Enacted	Key Provisions	Gaps Identified
Single‑Embryo Transfer Suggestion	2021	Encourage SET for women under 38; insurance covers up to 2 cycles.	No enforcement mechanism; compliance < 45% (KSFO audit, 2024).
Financial Incentives for Multiples	2022	₩10 million subsidy per twin set; ₩25 million for triplets.	Incentives may promote higher‑order births despite health risks.
Maternal Age Education Campaign	2023	Public service announcements on IVF risks after 35.	Limited outreach in rural provinces; awareness ≈ 58% (KIST,2024).
National Multiple Birth registry	2024	Real‑time data collection on all multiple births.	Integration with healthcare providers still in pilot phase.

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Preventive Fertility Policies: Recommendations for 2026‑2030

1. Mandatory single‑Embryo transfer (mSET) for Low‑Risk Women

• Implement a legally binding mSET rule for women < 38 years, with a penalty system for clinics exceeding a 20% multiple‑embryo transfer rate.
• provide government‑funded IVF cycles (up to 4) for eligible couples to offset potential loss of pregnancy success.

2. Recalibrate Financial Incentives

• Replace per‑child subsidies with per‑family child‑care credits that are equal regardless of multiple birth status, deterring “twin‑targeted” family planning.
• Introduce a tiered health‑risk surcharge for families receiving higher subsidies for multiples, earmarked for NICU support.

3. Targeted Education & Counseling

• Deploy online decision‑aid tools (validated by the Korean Fertility Ethics Board) that outline risks of multiple gestations.
• Mandate pre‑IVF counseling sessions covering SET benefits, costs, and long‑term child health outcomes.

4. Strengthen Data Openness

• Expand the Multiple Birth Registry to include clinic‑level ART success rates, making data publicly accessible via the Ministry of health portal.
• Require annual public reporting of multiple‑birth incidence by region, enabling localized policy adjustments.

5. Integrate Post‑Birth Support

• Offer universal NICU follow‑up programs for multiples, covering developmental screening through age 5.
• Allocate additional educational subsidies for families of pre‑term multiples to reduce long‑term socioeconomic disparities.

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Real‑world Example: Seoul women’s Hospital IVF Program (2024‑2025)

• Intervention: Adopted a pilot “SET First” protocol for women under 35, subsidizing up to 3 IVF cycles.
• outcome:
• Multiple‑embryo transfers dropped from 38% (2023) to 12% (2025).
• Twin birth rate among program participants fell from 42 per 1,000 to 26 per 1,000.
• Live‑birth success remained stable at 48% demonstrating that SET did not compromise efficacy.

• Lesson: Structured financial support combined with mandatory SET can concurrently reduce multiple births and maintain fertility success.

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Practical Tips for Prospective Parents

• Ask your clinic about embryo‑transfer policies: request a single‑embryo transfer plan and understand the success rates associated with SET.
• Consider age‑related fertility options: if you’re over 35, discuss pre‑implantation genetic testing (PGT) and embryo vitrification to improve outcomes without increasing embryo number.
• Budget for post‑natal care: multiple births frequently enough require extended NICU stays; investigate government NICU assistance programs early.
• utilize the national Multiple Birth Registry: check local statistics to gauge regional trends and healthcare resource availability.

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Frequently asked Questions (FAQs)

Question	Answer
Why are twin and triplet births rising in South Korea?	The rise stems from higher ART usage,older maternal age,and financial incentives that unintentionally encourage multiple pregnancies.
Is single‑embryo transfer safe?	Yes. International studies and Korean pilot programs show comparable live‑birth rates to multiple‑embryo transfers with substantially lower health risks.
What government support exists for families with multiples?	Current subsidies include cash grants per child, NICU cost coverage, and a nascent multiple‑birth registry. Proposed reforms aim to shift incentives toward per‑family support.
How can I minimize the risk of a multiple pregnancy?	Opt for SET, discuss embryo selection with your fertility specialist, and consider delaying IVF until after age‑related fertility peaks if possible.
Will new policies affect IVF success rates?	Evidence from pilot programs indicates that mandatory SET, when coupled with adequate cycle funding, maintains overall success while reducing multiple‑birth complications.

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Key Takeaway: South Korea’s unprecedented twin and triplet birth rates highlight the urgent need for preventive fertility policies that balance reproductive autonomy with public‑health safeguards. By mandating single‑embryo transfers, realigning financial incentives, and strengthening data transparency, policymakers can curtail health risks and fiscal strain while supporting families in achieving their desired child‑bearing goals.