Is ‘birth tourism’ a problem in Canada? Doctors on frontline of debate

All the available evidence shows that the numbers are extremely small, both in absolute terms and in relation to the overall number of births in Canada.

IRCC, if it is not already doing so, should be systematically collect better quality data, working with provincial health ministries, rather than the piece meal data that we have now.

Despite the small numbers, there is a need to regulate or prohibit birth tourism consultancy services to avoid a further increase in the numbers. The CMA might also wish to take a more pro-active role.

Changing birthright citizenship, as the previous government learned, is not feasible without provincial buy-in given the various linkages between provincial vital statistics agencies and healthcare systems and any measure to restrict birthright citizenship:

Birth tourism appears to be on the rise in some parts of Canada, raising questions for doctors and hospitals, as well as debate about Canada’s practice of offering instant citizenship to infants born in the country.

“We sense there’s a growing demand in birth tourism from several countries, especially considering the instability in today’s world,” Alex Davidson, managing partner of the Toronto-based LP Group, told CTV News. “There are more and more people coming in and approaching us.”

Davidson said he typically sees two types of clients. Some are wealthy individuals, often from European countries, who want a “second passport” for their children and are able to pay anywhere between $10,000 and $20,000 to deliver a baby in Canada.

Davidson said some of his recent clients have included U.K. residents worried about the post-Brexit future once their country leaves the European Union.

Others are people from poor, crime-ridden countries who want to provide security for their children, and hope that their Canadian babies can provide an anchor in the country for the rest of the family.

“Canada has been perceived — well, it is — as a safe harbour on this planet,” Davidson said.

He said LP Group helps birth tourism clients find temporary accommodations in the country and the firm also has a list of Canadian doctors who are willing to see foreign patients.

“Elena” is a pregnant woman from Russia now awaiting to give birth in Toronto. She spoke to CTV News on condition of anonymity.

“My baby will get Canadian citizenship upon delivery and also with a Canadian passport he will get some benefits like free school and free healthcare,” she said. “It is good for the baby I think because the baby gets to choose if he wants to live in Russia, as in my case, or in Canada.”

At a recent Society of Obstetricians and Gynecologists of Canada conference, Dr. Fiona Mattatall an obstetrician in Calgary, presented figures that show an increase in the number of overseas patients who have given birth in Calgary hospitals.

She said there are now about 10 “passport babies” born each month in the city’s hospitals. Her survey also found many doctors are uncomfortable with the practice.

While many overseas patients pay to have their babies delivered in Canada, some do not, leaving hospitals on the hook for the costs.

Dr. Saul Pytka, a Calgary anesthesiologist, said he’s alarmed by the issue.

“I am frustrated — and I have to be honest, angered — by the fact that as a society we are being abused. I think we are a very generous society,” he said.

Under the Citizenship Act, all babies born on Canadian soil are automatically granted citizenship, except for children of foreign diplomats.

Canada and the United States are the only G7 countries that have birthright citizenship. Other countries like France, Germany and Australia have revoked automatic citizenship unless at least one of the parents is a national citizen.

Birth tourism is not illegal in Canada. There is no official federal data on “birth tourism,” and some say the numbers are still small. According to Statistics Canada figures from 2012, the most recent year for which numbers are available, there were only 699 babies born in Canada to foreign mothers out of more than 382,000 births across the country.

But one immigration consultant says there has “certainly” been an increase in birth tourism in Canada over the past few years with sites advertising companies that assist in getting pregnant women to Canada.

“The best gift you can give your child is a Canadian passport” says one website.

A potentially costly overhaul

In 2014, immigration officials urged the Conservative government to restrict granting citizenship by birth on Canadian soil to children with at least one parent who is a citizen or permanent resident.

But the report cited limited data and possible increased costs to provinces and territories as potential barriers to legislation reform.

Will Tao, a Vancouver-based immigration lawyer, told CTV News Channel last week that overhauling birthright citizenship rules could be extremely costly for Ottawa.

“Let’s actually look at what are the motivating factors, what are the organizations that are working abroad, perhaps without reference to Canadian law, and promoting individuals to come here,” Tao said.

Online searches turn up dozens of organizations and groups in various countries that offer advice and help facilitate travel for women who want to give birth in Canada.

“Perhaps it is not illegal right now, but perhaps it needs to be curbed or organizations that are running the services need to be stopped,” Tao said.

He also said that panic over birth tourism, especially in British Columbia, is being fuelled by a “general misunderstanding of who a foreign national is.”

Many foreign nationals have study or work permits, “and in my mind these individuals are all on the pathway to permanent residency,” Tao said.

A petition that seeks to eliminate automatic citizenship for babies born to foreign nationals in Canada is adding fire to the debate.

Kerry Starchuk, a Richmond, B.C., woman, is calling on the federal government to enact legislation that will require at least one parent to be a Canadian citizen or permanent resident in order for a baby born on Canadian soil to be granted automatic citizenship.

The petition, sponsored by Conservative MP Alice Wong, has garnered more than 6,700 signatures since June 16 and will eventually be introduced in the House of Commons.

Starchuk said she started the petition because she suspects a house next door to hers serves as a motel for pregnant foreigners who come to Canada to secure birthright citizenships for their babies.

Source: Is ‘birth tourism’ a problem in Canada? Doctors on frontline of debate | CTV News

In a related story, the Canadian Medical Protective Association highlights potential medical and liability issues:

The Canadian Medical Protective Association is cautioning doctors about providing medical services to birth tourists coming here to have babies in order to acquire Canadian citizenship for their newborns.

“Canadian physicians who provide care to non-residents are at increased risk of medical-legal difficulties arising outside of Canada,” says a notice from the CMPA. “The Association is not structured to assist when medical-legal actions are instigated by non-residents outside of Canada.”

The CMPA is the legal defence organization for doctors; it provides and pays lawyers and settlements when doctors are sued for malpractice by Canadian patients. The new bulletin to physicians regarding medical tourism is relevant and timely, given a local trend where an ever-increasing number of non-residents (from 18 in 2010 to 339 last year) are having their babies, mostly at Richmond Hospital. The Vancouver Sun and The Province have reported that the provincial government is now aware of more than two dozen “birth houses” where pregnant women stay prior to, and after, the births of their babies, before returning to China.

Birth tourism brokers marketing their services show photos of Lower Mainland hospitals and lists of Mandarin speaking doctors to deliver babies.

The CMPA statement — titled “Emerging trends and medical-legal risks in medical tourism” — warns that while there are still more Canadians travelling abroad for medical treatment than foreign visitors coming here, there are risks to think about for both patient groups. Doctors should ensure foreign patients sign agreements promising not to sue outside of Canada and they should also make sure they fully document discussions with non-residents and the care provided to them.

 The CMPA said it cannot share information about the number of doctors sued by birth tourists. But it is attuned to the broader trend of medical tourism.

“We have published guidance for physicians on the medical-legal risks associated with medical tourism and the steps they can take to mitigate risks associated with this practice,” said Dr. Doug Bell, a managing director at CMPA.

Source: Canadian birth tourism doctors cautioned on risk of liability | Vancouver Sun