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Foreigners Seeking US Citizenship for Children Flout Law, Can Endanger Babies

by Jesusemen Oni

   Face covered in tears, Agnes endured each painful contraction in the
   basement where she had spent the past few months. Several hours later,
   she finally went to the emergency room of a Washington, D.C., hospital.
   Her husband, at home in Nigeria, cried when told by phone that she had
   delivered a healthy baby boy.

   Their dream was finally reality: They had a son, one with a
   "guaranteed" future.

   "I wanted to give my child an American passport," said Agnes, whose
   surname is being withheld to protect her child. "We believe when we
   come down there to have our babies, they are sure of a better future."

   Much of the debate about immigration has been over whether to build a
   wall along the U.S.-Mexico border, whether to halt refugees from
   entering the U.S., and what to do about the families who have settled
   in the United States illegally.

   On the campaign trail, President-elect Donald Trump dominated the
   airwaves, due in part to his calls for tighter immigration controls.

   "I wanted to give my child an American passport," said Agnes, whose
   surname is being withheld to protect her child. "We believe when we
   come [to the U.S.] to have our babies, they are sure of a better
   future." (J. Oni/VOA)

   However, for thousands of foreigners who desire American residency,
   there is no need to go through lengthy immigration or asylum
   procedures. Instead, a "baby on the way" is all it takes to gain access
   to land.

   There are no laws prohibiting foreigners from traveling to the United
   States to give birth; the children born here are automatically American
   citizens, according to the Constitution. However, in the attempt to
   gain citizenship for their children through birth, many commit
   immigration fraud, exploit the health care system and in some cases
   place the lives of the babies in jeopardy.

   Illegal access

   "There is nothing in the law that makes it illegal for pregnant women
   to enter the United States," said Virginia Kice, spokeswoman for U.S.
   Immigration and Customs Enforcement. She added, however, that the "vast
   majority" of women hoping for an American child misrepresent the
   purpose of their visit in order to gain tourist visas. That, Kice said,
   is criminal.

   Even if they declare they are entering the U.S. to give birth, there is
   another barrier to overcome. The State Department notes visas are
   granted on an individual basis, but the family must provide proof of
   sufficient funds to cover any planned and unplanned medical costs.

   The 14th Amendment grants citizenship to "all persons" born on U.S.
   soil, regardless of the laws broken to be born here. The United States
   is in the minority of countries that still grant birthright
   citizenship. (J. Oni/VOA)

   Agnes, who improperly used a tourist visa, said many of her friends
   were denied visas for disclosing the truth of their pregnancies. "Some
   of them were turned back at the airport simply because they want to
   come and have the child," she said.

   For those who make it through border controls without the right
   documentation, there is no threat of a penalty to the newborn. The
   child is still considered a beneficiary of the 14th Amendment, which
   grants citizenship to "all persons" born on U.S. soil, regardless of
   the laws broken to be born here.

   The United States is in the minority of countries that still grant
   birthright citizenship.

   And that has some Americans deeply upset.

   "It's totally inappropriate to bestow U.S. citizenship on the child
   without requiring a minimum residency requirement," said Dan Stein,
   president of the Federation for American Immigration Reform (FAIR), a
   group opposed to birthright citizenship.

   Stein argued that the 14th Amendment was never intended to undermine
   immigration controls by "allowing people to manipulate the system so
   that they could give birth to the people here, even though they really
   have no attachment to the community."

   While there are no official numbers on "birth tourism," the Center for
   Immigration Studies estimates that about 36,000 women come to the
   United States every year to give birth so their children can
   automatically become American citizens. CIS, which favors lower levels
   of immigration, reports that "birth tourism" is largely practiced by
   Chinese, but families also come from Taiwan, South Korea, Nigeria,
   Turkey, Russia, Brazil and Mexico.

   Many of these "birth tourists" hail from countries with economic or
   environmental instability; while some are motivated by the availability
   of better health care in the U.S., others hope the child may one day
   serve as the family ticket to the "American dream."

   This Chinese online forum on having babies in the United States
   includes links to and ads for businesses promoting one-stop birth
   tourism services. (J. Oni/VOA)

   These children are able to return to the United States at any time to
   receive opportunities reserved for residents, including free public
   education during the primary and secondary years, government aid and
   scholarships. They are also eligible for certain jobs, including many
   government positions.

   An added benefit is that a U.S. passport also allows visa-free or
   visa-on-arrival travel to most countries in the world -- 174, according
   to Henley & Partners, a global ranking firm. Perhaps the most coveted
   privilege is that these children, when they turn 21, can sponsor a
   green card for their parents.

   Very lucrative business

   Several U.S. and international businesses have seen birth tourism as
   their passport to wealth. These outfits give promises of healthy
   babies, with "USA" stamped on their backsides, while charging fees up
   to $80,000.

   Federal authorities raided several birthing houses last year in
   California, a hot spot for such businesses catering largely to Chinese
   women.

   According to affidavits by federal investigators, the companies offered
   not just lodging, meals, drivers and translators, but also counseling
   on how to fraudulently secure visas, deceive U.S. immigration
   authorities and scam hospitals.

   Undercover agents posing as clients were instructed by agencies to
   arrive two to three months before due dates, to wear loose clothing to
   hide protruding bellies and how to respond to customs officers in order
   to conceal the true intention of their visit.

   In the investigation of Chao Chen and Dong Li, who ran one of the
   raided birthing operations (You Win USA), court documents state that
   while customers had the ability to pay $50,000 to the business owners,
   they failed to pay hospital bills that often exceeded $25,000 per
   birth. In most cases, customers paid about $4,000, an amount designed
   for indigent or low-income patients lacking insurance. In some cases,
   the families paid nothing at all.

   According to ICE, the cases are all still pending, but depending on the
   nature of the activity and financial dealings of the business owners of
   such schemes, the birth house operators may also be charged with
   conspiracy and money laundering in addition to visa fraud.

   Despite the federal crackdowns, businesses continue to market to a
   broad range of clients while representing American childbirth as an
   affordable option. Deluxe Childbirth Services targets African parents
   with ads promising an "error-free" birth in the U.S. for $6,000 or
   less. The business, based in California and Lagos, Nigeria, was
   co-founded in 2012 by a Nigerian woman who herself gave birth to three
   children in the United States.

   In August, a private New Jersey hospital was exposed for advertising
   birthing services to families in Russia. "Childbirth in New York is the
   best investment in the future of your family!" read the
   Russian-language AmeriMama website, since taken down.

   According to a report by NJ Spotlight, the "AmeriMama" program at
   Meadowlands Hospital Medical Center offered to arrange medical services
   and secure the baby's citizenship papers, passports and travel visas
   for fees ranging from $8,500 to $27,500. The hospital is now under new
   management; no charges were brought against the former managers.

   Agnes' daughter holds her baby brother, born in a Washington, D.C.
   hospital, for the first time. (J.Oni/VOA)

   Dangerous way to save

   Back in her Lagos apartment, Agnes, the woman who spent part of her
   labor in a Washington basement, grappled with what she called the
   "Naija hustle": erratic electricity and surging prices for necessities
   like rice and cooking gas. Over the phone, the 33-year old mother of
   two complained about life in a country dealing with its worst economic
   downturn in more than a decade and plagued with a reputation of
   corruption across all levels of society.

   That's why, she said, her family looked for ways to cut corners in her
   pursuit of U.S. citizenship for her younger child. Instead of an
   agency, Agnes opted to stay with a family recommended by her pastor.
   She also avoided regular checkups with an obstetrician, even after her
   pregnancy went several weeks past her estimated due date.

   "I was scared I couldn't afford it," she said. "I was avoiding a lot of
   costs, like the antenatal [pre-birth] fee." Instead, she found a
   registered nurse who was willing, off the books, to stop by the house
   to administer a drug to induce labor. The medicine causes intense
   contractions and calls for close fetal monitoring, which was not done.

   According to Olu Ibironke, a former midwife in Nigeria, foregoing
   proper medical oversight is a cost-cutting practice common among
   African birth tourists, with many choosing to not see a doctor until
   after their water breaks.

   "It is cheaper but it is dangerous," said Ibironke.

   Now serving as a registered nurse in a Maryland maternity ward, she
   told of a pregnant woman who arrived at the hospital for delivery and
   discovered her baby no longer had a heartbeat.

   "A full-term baby! What do you say to that?" she added. "Sometimes it
   doesn't work out for them."

   Researchers at Children's Hospital of Orange County, in southern
   California, documented more deaths and higher complications in the
   neonatal intensive care unit among babies born to the birth tourist
   families.

   "They were more likely to need surgery" said Dr. Michel Mikhael, lead
   author of the study. "And just because they have more complex problems,
   they were more likely to stay in the hospital longer."

   Longer hospital stays amount to even higher bills in a country where
   the costs for medical services are rising. For some families, the quest
   to save money becomes dangerous.

   "That's the first thing they will ask -- if he [the baby] is going to
   stay in [intensive care], how much am I going to come out with?" said
   Ibironke.

   Mikhael added that many of the families in the study originated from
   the Middle East and China where, he said, treatment is sometimes based
   on cost rather than medical need.

   "We come across a lot of times when a family says, 'OK, so how much