Birth Tourism to the US: A Rare but Rising Concern

Birth tourism refers to the practice of foreign nationals traveling to the U.S. solely to give birth, so their child automatically gains U.S. citizenship. This practice has sparked intense public interest and legal scrutiny, particularly in discussions about potentially ending the constitutional guarantee of birthright citizenship. Estimations surrounding birth tourism suggest that about 26,000 babies born annually in the U.S. may relate to this practice, according to contentious analyses of U.S. Census Bureau data. While this number seems small compared to over 3.5 million annual births in the U.S., it has become a focal point in the Trump administration's battle against birthright citizenship. An executive order signed by President Trump on his first day back in office seeks to limit automatic citizenship to children born to at least one parent who is a U.S. citizen or lawful permanent resident. The administration argues that this executive order is crucial for curbing unauthorized immigration, making birth tourism a key issue in legal discussions during the Supreme Court's April 1 oral arguments regarding the status of birthright citizenship. Concerns regarding birth tourism have intermittently arisen over recent years, particularly over the past decade. Critics point to issues like immigration fraud, tax fraud, unpaid medical expenses, and national security risks associated with package deals that can cost tens of thousands of dollars to assist pregnant women in obtaining visas, housing, medical care, and transport. The Northern Mariana Islands, a U.S. territory in the Pacific, has faced increased scrutiny as it permits visa-free entry for nationals from certain countries. Congressional Republicans have expressed fears that women from China are utilizing this territory to attain U.S. citizenship for their children. Attention was further raised when authorities raided maternity hotels in Southern California catering to Chinese women in 2015. The trend among Russian women giving birth in South Florida has also been notable. The federal government has initiated various measures to tackle birth tourism. These initiatives include prosecuting individuals involved in birth tourism schemes and implementing a 2020 regulation that brands as inadmissible any woman on a tourist visa primarily seeking to give birth in the U.S. In 2024, a visa-free program for the Northern Mariana Islands was modified due to concerns about birth tourism abuse. In April, U.S. Immigration and Customs Enforcement (ICE) kicked off an investigation into birth tourism networks. The Trump administration defends the executive order as the only method to curtail birth tourism. Conversely, critics argue that the issues can be addressed without undermining a fundamental constitutional right rooted in U.S. history. They contend that the annual number of infants at risk of not obtaining U.S. citizenship might greatly exceed those born through birth tourism, as estimates indicate that about 255,000 infants born annually would end up lacking U.S. citizenship due to unauthorized immigration or long-term temporary visas. Data from the Migration Policy Institute (MPI) suggests that by 2045, eliminating birthright citizenship could swell the unauthorized population by an additional 2.7 million individuals and by 5.4 million by 2075. This article delves into the estimates associated with birth tourism in the U.S., the policies implemented to restrict it, and its relevance to the administration’s broader strategy to limit birthright citizenship. Although birth tourism is not a novel issue, the reasons behind it remain inadequately understood. Studies suggest that the opportunity of U.S. citizenship and the consequent advantages—such as access to higher education—are primary motivating factors. Conversely, factors like obtaining advanced medical care in the U.S. and specific policies in the expectant mother’s home country also significantly contribute. For instance, many Chinese mothers sought to give birth in the U.S. during China’s one-child policy from 1980 to 2015, as children born outside China were not subject to that policy. Birth tourism presents a dilemma for policymakers. While giving birth in the U.S. as a temporary visa holder is legal, applying for a visa primarily to secure U.S. citizenship for one's child constitutes fraud and grounds for inadmissibility. Concerns extend beyond visa fraud to include potential tax evasion by businesses involved and the likelihood that these mothers may not cover their healthcare expenses during pregnancy and delivery. No official number exists for the infants born as a result of birth tourism; however, the U.S. Centers for Disease Control and Prevention (CDC) provides an estimated figure based on annual birth data. According to the CDC, in 2024, approximately 9,600 infants were born in the U.S. and its territories to foreign mothers who claimed their permanent address is outside the U.S. Though this figure may suggest births attributed to birth tourism, it includes women who may not have intended to give birth in the U.S. Additionally, it excludes births by women who came with the express purpose of giving birth but used a U.S. address to elude scrutiny, a tactic employed by some birth tourism businesses. Overall, these births remain a mere fraction of the total 3.7 million U.S. births in 2024, and the trend appears stable. Even the highest estimates based on government data assert that birth tourism constitutes a tiny segment of all U.S. births. The Center for Immigration Studies, a think tank advocating for reduced immigration, suggests that births from birth tourism range from 22,000 to 26,000 annually, although this estimate remains subject to debate. There has been a rise in companies targeting clients in China, Russia, and beyond, promoting comprehensive services to facilitate travel, visas, medical care, and guidance for expectant mothers who aim to give birth in the U.S. Reported fees for these services range from $20,000 to $100,000. Particularly in Southern California, companies that cater to Chinese women and those in Florida focusing on Russian clientele have gained attention for their end-to-end maternity hotel services. During a Senate hearing in March 2026, various witnesses emphasized a range of concerns, especially potential national security threats posed by children born to nationals from U.S. adversarial nations. Reports indicate that over 500 companies operate in China facilitating birth tourism. However, unsubstantiated claims suggest that there could be around 1.5 million individuals in China whose U.S. citizenship emerged from birth tourism. National security discussions also influenced the Supreme Court hearings, with Justice Samuel Alito raising concerns about children of Iranian descent born in the U.S. being obliged to fulfill military obligations from Iran. The challenges and concerns surrounding birth tourism are not isolated to the United States. More than 30 nations offer birthright citizenship (jus soli), experiencing similar issues. Canada, for instance, has been embroiled in debates concerning 'maternity packages' and 'baby houses' marketed to foreign mothers. Ireland, which prior to a 2004 referendum was the last EU country to guarantee citizenship for all at birth, faced comparable worries. The U.K., inheritor of the birthright citizenship principle, abolished it in 1983 amid a reevaluation of nationality post-colonialism. The term 'birth tourism' has replaced the older, pejorative concept of 'anchor baby,' which described, since the 1970s, the practice primarily noting Mexican immigrants crossing the border to give birth to U.S. citizens, facilitating future legal immigration for their families. While Congress subtly addressed this in the Immigration and Nationality Act Amendments of 1976—setting a 21-year age requirement to sponsor relatives for green cards—it did not explicitly name birth tourism. However, a State Department memo acknowledged the issue, stating that the provision aimed to curb the practice among a sizable number of Mexican nationals gaining U.S. immigration through their citizen children. Concerns over potential growth in birth tourism, especially related to visa fraud and tax evasion by supportive businesses, emerged prominently during the Obama administration. In February 2015, the State Department clarified travel under a B-2 (visitor) visa for medical purposes—including giving birth—was lawful, yet emphasized compliance with certain medical care standards. Individuals had to provide documents from their home country's physician outlining the need for U.S. medical services, confirmation of a relevant U.S. medical team’s agreement to provide treatment, and proof of their ability to pay for the care. In 2015, the first federal investigations targeting Southern California maternity hotels emerged, followed by burgeoning criminal cases in 2019 against 19 individuals linked to birth tourism schemes. This scrutiny aimed to combat the growing phenomenon. A case involving USA Happy Baby was resolved in late 2024, resulting in prison sentences for its owners. The FBI has touched on the birth tourism issue as well, notably charging a Miami Mama employee in 2017 for passport application fraud. A regulation from the Trump administration in 2020 established a clear inadmissibility ground for B-2 visa holders linked to birth tourism, placing the onus on pregnant women to prove their visit intent excluded U.S. citizenship aspirations for their child. This shift purportedly targeted national security and fraud concerns. Proponents hailed the regulation as progress but argued it fell short, raising concerns about legitimate healthcare access and a potential shift towards more covert birth tourism practices. In light of revelations about wealthy individuals engaging U.S. surrogates for citizenship purposes, Senator Rick Scott (R-FL) proposed legislation to eliminate such practices. The recent ICE initiative began in April, concentrating on businesses involved in birth tourism, visa fraud, and associated financial crimes. The situation in the Commonwealth of the Northern Mariana Islands (CNMI)—situated roughly one-third of the distance between China and the continental U.S.—has caught congressional Republicans' attention due to perceived national security risks. The Guam-CNMI Visa Waiver Program enables nationals from selected countries to visit Guam or CNMI without a visa for up to 45 days, while the Economic Vitality and Security Travel Authorization Program (EVS-TAP) permits Chinese individuals visa-free access for 14 days. These programs, initiated in 2009 and capitalizing on the tourism sector, have prompted concerns about birth tourism since their adoption. Pregnant travelers using these visa-waiver programs evade the scrutiny faced by those traveling to the U.S. mainlands, leading to increasing birthing rates among foreign tourists. Reports indicate births jumped from fewer than ten in the year before the program's inception to around 600 by 2018. Yet, since then, adjustments to the policies have resulted in significant declines, with only 47 babies born to tourists reported in 2025, according to CNMI delegate Kimberlyn King-Hinds. As with the mainland, birth tourism in the Northern Mariana Islands raises complex policy issues. There are legitimate concerns about covert operations and visa fraud, illustrated by the sentencing of translator Sen Sun in 2018 for running an illegal birth tourism business. Conversely, tourism is vital to the islands' economy, making it imperative to balance scrutiny with potential revenue loss. Despite ongoing discussions and measures taken to tackle birth tourism, it has resurfaced prominently in recent Supreme Court arguments regarding birthright citizenship in Trump v. Barbara. While public perception may suggest the administration aims to reduce unauthorized immigration, its arguments heavily cited birth tourism. Solicitor General D. John Sauer noted that current accessibility to the U.S. differs significantly from 1868, when the 14th Amendment was ratified, signaling an urgent need for reform. However, Chief Justice John Roberts aptly remarked, “It’s a new world. It’s the same Constitution.” Central to the discourse is the interpretation of five words from the 14th Amendment, stating that citizenship is granted to individuals born or naturalized in the U.S. and “subject to the jurisdiction thereof.” The administration claims this phrase implies a requirement for domicile or permanent residency in the country, especially relevant to birth tourism. This assertion underscores the idea that unauthorized immigrants, being unlawfully present, lack a permanent intent to reside. On the contrary, challengers of the executive order draw from common law traditions underlying the 14th Amendment, asserting that domicile is geographically defined. They emphasize that exceptions to birthright citizenship are confined to English common law interpretations concerning diplomats and “alien enemies.” The administration's viewpoint equates domicile with political allegiance to the U.S., proposing that a lack of U.S. domicile also applies to children of unauthorized immigrants and those born in a birth tourism context, thus highlighting national security concerns. The administration has significantly ramped up immigration enforcement efforts, including advocating against birthright citizenship. It is notable that birth tourism, historically viewed as a peripheral issue, became integral to the current legal debate. Understanding when and why this evolution occurred remains uncertain. Yet, it is clear that birth tourism is a negligible phenomenon, presenting ongoing challenges regarding visa fraud, tax cheating, business integrity, and medical access—complex issues that intersect immigration, economic, and national security policies. Fortunately, existing executive actions have targeted the issue effectively, preventing birth tourism from morphing into a larger problem. Measures taken prior include regulations from 2020 that curtail B-2 visa use for sole purposes of birth tourism, ongoing investigations, and increased scrutiny of pregnant travelers to confirm their capacity to cover maternity and neonatal healthcare costs. Moving forward, proposals suggest strengthening collaboration with law enforcement agencies to disrupt businesses supporting birth tourism and implementing tighter scrutiny on pregnant travelers. In addition, some advocates are pushing for enhanced data collection aimed at accurately quantifying the scope and extent of birth tourism. By ensuring these measures are well-funded and efficiently executed, policymakers can address birth tourism issues without compromising constitutional integrity. Birthright citizenship, recognized as a core principle of American inclusivity and a constitutional protection established over 150 years ago to rectify historical injustices, remains vital. Eroding this principle to resolve a minor policy issue disregards the potential ramifications of eliminating birthright citizenship. Source: https://www.migrationpolicy.org/article/birth-tourism-trump

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