Why ‘birth tourism’ from China persists, despite US crackdown
Many Chinese mothers say the ability of their child to get American citizenship gives them a better chance in life than settling down on the mainland
At 10am on a cold morning in April at the Whittier Medical Centre in California, Sophia was born.
She was a healthy baby girl weighing 3kg with a future in the United States to look forward to, if she chose it.
Her mother, Tracy, came from Shanghai to give her this choice, a chance at arguably the world’s best education, a safe childhood and reliable medical care without long lines.
“I’m here to give my kids better options,” said Tracy, who asked to be referred to by only her first name because she has read stories about officials cracking down on mothers who come to the US to give birth.
Even as middle-class incomes in China enjoy explosive growth and 96 per cent of Chinese people in a recent Pew Research poll say their lives are better than their parents’, an unknown number of “birth tourists” like Tracy cross oceans each year to have their babies in America.
And in the United States’ Chinese enclaves, they find a cottage industry of Chinese midwives, drivers and doctors who accept cash, plus “maternity hotels”, apartments or homes run as hotels for the women during their pregnancies.
Chinese listing sites show several hundred maternity hotels in southern California, although it is not clear how many of the listings are active.
Anyone who lies about the purpose of their visit to the US can be charged with visa fraud, but birth tourism is not against the law.
“There is nothing in the law that makes it illegal for pregnant women to enter the United States,” said Virginia Kice, a spokeswoman for US Immigration and Customs Enforcement.
Critics, however, blast the practice as a way to gain citizenship for children by unfairly gaming the immigration system. And spurred in part by those complaints, US officials at every level are exploring ways to crack down on maternity hotels.
That the practice persists, birth tourists say, is a testament to the hold that America still has on Chinese imaginations.
Restrictive family planning policies may have driven some Chinese mothers to give birth in the United States before 2015 when the one-child policy ended. But many others are simply curious about exploring the possibility of a life in the US, said Kelly, a birth tourist who has settled in Riverside County’s Eastvale neighbourhood.
“China has developed very quickly,” said Kelly, who also declined to give her first name. “But … Chinese people still have this perception of America as a dream place to live, that it is bigger, better, stronger.”
The State Department issued 2.27 million visas to Chinese tourists in 2015. It does not track what proportion of visas are issued to birth tourists. Childbirth is a legitimate reason to travel to the US and as long as Chinese nationals provide the correct paperwork and evidence they can pay for their medical care, they will be issued a visa, department officials said.
But other federal officials have handled the issue differently, acting on suspicions that the practice involves large scale visa fraud. Border Patrol agents at major ports of entry such as Los Angeles International Airport have recently tightened security for pregnant Chinese women and sometimes block them from entering the country.
Officials raided birth hotels in Riverside, Rowland Heights and Irvine in 2015, accusing the operators of tax code violations and of committing fraud by helping birth tourists get visas under false pretences.
“People who provide false information in order to gain entry to the US pose a potential security vulnerability,” Kice said.
In the San Gabriel Valley, where birth hotels are an open secret, local leaders field a steady stream of complaints from area residents who oppose maternity hotels. In Chino Hills, a group of residents protested against the presence of birth hotels in the neighbourhood and Arcadia police even assigned a detective to investigate the businesses in response to residents’ complaints.
Los Angeles County formed a birth tourism task force to tackle the issue in 2013. It has identified and cited 34 birthing hotel operators for running businesses on land that is zoned for residential use. But there is still no county regulation against running hotels for foreign nationals travelling to the US for the sole purpose of giving birth.
The same year that authorities cracked down on birth tourism, Finding Mr. Right, a dramatisation of a Chinese mother’s trip to Seattle to give birth, grossed US$82 million in China, the ninth-highest-earning domestic film that year.
The film wraps the controversy of birth tourism in the familiar narrative confines of a sugary romantic comedy, telling the story of a Beijing tycoon’s wife who flies to Seattle to give birth and falls in love with a driver at the maternity hotel.
One of the first scenes shows her preparing to navigate customs by wrapping a loose cloth around her pregnant belly. At customs, she tells the officer that she’s here to “travel”. When he asks if she is married, she responds by performing Beyonce’s Single Ladies dance.
Rosy depictions of the US in that film and others fuel the American dreams of the growing Chinese middle class. And a deteriorating belief in China’s future drives still others to consider giving birth in America.
Food safety, pollution and income inequality are now among Chinese citizens’ top concerns, according to Pew Research. Just six percent of high-net-worth Chinese individuals say they plan to remain in China full time, according to a Hurun Report poll in 2015, and the US is their top destination.
The authorities say it is virtually impossible to tell how many Chinese birth tourists come to the US each year. The Centre for Immigration Studies, a conservative-leaning think tank, estimates that nearly 36,000 Chinese nationals give birth in the US each year, but “that’s just a guess”, said Jessica Vaughan, the centre’s executive director.
Birth tourists are using US citizenship as a safety net, Vaughan said. And they can use welfare and health care benefits that they did not pay taxes for. She thinks the government should make it harder for babies born from birth tourism to retain their citizenship by requiring them to spend the first five years of their lives in the US, rather than allowing families to take the babies back to their homeland.
“Birth tourism commodifies US citizenship rather than keeping it something that is earned through the legal immigration system. It cheapens citizenship in the eyes of native-born Americans,” Vaughan said.
Karin Wang, a vice president at Asian Americans Advancing Justice, says she is concerned that such attitudes toward birth tourism reflect xenophobia and anti-Asian sentiment. She cast birth tourism as the side effect of a broken immigration system.
“If the immigration system itself worked better, then these convoluted paths that people take to secure status in America would lessen or disappear,” Wang said.
Birth mothers often arrive in the US a few months before they’re set to have their babies because their pregnancies are not as visible then and they have heard that officials block pregnant women from entering the country.
Many mothers stay in the US at least long enough to observe the Chinese custom of zuo yuezi, a monthlong regimen and diet that is supposed to promote health among new mothers.
Before and after the birth, the mothers, who are sometimes joined by their husbands, fight boredom in the suburban communities around Los Angeles where the hotels are often located.
On a recent weekday in Rowland Heights, a block from the birth hotels raided by immigration officials in 2015, a Target store was having a 50 per cent off sale on baby clothes and items. Pregnant Chinese mothers packed the aisles.
Tracy settled into a chair at the Starbucks in the Target, wrapped a jacket around Sophia, installed a toy in her chubby fists, then warmed her hands on a cappuccino.
For better or worse, Chinese mothers’ first impression of American life is often in places like Rowland Heights, a mostly Asian sprawling suburb of homes and vast strip malls 40 km east of downtown Los Angeles.
Birth tourism is the neighbourhood’s incognito economic engine, dozens of pregnant Chinese women visit these shopping centres each day, walking from nearby maternity facilities or transported by cars the hotel operators provide. There’s Osh Kosh B’gosh, Baby’s R Us, Ibiya Family, mattress and crib stores, doctors, dentists and Chinese banks.
Life in America tempts from the strip malls. Among the baby stores, there are home loans on offer, car rentals to go see the homes, real estate agents to guide shoppers and immigration attorneys to handle paperwork.
Many mothers, like Tracy, consider staying. Her reasons have more to do with China’s flaws than US freedoms.
In Shanghai, she says, the buildings are tall and modern, but the rent is high. The skyline is beautiful, but the air isn’t clean and the food isn’t safe. The airport is architecturally impressive, but inconvenient. The people speak her language, but they are always judging and comparing, evaluating the clothes she wears, the home and neighbourhood she lives in, the school her children will attend. A life in America is a break from all of that.
“Here people are not so competitive, trying to wear better clothes and use better things,” Tracy said. “I don’t even have to wear makeup.”
Later in the afternoon, two pregnant Chinese women wandered into the Starbucks at the Target with a pint of Haagen-Dazs ice cream each, searching for spoons.
They couldn’t speak English and the employees behind the counter were busy with a long line of customers. They settled for wooden stirrers, poking away small dabs of ice cream at a time, laughing at each other’s failed attempts.
The women are birth tourists from China who met in Los Angeles. Zhu is not married yet and she is not sure when she will be or if she wants to stay in the US, but she flew from Guangdong to have her baby because she says she has no other choice.
She said she was fleeing family-planning regulations that fall particularly hard on single mothers in China. To have a baby, the government must issue a reproduction permit and single women have had trouble getting them. In Wuhan, China a few years ago, the authorities even considered fining single pregnant women 80,000 yuan (HK$89,000).
Rowland Heights, along with Arcadia and Irvine, have long been plagued with rumours that the communities host “mistress villages”, a slang term in China to describe a housing complex where rich Chinese men house their mistresses.
The rumours are unverifiable, but birth tourists, birth hotel operators, nurses and other people working in the industry said Chinese single women form a significant part of the birth tourism industry.
A baby without the proper permits cannot access public services like school or healthcare, Zhu said. And mothers giving birth out of wedlock face withering social persecution.
So a few months ago, she came to the US alone to give birth.
It was her unborn child’s only chance at a future, she said.