The collapse of perinatal healthcare is inevitable considering demographic factors and factors associated with medical resources due to the rapid decrease in the fertility rate in South Korea. In order to maintain the perinatal healthcare system, an appropriate healthcare delivery system must be established, but even the regional hospitals are facing a situation in which medical care is disabled due to a shortage of workforce. Government support is required to prevent the collapse of perinatal healthcare as public healthcare, emergency healthcare, and national essential healthcare system. In reality, it is necessary to strengthen perinatal healthcare through regionalization and to establish a maternal and child transport system. However, there are no guidelines for the perinatal transport system in South Korea, which also lacks professionalism, with a focus on the simple transportation of patients. Therefore, by integrating the transport systems of advanced countries and domestic efforts to improve transport systems, a realistic perinatal transport system establishment plan is proposed as follows. In order to strengthen the perinatal healthcare center under legal and institutional support, a professional workforce equivalent to that of the emergency healthcare center is ensured to organize a specialized perinatal transport team, and a perinatal emergency information center is established to form a safe transport linkage system. The perinatal emergency information center, which provides information on perinatal healthcare, linking and evaluating transportation between hospitals, should be incorporated into the emergency healthcare system, playing a pivotal role in the perinatal emergency healthcare management system. In addition, a dedicated transport team for perinatal healthcare should be formed for each region, transport guidelines for transport vehicles and equipment should be established, and legal and financial support should be provided to ensure safe perinatal healthcare transport. The prehospitalization level perinatal transport is configured as an integrated model of the 119 paramedics, aiming at quick transport. A team of perinatal special paramedics should be organized for each base to transport patients by special vehicles, and information from the perinatal emergency information center should be used to select a transfer hospital and to receive medical guidance from a perinatal care physician during transport between hospitals. Transport between hospitals aims at safe transport with triangular transport. A perinatal transport team is in charge of transport between hospitals, and a specialist is on board in a special ambulance to provide medical care during transport between hospitals. Support from the government and local governments is absolutely necessary to strengthen the perinatal healthcare center and establish a perinatal transfer system, which must be realized through a pilot project with fee support.