As part of a series on birthright citizenship, Marketplace’s China correspondent Jennifer Pak explores why Chinese parents come to America to give birth. You can read more about how parents make the decision to have a child in the U.S., the agencies that help families arrange the trip, and the U.S. medical care they receive on arrival.
Thousands of Chinese parents-to-be make the trip to give birth in the U.S. every year so that their kids are born American citizens, according to experts in the industry.
Under the 14th Amendment to the Constitution, children born on U.S. soil are granted citizenship automatically, regardless of where their parents are from.
According to the CIA World Factbook, the U.S. is one of more than 30 countries and territories worldwide that offer citizenship by location of birth.
A map by Quartz shows the status of citizenship acquisition around the world:
Agencies across China charge parents tens of thousands of dollars to make all the arrangements to give birth in the U.S. — everything from help with visas and booking air travel to arranging stays in apartments and postpartum care.
This is the typical three-month journey that those pregnant mothers make.
Step 1: Sign with an agency
A search using phrases like “going to the U.S. to give birth” or “American baby” on the popular Chinese search engine Baidu yields some 4 million results.Many agencies list fees starting at $20,000. Some can charge more than a $100,000 depending on the accommodation pregnant mothers choose for their U.S. stay. Read more about what agencies provide here.
Step 2: Apply for a U.S. tourist visa
In late 2014, the United States made it easier for individual Chinese citizens to visit America by issuing 10-year tourist and business visas under a reciprocal agreement with China.
Still, the process of obtaining a visa is complex. Agencies assist families in filing applications and offer guidance on what to expect during face-to-face interviews at U.S. embassies or consulates.
Step 3: Interview at the U.S. embassy/consulate
Parents usually apply for tourist visas for medical purposes.
“Travel to the United States for medical purposes does not in and of itself make an applicant ineligible for a tourist visa,” a U.S. consulate spokesperson in Shanghai wrote in a statement to Marketplace.
Read more about what families go through here.
Step 4: Travel to the U.S.
Pregnant Chinese mothers usually arrive in the U.S. during their 30th week of pregnancy, sometimes with their spouse and relatives in tow.
Agencies provide transportation from the airport to their accommodation. They offer clients a range of apartments and suburban homes to choose from. The homes are so much larger than homes in Chinese cities that agencies refer to them as “villas.”
Step 5: Wait 60 days in the U.S., then give birth
Agencies provide pregnant mothers three meals a day and recommend doctors.
They also organize outings and activities like shopping trips.
Agencies often advertise “pain-free births” in the U.S. in their brochures because epidural anesthesia is uncommon in China.
Step 6: “Sitting the month”
The agencies also arrange for professional Chinese maternity care after birth called “sitting the month.” New mothers eat special foods and avoid the elements to regain their strength.
Step 7: Obtain the child’s American passport
Agencies assist new parents with applying for American passport and other identification documents so that the newborn can travel back to China.
Step 8: Return to China
Once new mothers recover, they return with their babies to China.
The agencies assist families with enrolling the newborns in China’s household registration system.
While China does not recognize dual nationalities, entering the household registration system essentially gives U.S.-born babies access to public schools, hospitals and the same rights as Chinese citizens.
Additional research by Charles Zhang.