Richmond Hospital leads the way as birth tourism continues to rise

No new data in this report:

The number of pregnant foreigners coming to B.C. hospitals so their newborns can get automatic Canadian citizenship continues to rise.

Births by non-residents of B.C. increased 24 per cent from the 2016-17 fiscal year to 2017-18, from 676 babies to 837 the following year, according to records obtained through freedom of information requests.

About two per cent of all births in B.C. hospitals are now by non-residents, just as the birthrate among B.C. residents is dropping.

Richmond hospital continues to be at the forefront of the phenomenon, with the total number of babies born to non-residents of B.C. at the hospital rising from 337 in the 2014-15 fiscal year to 474 by 2017-18. Four years ago babies born to non-residents accounted for 15.4 per cent of all births at Richmond Hospital, compared to 22.1 per cent in the last fiscal year.

By comparison, St. Paul’s Hospital and Mount Saint Joseph Hospital — both operated by Providence Health Care — had a combined 132 babies born to non-residents of B.C. in the 2017/18 fiscal year.

While non-resident births account for about two per cent of all babies delivered in B.C., at Richmond Hospital, that proportion is 10 times higher. Indeed, as a New York Times article reported, the hospital is now perceived around the world as a coveted destination for so-called anchor babies, a term to describe children born here to non-residents to gain citizenship.

Health minister Adrian Dix is concerned by the numbers.

“The immigration issues are in federal jurisdiction. This is where concerns must be addressed, not by turning health professionals and skilled health care workers into immigration officers. That is not their role,” said Dix.

Richmond Mayor Malcolm Brodie agreed with Dix that birth tourism is a federal issue but said there are significant local impacts as well.

“As a city council, we haven’t discussed this but there are individuals who have concerns about the impacts on our already crowded hospital resources,” said Brodie, referring to the aging facilities and to situations when local women are diverted to other hospitals when Richmond Hospital is full.

Brodie said he supports a change to federal laws because he doesn’t believe anchor babies should get automatic citizenship.

“The practice of birth tourism should be curtailed,” he said.

Birth tourism is not illegal and a report by the Institute for Research and Public Policy showed that the numbers are climbing year after year. In 2017, there were at least 3,628 births, mainly in B.C., Alberta, and Ontario, by mothers who live outside Canada.

In 2016, Postmedia reported 295 of the 1,938 babies born at Richmond Hospital for the year ended March 31 were delivered, largely to foreign Chinese mothers. And dozens of birth houses were cropping up across the municipality, catering to women who need housing, meals, transportation and help with documents like birth certificates and passports.

As Dix has said, the provincial government has taken the approach that it doesn’t endorse the marketing and provision of birth tourism services but at the same time, patients needing urgent care can’t be turned away. 

While hospital staff cannot refuse care when women in labour arrive at the front door, Dix said measures have been put in place to help ensure taxpayers aren’t subsidizing the costs of non-resident hospital care.

For instance, late last year the ministry and Vancouver Coastal Health decided to raise fees charged to non-residents when they go to the Richmond Hospital. The cost for a vaginal birth increased to $8,200 from $7,200 and the cost of a caesarean section rose by $300 to $13,300. If their medical care becomes more complicated patients are assessed higher fees.

In 2017, Vancouver Coastal Health billed non-residents of B.C. about $6.22 million for maternity services at Richmond Hospital.

For maternity cases at Richmond Hospital … the majority of non-residents pay their bills in full,” said Vancouver Coastal Health spokesperson Carrie Stefanson. Approximately 80 per cent of billing to non-residents is recovered, she added.

But sometimes, as in the case of Yan Xia, a birth tourist from China, patients leave Canada after giving birth and leave behind a healthy bill.

Vancouver Coast Health has filed a lawsuit against Xia, who gave birth at Richmond Hospital in 2012. The bill for an extended stay in hospital due to complications totalled $313,000.

The case remains in legal limbo as Xia’s exact whereabouts are unknown and the bill may eventually have to be written off by Vancouver Coast Health.

Stefanson said the Xia case is believed to be VCH’s only maternity debt lawsuit over $100,000.

Richmond Liberal MP Joe Peschisolido has sponsored a petition calling on the federal government to end birth tourism. The petition garnered 11,000 signatures and denounces the practice as “abusive and exploitative” for “debasing” the value of Canadian citizenship. The Peschisolido petition was presented to Parliament last fall.

“The Government of Canada is committed to protecting the public from fraud and unethical consulting practices and protecting the integrity of Canada’s immigration and citizenship programs,” said Ahmed Hussen, minister of immigration, refugees and citizenship in response to the Peschisolido petition.

“To this end, (we) are currently undertaking a comprehensive review, with a view to developing additional information and strengthened measures to address the practices of unscrupulous consultants and exploitation of our programs through misrepresentation.”

Birth tourism will likely be an issue in the upcoming federal election as the Conservatives have vowed to withhold citizenship unless one parent is a Canadian or a permanent resident.

Source: https://vancouversun.com/news/local-news/richmond-hospital-leads-the-way-as-birth-tourism-continues-to-rise

When does birthright citizenship become citizenship for sale?

No new information and misses government response to petition (the ongoing study):

Kerry Starchuk’s activism begins with homemade granola cookies – specifically, when she took a plate to her new neighbors.

Except the man and a toddler boy who she heard bouncing a basketball outside, and the two pregnant women with them, hadn’t moved into the house next door to hers, where she has lived since 1988. Visitors from China, they were residing in her neighborhood only temporarily and didn’t respond to her greeting. After they awkwardly accepted her cookies, she never saw the group again.

It wasn’t the first time she’d seen pregnant women coming and going in her neighborhood or heard about why they were there. But the meeting began her personal battle against “birth tourism,” where wealthy mothers like the ones she encountered next door pay to give birth, get citizenship for their babies, and return home.

It is an issue gaining prominence across North America, where jus soli, or rules by which citizenship is determined by birthplace, is the standard practice (yet otherwise rare among developed countries, as in Europe where citizenship is more restricted and often granted along bloodlines). An online petition that Ms. Starchuk started against the practice last year, garnering some 11,000 signatures, was supported by a federal Liberal lawmaker representing Richmond. Meanwhile, the federal Conservatives, in opposition during an election year, voted on a motion last summer to tighten laws around birthright citizenship. In the United States, President Donald Trump has said he will end it by executive order.

Mr. Trump’s threat drew widespread criticism by critics who call it anti-immigrant pandering. But concerns about citizenship rules span partisan lines. In Canada, a poll from the Angus Reid Institute in March showed that while more believe birthright citizenship is a good policy than a bad one (40% versus 33%), 60% believed rules needed to be tightened to counter abuse of the system.

Ms. Starchuk, a part-time housecleaner, insists her position is not anti-Chinese or anti-immigrant but is about rules and values, especially in a region where foreign wealth and capital have changed the face of communities. In Richmond, the mothers hail mostly from China, lured by advertisements that sell all-inclusive packages including a stay at a “birth hotel.” Other hospitals in Toronto and Montreal have seen increases in mothers from Eastern Europe or Africa. A recent data analysis showed Richmond’s local hospital with the highest percentage of births to mothers residing outside Canada.

“It does undermine me, because I’m trying to build community and welcome my neighbors to the neighborhood,” she says. “And then I find out it’s not a single-family home where there’s going to be a new family but an international, underground birth-tourism hotel. … It’s like selling citizenship.”

An abuse of the system?

The issue under debate in Canada, which established citizenship rules under the 1947 Canadian Citizenship Act, is largely about the power of foreign money and how it devalues citizenship. The debate in the U.S., on the other hand, sometimes targets so-called anchor babies but revolves around undocumented migration. It was rekindled last fall with Mr. Trump’s threat, which has been highly polarizing.

The national conversations converge around questions of fairness and the changes people fear and perceive around them.

Joe Peschisolido, a Liberal lawmaker, says birth tourism is an abuse of the system. ‘It’s a business where people are making money off of the goodness of Canadians.’

Martha Jones, who wrote “Birthright Citizens: A History of Race and Rights in Antebellum America,” says that citizenship is always an evolving political question. In the U.S., questions about birthright citizenship arose in the early 19th century around the status of former slaves, which culminated in the 14th Amendment in 1868.

But that didn’t settle the issue, and in some ways the debate today is analogous to the one around former slaves because it leaves an entire class of people in a legal limbo. “It is a tragic example of the ways in which American lawmakers have failed in my view to fulfill their obligation to extend to people some basic sense of who they are,” Ms. Jones says.

In Canada, the Conservatives last summer voted that the party should support the position that a baby born in Canada should receive citizenship only if one parent is a Canadian or permanent resident.

Not all Conservatives agree with their party. Deepak Obhrai, a Tory lawmaker from Calgary, says that birth tourism abuses could be addressed with immigration procedures that target the parents but not the child. “It takes away the fundamental right of the child,” he says. “A Canadian is a Canadian is a Canadian.”

Those fighting birth tourism have been accused of overexaggerating the problem. Federal statistics show only 313 births by nonresident mothers in 2016. But new research using hospital financial data puts the number at 3,223 that year. One of 5 births at Richmond Hospital is to nonresident mothers, those figures show.

Joe Peschisolido, the Liberal lawmaker who sponsored Ms. Starchuk’s petition and is awaiting a government response, says it might not be illegal, but that doesn’t make it right. “It’s an abuse of the system,” he says at his offices in Richmond. “It’s a business where people are making money off of the goodness of Canadians.”

And it’s something that many in the community care about, he says. His next meeting is with a constituent who, on his way in, says he’s here to talk to Mr. Peschisolido about ending “birth tourism.”

Among some of the fiercest critics of birth tourism are Chinese immigrants in Richmond.

“Why would the parents want to get their children Canadian citizenship if they themselves don’t want Canadian citizenship?” says one mother, who didn’t want to share her name. She’s at Parker Place, one of several shopping centers catering to the Chinese community.

She emigrated to Canada in 1990 from Beijing and says she had to work hard to learn English. But today, Richmond is 54% Chinese, compared with 34% in 1996. And now newer Chinese immigrants don’t learn the language as she had to, she says, and Mandarin is increasingly heard in town.

‘It’s the unfairness of it’

It is easy to dismiss Ms. Starchuk, who also ran a campaign against Chinese-only signage in Richmond, in a country that embraces multicultural tolerance. But, as a fourth-generation resident of Richmond that has always been diverse, she says her fight is about inclusion and maintaining a healthy community.

This battle is, in fact, amplified by the backdrop of larger changes taking place around her in Greater Vancouver. Foreign money has pushed up housing prices and displaced locals, including her own grown children, who she says haven’t been able to purchase homes and instead rent in Richmond.

She says she probably wouldn’t have gotten involved in the birth tourism fight if it had not been in her backyard, literally.

“This is not ‘a nothing issue,’” says Ms. Starchuk, who has binders full of letters, petitions, and news clips she’s collected about her efforts.

She says not everyone will agree with her. “Some will say, about birth tourism, that they will do whatever they can to get to Canada, even if I have to cheat. Others will say, ‘I paid for it. Why shouldn’t I be able to get what I want?’”

Ultimately, though, it violates her sense of what it means to be Canadian.

“It’s the unfairness of it,” she says. “Citizenship is not partisan, Liberal or Conservative, but about Canadian values. When you’re an immigrant, you take and you contribute.”

“This,” she says, “is a free-for-all.”

Source: When does birthright citizenship become citizenship for sale?

ICYMI: This English same-sex couple fathered twins who are half-siblings — and a Canadian surrogate helped them

A different wrinkle to birthright citizenship (see earlier How Canada became an international surrogacy destination [another form of birth tourism]) as well as U.S. example below:

With two kids under two, the Berney-Edwards household in southeast England is a busy one. There are toddlers running all over the place. One pokes his dad in the eye and laughs before accidentally hitting his sister with a toy vacuum cleaner, causing her to wail. It can be a bit chaotic.

But Graeme and Simon Berney-Edwards wouldn’t have it any other way. As gay men, there was a time when they thought they could never have any of that.

Now, however, they have their twins, the result of an arrangement involving a Canadian surrogate and Canadian surrogacy laws they feel are more progressive than those on the books in the United Kingdom.

“You see them tearing around and they’re having fun, and just for a moment, you just sort of step back and go ‘Wow, this is it. They’re here,’ ” Simon Berney-Edwards said in an interview at their home in Redhill, south of London.

“It can be very surreal,” his husband Graeme Berney-Edwards chimed in.

When they decided surrogacy was the way they would have a family, they reached out to a surrogacy organization that helped them understand their options.

That organization connected them with a clinic in Las Vegas where in vitro fertilization took place. That’s also where they learned they could have twins and each be a biological father to one child by fertilizing half of their American donor’s eggs with Simon’s sperm, the other half with Graeme’s sperm, and then implanting the embryos in the same surrogate.

It means Alexandra and Calder, now 21 months old, are twins but only half-siblings. Born just minutes apart, they have the same biological mother, but different fathers.

They quickly chose to have the birth take place in Canada rather the U.K. That was because, they say, the surrogacy laws in their country are dated, primarily as a result of the U.K. considering the surrogate, and her partner, if she has one, to be the legal parents for the first six weeks of the child’s life.

“And in that time, if the surrogate decides to change their mind, you have no recourse,” said Simon Berney-Edwards. “Basically, that’s it. Your child is gone.”

Andrew Spearman, a British fertility and surrogacy lawyer, said the U.K. laws are “archaic” and that many of his clients turn to Canada for surrogacy.

“I think it gives an element of certainty. It gives the transparency, which we can’t offer always, and it gives a very clear structure,” he said in his London office.

Spearman said while U.K. surrogates and intended parents do draw up contracts outlining their agreement, the contracts aren’t legally binding as they are in Canada.

Neither country allows surrogates to be paid, other than to cover their expenses, which Spearman said helps British parents explain the process to English courts when they return home. They still need to get a “parental order” in the U.K. that makes them legal parents and gives their children U.K. citizenship.

The Berney-Edwards say they were also drawn to the altruistic nature of Canadian surrogacy because they wanted more than a “transactional” experience.

“We wanted someone that was prepared to be part of a family throughout the children growing up,” said Graeme Berney-Edwards.

After consulting a website that has profiles of women wanting to be surrogates, they found that in Meg Stone of Hamilton, Ont. Stone said that’s also what drew her to them.

“They mentioned that they wanted twins and I’m always up for a challenge,” she said. “And they also said they wanted lifelong friendship, which was also something I wanted.”

After a couple of false alarms that saw the dads dashing off to Canada early, Alexandra and Calder were born on June 25, 2017, in Hamilton, where they stayed for the first seven weeks of their lives.

Stone, who has two of her own children, has continued to watch the twins grow from afar, swapping messages and photos and even making the trip to England for the twins’ first birthday.

Her 12-year-old son, Jeffrey Seroski-Stone, said he’s proud of his mom for helping to create a family.

“I think it’s exciting how my mom ended up helping them out by giving them children, and I think we usually have a really good time, so I consider them to be like family to me,” he said.

Stone is pregnant with twins again, helping another same-sex family have children.

“I love being a mom and why wouldn’t I want to help somebody else do that, too?” she said.

She maintains she wouldn’t want to be paid for helping others have children, but there is a debate in Canada about whether paying surrogates should be decriminalized.

The current Canadian law came into force in 2004 and prohibits paying surrogates other than to reimburse them for certain medical and maternity costs.

The federal government is reviewing the legislation, including identifying categories for reimbursement and making them more clear. A Liberal MP tabled a private member’s bill that would decriminalize payments to surrogates but opponents say it amounts to commercializing a woman’s body.

Stone disagrees with the idea that a surrogate be given the chance to change her mind, as is set out in the current U.K. law.

“I never felt like they were mine to give away,” she said. “They were [with] me to watch and nurture until Simon and Graeme were able to.”

The Berney-Edwards say when it comes to surrogacy law, Canada has it right, but that doesn’t mean it was easy or cheap.

They won’t put a figure on it, but experts say they would have spent tens of thousands of dollars on Stone’s expenses, agency and legal fees, not to mention three trips back and forth to Canada.

“But it was worth it,” said Simon.

“Every single penny, cent, was worth it,” said Graeme.

Although none of their biological parents is Canadian, Alexandra and Calder are Canadian citizens because they were born in the country, and their fathers say it’s an important part of their heritage.

They look forward to the day they can explain to their children how they came into the world, how badly they were wanted and how much love was around them.

In fact, they’ve already started to do just that.

As the children begin to get ready for bed, the entire family sits on the living room floor sharing a story.

Simon reads aloud, “Before I settle down to sleep, I’ll blow a kiss goodnight, to make sure all of Canada will have sweet dreams tonight.”

Source: https://www.cbc.ca/news/world/u-k-canada-same-sex-surrogacy-twins-half-siblings-1.5069654

In 2016, a married gay couple in Canada became parents of twins using a surrogate mother. One father is a U.S. citizen, the other an Israeli citizen. The two fathers made a decision to contribute one embryo each to the surrogate mother so the twins would be biologically related to each of them. However, that turned out to be a determinative factor when the parents went to the U.S. Consulate in Toronto to register the twins for U.S. citizenship. Only one of the twins, Aidan, who was biologically related to his U.S. citizen father, was granted a U.S. passport. The family was devastated by this decision. When the Dvash-Banks family decided to move to California, the other twin, Ethan, had to enter as a visitor on a B visa. His B visa eventually expired, leaving him “undocumented.” [both are Canadian given  birthright citizenship]

With regard to children born in wedlock, section 301 of the Immigration and Nationality Act states that a “child born outside of the United States . . . acquires citizenship at birth if at the time of birth one parent is a foreign national and the other parent is a U.S. citizen; and the U.S. citizen parent was physically present in the United States for at least 5 years, including at least 2 years after 14 years of age.” Section 309, which applies to children born out of wedlock, requires, among other things, that “blood relationship between the child and the father is established by clear and convincing evidence.” The State Department, in its published policy, apparently reads the “blood relationship” clause into section 301 and would not budge on that policy for the Dvash-Bankses.

The Dvash-Bankses challenged the Department of State’s (DOS) decision with regard to Ethan in the U.S. District Court, Central District of California. In response to a motion for summary judgement, Judge John F. Walter declared that Ethan was a U.S. citizen and ordered DOS to issue him a U.S. passport as soon as possible. The order applied only to Ethan and did not prevent DOS from applying its “blood relationship” policy to other families. In post-summary judgement proceedings, the Dvash-Bankses argued, “The State Department’s refusal to approve [Ethan’s] applications . . . and its persistence in litigating this action full-bore to summary judgement, was manifestly unreasonable and not substantially justified.” The Judge awarded $1.3 in attorney’s fees and costs to the couple.

Ethan’s fathers believe that a straight couple who had used assistive reproductive technology would never have been asked to submit to a DNA test, as they were required to do by DOS. In a similar case, a lesbian couple of one U.S. citizen and one Italian citizen whose children were born in London brought a claim in the federal district court in D.C. – using the same lawyers who represented the Dvash-Banks family.

Source: Birthright Citizenship for Child of Same Sex Couple

South Florida Sees a Boom in Russian ‘Birth Tourism’

Another birth tourism centre and clientele:

Every year, hundreds of pregnant Russian women travel to the United States to give birth so that their child can acquire all the privileges of American citizenship.

They pay anywhere from $20,000 to sometimes more than $50,000 to brokers who arrange their travel documents, accommodations and hospital stays, often in Florida.

While the cost is high, their children will be rewarded with opportunities and travel advantages not available to their Russian countrymen. The parents themselves may benefit someday as well.

And the decidedly un-Russian climate in South Florida and the posh treatment they receive in the maternity wards — unlike dismal clinics back home — can ease the financial sting and make the practice seem more like an extended vacation.

The Russians are part of a wave of “birth tourists” that includes sizable numbers of women from China and Nigeria.

President Donald Trump has spoken out against the provision in the U.S. Constitution that allows “birthright citizenship” and has vowed to end it, although legal experts are divided on whether he can actually do that.

Although there have been scattered cases of authorities arresting operators of birth tourism agencies for visa fraud or tax evasion, coming to the U.S. to give birth is fundamentally legal. Russians interviewed by The Associated Press said they were honest about their intentions when applying for visas and even showed signed contracts with doctors and hospitals.

There are no figures on how many foreign women travel to the U.S. specifically to give birth. The Center for Immigration Studies, a group that advocates for stricter immigration laws, estimated that in 2012, about 36,000 foreign-born women gave birth in the U.S., then left the country.

The Russian contingent is clearly large. Anton Yachmenev of the Miami Care company that arranges such trips, told the AP that about 150 Russian families a year use his service, and that there are about 30 such companies just in the area.

South Florida is popular among Russians not only for its tropical weather but also because of the large Russian-speaking population. Sunny Isles Beach, a city just north of Miami, is even nicknamed “Little Moscow.”

“With $30,000, we would not be able to buy an apartment for our child or do anything, really. But we could give her freedom. That’s actually really cool,” said Olga Zemlyanaya, who gave birth to a daughter in December and was staying in South Florida until her child got a U.S. passport.

An American passport confers many advantages. Once the child turns 21, he or she can apply for “green card” immigration status for the parents.

A U.S. passport also gives the holder more travel opportunities than a Russian one; Americans can make short-term trips to more than 180 countries without a visa, while Russians can go visa-free only to about 80.

Traveling to the U.S. on a Russian passport often requires a laborious interview process for a visa. Just getting an appointment for the interview can take months.

Some Russians fear that travel opportunities could diminish as tensions grow between Moscow and the West, or that Russia might even revert to stricter Soviet-era rules for leaving the country.

“Seeing the conflict growing makes people want to take precautions because the country might well close its borders. And if that happens, one would at least have a passport of a different country and be able to leave,” said Ilya Zhegulev, a journalist for the Latvia-based Russian website Meduza that is sharply critical of the Kremlin.

Last year, Zhegulev sold two cars to finance a trip to California for him and his wife so she could give birth to their son.

Trump denounced birthright citizenship before the U.S. midterm election, amid ramped up rhetoric on his hard-line immigration policies. The president generally focuses his ire on the U.S.-Mexico border. But last fall he mentioned he was considering executive action to revoke citizenship for babies born to non-U.S. citizens on American soil. No executive action has been taken.

The American Civil Liberties Union, other legal groups and even former House Speaker Paul Ryan, typically a supporter of Trump’s proposals, said the practice couldn’t be ended with an order.

But others, like the Center for Immigration Studies, which advocates for less immigration, said the practice is harmful.

“We should definitely do everything we can to end it, because it makes a mockery of citizenship,” said Mark Krikorian, executive director of the Center for Immigration Studies.

Vladimir Zhirinovsky, an outspoken Russian lawmaker, said the country can’t forbid women from giving birth abroad, and many of them also travel to Germany and Israel.

“Trump is doing everything right, because this law is used as a ploy. People who have nothing to do with the U.S. use it to become citizens,” Zhirinovsky said.

Floridians have shown no problem with the influx of expectant mothers from Russia.

Yachmenev, the agency manager, says he believes it’s good for the state because it brings in sizable revenue.

Svetlana Mokerova and her husband went all out, renting an apartment with a sweeping view. She relished the tropical vibe, filling her Instagram account with selfies backed by palm trees and ocean vistas.

“We did not have a very clear understanding about all the benefits” of a U.S. passport, she said.

“We just knew that it was something awesome,” added Mokerova, who gave birth to a daughter after she was interviewed.

Zemlyanaya said that even her two nights in the hospital were a treat, like “a stay in a good hotel.”

In contrast to the few amenities of a Russian clinic, she said she was impressed when an American nurse gave her choices from a menu for her meals.

“And then when she said they had chocolate cake for dessert, I realized I was in paradise,” Zemlyanaya added.

She even enjoyed how nurses referred to patients as “mommies,” as opposed to “rozhenitsa,” or “birth-giver” — the “unpleasant words they use in Russian birth clinics.”

Zemlyanaya said she was able to work remotely during her stay via the internet, as were the husbands of other women, keeping their income flowing. Yachmenev said his agency doesn’t allow any of the costs to be paid by insurance.

Most of the families his agency serves have monthly incomes of about 300,000 rubles ($4,500) — middling by U.S. standards but nearly 10 times the average Russian salary.

Yachmenev said he expects that birth tourism among Russians will only grow.

Business declined in 2015 when the ruble lost about half its value, but “now we are coming back to the good numbers of 2013-14,” he said.

Source: South Florida Sees a Boom in Russian ‘Birth Tourism’