North Korea is taking strict measures to address its declining birth rate by punishing doctors who perform abortions and cracking down on the sale of smuggled contraceptive pills, according to a report by Radio Free Asia (RFA).

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Abortion has been illegal in North Korea since the 1990s famine, which killed millions. However, many doctors secretly perform abortions at home to supplement their small government salaries. They charge around 30,000 won (US$1.76) per procedure, which is about the monthly salary of an average worker in North Korea.

A recent case highlighted the risks for doctors performing these procedures. According to an RFA report, on August 28, a doctor from Paegam County Hospital was sentenced to five years in prison for performing abortions at home. Another doctor from Unhung County Hospital received a three-year sentence after a patient died during an abortion in June.

To deter such practices, the government increased doctors' salaries by over 40 times, but many still engage in private medical work to make ends meet.

In response to the falling birth rate, North Korea has introduced policies encouraging larger families, including providing extra food and housing for those with many children. Despite these efforts, the birth rate remains low.