birth tourism uk

Andrew Henderson

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Birth Tourism: 31 Countries Giving Birthright Citizenship

Last updated October 28, 2020

Dateline: Kuala Lumpur, Malaysia

If you have spent any time on our blog, you probably already know that there are a number of ways to get a second passport , depending on how badly you want one.

We recently discussed 13 citizenships you could get rather easily by using one of the oldest tricks in the book: marrying a foreigner .

However, obtaining second citizenship for your children and future generations is just as important – if not more so. 

For years, surveys such as The Best Places to Be Born , the Better Life Index , the Human Development Report , and many Quality o f Life Indices have chronicled where children are likely to have it best.

I recently discussed this in my article on tips for parents-to-be , suggesting that parents who apply our principles of international diversification practice something called “ birth tourism .”

If you live in the United States, you have probably heard the term “anchor baby” – when a non-citizen gives birth to a child in a country with birthright citizenship to gain residence and citizenship advantages – positioned in a bad light. However, there is nothing stopping you from using the same principle to give your kids a head start in other countries around the world.

Parents have a unique opportunity to choose the best country to give birth in. It’s an opportunity even western citizens should consider since even the “first world” United Kingdom failed to crack the top 20 places in which to give birth, falling behind the likes of Montenegro and Lithuania . The study concluded that children born in Britain suffer higher infant mortality rates than many emerging countries.

So, how can you take advantage of the quality of life in other countries to give your child a better future by securing them a second passport just by being born? In this article, we’ll tell you how and where you can take advantage of birthright citizenship to do just that, and maybe even earn a second passport for yourself in the process.

How Does Birth Tourism Work?

When it comes to determining a child’s citizenship at birth, countries usually apply one of two rights: jus soli (right of soil) or jus sanguinis (right of blood).  Jus soli grants citizenship merely on the basis of being born “on the soil” of the country in question.  Jus sanguinis determines the child’s citizenship based on the parents’ nationality.

Birth tourism is simple: give birth in a country that grants citizenship based on  jus soli and provides benefits to all children born there. This will not only give your child a better qualify of life but also entitle them to a second passport immediately from birth. In many cases, parents of such children enjoy a faster naturalization timeline as well.

The process of “ jus soli ” is generally available to anyone who has a child within the territory of a country with birthright citizenship, even if they are a temporary resident or an illegal alien. The only people whose children do not qualify for instant citizenship are diplomats.

These countries offer what is called “ absolute jus soli ,” meaning that the biggest hurdle you’ll face in some countries is having to register your bundle of joy with the local authorities to secure their passport.

The United States and Canada are the only “first world countries” that offer unconditional citizenship to children born in the territory, although there are plenty of other excellent places that I would actually prefer to live in that offer this as well.

Here in Asia, Mainland Chinese parents often seek to give birth in Hong Kong to obtain the “right of abode” for their children. (Hong Kongers are Chinese citizens, but with special privileges to reside in Hong Kong.)

Of course, we know that the United States offers birthright citizenship for the same reasons that ancient Rome did: to increase the number of US tax-payers needed to pay off the country’s catastrophic debts.

Giving birth to a child in the United States is setting them up for a lifetime of taxes which they can’t even get out of without renouncing their citizenship. That means even opening a bank account for their college savings will require you to file paperwork with the US government.

What Countries Offer Birthright Citizenship?

For those who want to bestow their child with a second citizenship outside of the highly taxed western world, there are a number of places that offer “jus soli” or birthright of the soil.

Any child born within that country’s territory becomes a citizen at birth, and there are dozens of countries whose laws allow the practice. So, which countries automatically give a passport and citizenship to children born there, regardless of the nationality of the child’s parents?

Almost two decades ago, Ireland amended its constitution to end their practice as the last European country offering unconditional citizenship rights to children born to two foreign parents. Malta had amended theirs earlier, too. Other countries, such as Australia , have similarly tightened their laws.

But when you follow the birth tourism blueprint, you can forget about dual citizenship and give your child multiple citizenships .

Here is the full list of the best countries in which to give birth when seeking birth tourism options, excluding countries where a ban on the practice is currently underway.

• El Salvador
• St. Kitts and Nevis
• St. Vincent and the Grenadines
• Trinidad and Tobago
• United States

*For a child to become a Chilean citizen at birth, their parents must already have a temporary or permanent residence in Chile at the time of their birth.

**As of September 2020, Portugal is just a few formalities away from expanding its jus soli laws granting birthright citizenship to children born on Portuguese soil. Currently, children born in Portugal to foreign nationals can obtain citizenship at birth if at least one parent has been a resident for two years or more. The new law would reduce that timeline to one year. 

This is an especially attractive change for Golden Visa investors in Portugal as they will now have the opportunity to bestow Portuguese citizenship on their children after just one year of residence.

The Best Birth Tourism Countries

Out of that list are a few gems…

Panama, Brazil, Mexico, and Argentina are particularly noted for their quality medical care , including for world-class facilities that make giving birth there not only easy but much cheaper than any country in the West.

Two of the countries — Dominica and St. Kitts and Nevis — sell economic citizenships for six-figure price tags and even charge for your children to receive a passport, as well. Other countries that used to offer citizenship by investment programs, such as Belize, are also attractive birth tourism options.

Similar to how US persons complain of illegal immigrants getting access to welfare benefits for their US citizen child, several countries on this list offer the ability to fast track your own naturalization as the parent of a local child.

In Brazil, the wait is only one year, prompting my friend Neil Strauss to suggest “knocking up a Brazilian girl” in his book Emergency . But in all seriousness, even foreigners on tourist visas can give birth on Brazilian soil, earning their child immediate Brazilian citizenship and a one-year timeline to their own naturalization. You can learn more about Brazil’s birthright citizenship laws here .

Most other countries will fast track the parents’ naturalization so that you will be able to get citizenship in two to seven years. 

And surprisingly, some of these countries offer remarkably good passports . Holders of passports from Argentina, Costa Rica, Mexico , Panama , St. Kitts and Nevis, Uruguay , and Venezuela enjoy visa-free travel to all of Central and South America as well Europe’s borderless Schengen Area and almost every country in Europe.

Some even offer travel privileges to countries that westerners do not have visa-free access to, like Russia.

Guatemala passport holders enjoy all of these privileges save the right to travel to Mexico. Nicaragua citizens enjoy Schengen area access, but more limited options within the Americas. And even some of the lesser passports here allow for visa-free travel of some sort to the UK, Ireland, Malaysia, and Singapore.

For someone interested in raising their family in the world’s emerging markets, the Peruvian passport allows for more visa-free travel to Southeast Asia and South American countries than most “first world” passports.

Outside of Canada and Chile , none of these citizenships will allow your child to visit the United States visa-free. But if you’re reading this, you might actually view that as an added benefit rather than a detriment.

Keeping your child in a growing, more laissez-faire environment is the best way to make the most of his or her birth tourism citizenship.

Be careful that you have the most up-to-date information before giving birth overseas, as a number of countries have ended their policy of giving citizenship based on birthplace; these include Australia, most recently, as well as New Zealand, Ireland, France, Malta, the Dominican Republic (which led to tens of thousands of deportations ), and India.

Of course, only you can determine how far you want to take the second citizenship and birth tourism game in an effort to bestow as many nationalities on your children as possible.

And if you happen to be pregnant now, you could always book your hospital stay and join us for one of our upcoming events on the beach.

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From Wombs To Passports: Here’s All You Need To Know About Birth Tourism

Discover the controversies, tightening regulations, and global implications surrounding this unique practice..

In the global quest for citizenship, there’s a unique, albeit controversial, strategy that involves crossing borders not for work or leisure but for childbirth. Birth tourism, a practice where expectant mothers journey to foreign lands to secure citizenship for their newborns, has become a curious phenomenon. From affluent nations like the United States and Canada to various corners of the world, this pursuit of nationality by maternity has sparked debates, tightened regulations, and raised questions about the rights of “anchor babies” and the strains on healthcare systems.

The Rise Of Birth Tourism And Nationality By Maternity

Birth tourism is a practice where pregnant individuals travel to another country to give birth there so that the child born on that country’s soil becomes a citizen by birthright. Those engaged in birth tourism often choose countries that offer birthright citizenship, typically nations like the United States, Canada, or some other countries. They chose nations where citizenship is automatically granted to those born within their borders.

The process usually involves individuals obtaining a travel visa to enter the chosen country. They often claim they are visiting for tourism or medical purposes. Once in the country, they seek medical care to give birth. Some may stay in maternity hotels or special facilities catering to birth tourists.

The motivations behind birth tourism certainly vary. Some parents seek better educational or career opportunities for their children, while others aim to secure a foothold in a more stable country. Some also make this choice to access better healthcare. Additionally, obtaining citizenship through birth can provide the child with the option to sponsor their parents for immigration.

Also Read: How To Spend 48 Hours In Ayodhya: Things To Do, To Eat, To Shop

Exploring The Impact On National Identities

However, birth tourism is a contentious issue in many countries. Critics argue that it can be a loophole for immigration and citizenship laws, potentially straining social services and contributing to fraudulent practices. In response, some countries have taken steps to restrict or regulate this practice. They have implemented stricter visa policies or cracked down on businesses catering to birth tourists. Concerned about the implications, the US government has begun imposing restrictions on this practice. Notably, pregnant women entering the US on tourist visas must now demonstrate a purpose other than childbirth. According to News 18, temporary B-1 and B-2 visas for birth tourism are no longer being issued.

It’s worth noting that birth tourism is often used by women from economically disadvantaged backgrounds. These mothers also seek better opportunities or access to citizenship for their children. These children born through birth tourism are colloquially referred to as “anchor babies.” This is a term used to describe their role in family immigration or eventually securing citizenship rights for their parents.

Birth tourism continues to provoke discussions on citizenship, ethics, and the ever-evolving boundaries of international law.

Cover Image Courtesy: Canva

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• Introduction to Giving Birth in the UK for Foreigners
• 1 Legal and Administrative Requirements
• 2 Choosing a Hospital or Birth Center
• 3 Prenatal Care and Support Services
• 4.1 Cultural Considerations and Birth Experience
• 4.2 Citizenship and Passport Application for the Newborn
• 4.3 Challenges Faced by Foreigners Giving Birth in the UK
• 5.1 Legal Implications for Parents and the Newborn
• 6.1 Common Questions and Concerns Answered
• 7 Birth Tourism and Ethical Considerations
• 8 Conclusion

In recent years, there has been a noticeable increase in the number of foreigners choosing the United Kingdom as the destination for childbirth. This article aims to provide a comprehensive guide for international parents considering giving birth in the UK, covering everything from the advantages and legal requirements to postnatal care and community support.

Legal and Administrative Requirements

Necessary Paperwork and Documentation

Before embarking on the journey of giving birth in the UK, international parents must navigate the administrative requirements. This includes ensuring all necessary paperwork, such as medical records and identification documents, is in order.

Understanding Visa Requirements for Parents

Navigating the complex landscape of UK visas is crucial. Parents must understand the specific visa requirements for childbirth and ensure compliance with immigration regulations to avoid any legal complications.

Choosing a Hospital or Birth Center

Overview of Birth Options

The UK offers a variety of birthing options, from hospitals to birth centers, each catering to different preferences. Understanding these options empowers parents to make informed choices based on their needs and expectations.

Factors to Consider When Selecting a Healthcare Facility

Choosing the right hospital or birth center involves considering factors such as location, available amenities, and the reputation of healthcare professionals. This decision significantly impacts the overall birthing experience.

Prenatal Care and Support Services

The Importance of Prenatal Care for International Parents

Comprehensive prenatal care is essential for the health and well-being of both the mother and the unborn child. International parents should be aware of the available healthcare services and make timely appointments for adequate prenatal support.

Support Services Available for Expecting Foreigners

Cultural differences and language barriers can pose challenges during pregnancy. Understanding the support services available, including interpreters and cultural liaisons, ensures a smooth and comfortable experience for foreign parents.

Costs and Financial Considerations

Breakdown of Medical Expenses for Childbirth

Giving birth in the UK comes with associated medical expenses. This section breaks down the costs, including hospital fees, medical procedures, and any additional charges parents may incur.

Insurance Options and Coverage for International Parents

Securing comprehensive health insurance is paramount for international parents. Exploring insurance options and understanding coverage details helps mitigate unexpected financial burdens associated with childbirth.

Cultural Considerations and Birth Experience

Cultural Differences in Childbirth Practices

Childbirth practices vary across cultures, and international parents may find differences in the UK’s approach. Understanding and embracing these cultural nuances contribute to a positive birth experience.

Ensuring a Positive and Culturally Sensitive Birth Experience

Healthcare providers in the UK strive to create a culturally sensitive environment for childbirth. Open communication with healthcare professionals and expressing cultural preferences ensures a positive and inclusive birth experience.

Citizenship and Passport Application for the Newborn

Procedures for Obtaining Citizenship for the Newborn

For international parents, understanding the process of obtaining citizenship for their newborn is crucial. This section outlines the necessary steps and documentation required to ensure the child’s legal status in the UK.

Passport Application Process for International Parents

Navigating the passport application process adds another layer of administrative tasks. International parents must be aware of the procedures involved in obtaining a passport for their newborn before returning to their home country.

Challenges Faced by Foreigners Giving Birth in the UK

Language Barriers and Communication Challenges

Language can be a significant barrier for foreign parents during the childbirth journey. Addressing language challenges by seeking translation services ensures clear communication with healthcare providers and enhances the overall experience.

Navigating the UK’s Healthcare System as a Foreigner

The UK’s healthcare system may differ from what international parents are accustomed to. Understanding the system, including accessing primary care and emergency services, is essential for a seamless experience.

Community Support and Integration

The Role of Community Support for Foreign Parents

Communities play a vital role in supporting foreign parents during the childbirth journey. Connecting with local support groups and fellow expatriates provides a sense of belonging and valuable insights.

Tips for Integrating Into the Local Community

Integrating into the local community enriches the overall experience for international parents. This section offers practical tips on forging connections, participating in community events, and making the most of the cultural diversity.

Legal Implications for Parents and the Newborn

Understanding Legal Rights and Responsibilities

Clear understanding of legal rights and responsibilities is essential for international parents. This includes knowing the legal implications of giving birth in the UK, particularly concerning residency and potential obligations.

Implications of Giving Birth in the UK for Residency

The decision to give birth in the UK may have implications for the residency status of parents and the newborn. Being aware of these implications ensures proactive measures can be taken, if necessary.

FAQ Section for Expecting Foreign Parents

Common questions and concerns answered.

Is giving birth in the UK automatically granting citizenship to the newborn?

No, giving birth in the UK does not automatically grant citizenship. There are specific procedures to follow for obtaining citizenship.

What healthcare support is available for pregnant foreigners in the UK?

Pregnant foreigners have access to the National Health Service (NHS) for prenatal care. Understanding the services and registering early is recommended.

Can international parents choose any hospital for childbirth in the UK?

Yes, international parents can choose a hospital or birth center based on their preferences and needs. Factors such as location and facilities should be considered.

Do international parents need special insurance for childbirth in the UK?

Yes, comprehensive health insurance is essential for covering medical expenses associated with childbirth. It is advisable to secure insurance before arriving in the UK.

Are there language assistance services available during childbirth?

Yes, many healthcare facilities in the UK provide language assistance services, including interpreters, to ensure effective communication during childbirth.

Birth Tourism and Ethical Considerations

Discussion on the Concept of Birth Tourism

The concept of birth tourism has gained attention in recent years, raising questions about the ethics and motivations behind choosing a foreign country for childbirth. This section delves into the reasons behind birth tourism and the ethical considerations associated with this practice.

Ethical Considerations Surrounding International Childbirth

Exploring the ethical considerations helps expecting parents make informed decisions. From the potential strain on local resources to questions about citizenship motivations, understanding the ethical implications contributes to responsible decision-making.

In conclusion, the journey of giving birth in the UK for foreigners is a multifaceted experience, blending administrative intricacies with cultural diversity. International parents should approach this journey with thorough research, understanding the legal landscape, and embracing the cultural nuances of the UK’s healthcare system. From prenatal care to postnatal services, navigating the process requires a proactive and informed approach. Birth in the UK not only shapes the beginning of a new life but also contributes to the broader narrative of globalized childbirth.

As you embark on this unique journey, remember that the decision to give birth in a foreign country comes with its challenges and rewards. Seek support from the local community, engage with healthcare professionals, and ensure that you are well-informed about the legal and cultural aspects of childbirth in the UK.

'Maternity Tourists' Using NHS For Free Care

A new report claims immigration officials stopped 300 women at Gatwick Airport who were too heavily pregnant to fly home.

By Jon Craig, Chief Political Correspondent

Sunday 29 December 2013 11:10, UK

Hundreds of "maternity tourists" are flying to Britain just days before they give birth to receive free care on the NHS.

On the eve of a Government crackdown on "health tourism", it has been revealed that women are cheating their way into Britain for free birth care.

According to a Government report, immigration officials at Gatwick Airport stopped more than 300 such mothers-to-be over two years.

Most of the women had to be admitted and allowed to give birth on the NHS , the report found, because their pregnancies were too advanced for them to fly home.

Airlines typically do not carry women more than 36 weeks pregnant. However, the women boarded flights in their home countries with a forged doctor's note concealing the length of their pregnancy.

The problem has become so acute that staff at Guy's and St Thomas' NHS Foundation Trust , in London, refer to the flow of West African women flying in to give birth as the "Lagos Shuttle", The Sunday Telegraph reported.

The Government says health tourism costs the NHS as much as £80m a year — enough to pay for about 2,000 nurses. However, the true figure may be far higher.

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Guy's and St Thomas' alone may be losing more than £5m a year.

Labour MP Kate Hoey, whose central London constituency includes both hospitals, says health tourists head straight to St Thomas's, across the River Thames from the Houses of Parliament, from Heathrow Airport "with something they knew perfectly well they had before they came".

The disclosures come as ministers unveil a range of measures tomorrow to tackle the problem.

They are expected to include a new system for identifying patients who should be charged and new fees for some services currently free for foreigners, including accident and emergency.

And later this week, restrictions on Bulgarians and Romanians working in Britain will be lifted, amid concerns that tens of thousands could arrive and be entitled to benefits.

The disclosures about "maternity tourists" emerged from a previously unpublicised consultation document, prepared in 2010, on plans to refuse entry to foreigners with unpaid NHS bills.

The report found that over a two-year period, immigration officials at Gatwick stopped more than 300 expectant foreigners found to be in an "advanced stage of pregnancy [and] who evidently intend[ed] to access NHS maternity services".

Gatwick has few flights from the countries producing the most health tourists, suggesting the total British figure will be far higher.

Another unpublicised report, Visitor and Migrant Use of the NHS in England: Observations from the Front Line, published this autumn, quotes extensively from staff frustrated at what they see as visitors playing the system.

An immigration officer said: "Sometimes they will come back for their second or third baby.

"Sometimes they will quite blatantly say, 'I'm coming because the care is better'. And once they are here, if they are assessed to a certain gestation, then we are stuck."

An NHS overseas visitor officer said: "People coming into hospital from overseas know the rules better than the hospital staff."

Another said: "They lie through their teeth."

Guy's and St Thomas' Trust was last year owed £8.1m in unpaid bills to health tourists over the past few years, according to freedom of information requests.

The trust recovered £600,000 from health tourists in 2012 — only 30% of the amount billed — according to a recent report compiled by Westminster City Council .

But even this may be a substantial underestimate, the report says, since up to two thirds of health tourists in the NHS are never identified or issued with bills.

This suggests that health tourists could be using up to £6m worth of services a year at these two hospitals alone, with £5.4m of that figure unrecovered.

The trust said it took the problem "very seriously" employing a dedicated team to identify and charge ineligible patients.

A spokesman said the trust did not recognise the £8.1m figure.

Matt Akid said: "Guy's and St Thomas' takes the recovery of money owed by overseas patients who are not entitled to NHS care very seriously and works hard to recover any money owed.

"We have a dedicated team of staff who identify patients who fall into this category and actively pursue costs during a patient's stay.

"Where this is unsuccessful, we employ an international debt recovery agency. We also work closely with the UK Border Agency, participating in their 'notification scheme' which is designed to assist with debt recovery."

Many individual NHS clinical commissioning groups, or CCGs, the 211 local bodies that fund hospital trusts and GPs have also identified substantial "risks" to their finances from foreign visitors.

West London and City & Hackney CCG s put it at up to £2.4m each this year and Camden CCG at up to £5m, though not all was for "fly-in, fly-out" health tourism.

A Department of Health spokesman said: "We have a National Health Service, not an international health service, and we must stamp out abuse of the system."

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‘A lot of these women had no idea what they got into’: inside the world of birth tourism

A new documentary follows Chinese women who travel to the US to give birth so their children can have citizenship

I t started a decade ago, when Leslie Tai, who lives outside San Francisco, heard from a woman she’d met in Beijing and who told her that she was staying for a few months in Los Angeles. Tai’s friend was evasive about the purpose of her visit, until the pair finally had a video call and Tai watched her friend oil a round belly on camera. “She said, ‘I have a surprise for you,’” Tai recalled. “‘I’m having an American baby.’” Tai, who knew that her friend came from a poor family and was dating a wealthy older artist in China, asked if he had friends in southern California. “And she was like, ‘No, honey, you don’t need friends to do what I’m doing.’”

She was part of the birth tourism industry, which boomed during the Obama years, when scores of pregnant Chinese women of means invested in package deals that cost anywhere from $30,000 to $100,000 and granted buyers the ability to fly across the world and stay for three months at a facility that catered to expectant mothers looking to score US citizenships for their children or skirt the one-child policy that was the law in China until 2015.

Tai, a Chinese American documentary film-maker, wasted no time embedding in the group home where her friend was waiting out the final days of her pregnancy, alongside a handful of other expectant mothers. “I got kind of obsessed with this idea of how on the outside, it’s just nondescript suburban tract housing, with palm trees everywhere, but then behind closed doors there’s this whole world with multiple families living in close quarters and all in this crazy intense situation of waiting to have a baby,” she said.

Securing subjects’ permission was not easy for Tai. “I started asking my aunties and uncles like, do you know anybody who is involved in this industry? They were all like, yeah, actually, my cleaner, or our nanny from when our kids were children ended up working in one of these maternity hotels,” she recalled. Tracking down subjects and winning over their trust took an enormous amount of care and strategy. “Even though what they were doing was not illegal, they had reservations, so it was not like I came in like guns blazing.” Tai’s English fluency proved a valuable resource as she pursued mothers-to-be, nannies, drivers and cooks to grant entry to their private world and anchor the vignettes in her film. “I made myself of service because actually, when they saw me, they were like, ‘Oh my God, you speak English. Can you help me call PG&E?’” She had given similar help to her friend, who did not speak English, in the delivery room.

Nearly 10 years in the making, Tai’s entrancing and heartrending film How to Have an American Baby provides viewers insider access to a phenomenon that took place behind closed doors and on Chinese websites where brokers offered pregnant women package deals as if they were cruise holidays. Money-hungry operators offered help obtaining visas and lining up rooms at specialized facilities. There were enormous industrial maternity hotels, as well as private Beverly Hills homes and boutique group homes where up to five women at a time waited out their births and holed up for the 30-day postpartum quarantine that is a Chinese tradition. Then, more often than not, they returned to China.

“By and large, the majority of the women that were coming were simply coming to evade the one-child policy,” Tai said. Some, though, were mistresses, as Chinese law did not allow unmarried mothers to give birth in public hospitals until earlier this year. Sales agents knew how to tap into maternal anxieties, playing up the supposed advantages of US citizenship. “There’s a lot of misinformation that the customers are receiving,” Tai said. “They think that there’s universal healthcare. They think that there’s universal education. It’s sold as a really good investment, but they’ve been lied to.” Babies born in the US have the right to declare their American citizenship at age 18, and apply for green cards for their families when they turn 21. “There was a sentiment of: who knows what the world is going to look like in 18 years? If China goes to hell, what if America goes to hell, whatever, they have two passports.”

Tai’s film is less concerned with policy than offering a textured portrait of the day-to-day, minute-to-minute experience that the mothers went through. The exteriors are mostly shot at night on suburban streets of southern California and the interiors sit with women bathing their babies or microwaving cups of tea while they wait to go into labor. A meditative quality pervades the work, which weaves several vignettes together into a broader portrait of women navigating a terrifying life phase in a strange land. “A lot of these women had no idea what they got into,” Tai said. “It’s almost like they were sold on the pretty pictures of this vacation and then when they come here, they realize: ‘My family’s not here, and I’m having a baby. Oh, my God, I’m sequestered with a bunch of pregnant women. Plus there’s all the drama living in the suburbs. It’s like Real Housewives from hell.”

While many of the visitors enjoyed daily meal deliveries and shopping excursions, they were surrounded by people who saw them as financial marks. The doctors in the film offer all-cash birthing options (vaginal for $3,000 or caesarean for $5,000) with the tenderness of night market vendors hawking ripoff handbags. Tai captured a maternity hotel worker saying about the residents: “If you become too friendly they will use you. The more you give them, the more they complain.”

The birth tourism world underwent major upheaval over the course of filming and editing, to the point where Tai said her film was “like a time capsule”. With the rise of Trump and the travel restrictions around Covid, and anti-Chinese and anti-American sentiment flying in both directions, the phenomenon has come to a standstill.

Tai had her own changes as well, namely, the birth of a baby this past January, a few weeks before the world premiere of her film at a festival. “I definitely took a lot of lessons from watching all these births, like making sure I was set up with the right support,” she said.

And now she is in what she called “double postpartum mode”, watching both her baby and film find their footing in the world. While the film has a jaw-dropping concept at its core, the bulk of the footage focuses on the mundanity and emotion that color the days leading up to and following childbirth, as well as the terror and ecstasy of labor itself. (There is a birthing scene more honest and beautifully gruesome than any video they’ll show you at birth class.) Tai’s ambition for her movie is strikingly tender. “I want to fight for the moving image that allows you to really sink into the humanity of the people, regardless, and even in spite of, how controversial the situation is,” she said.

How to Have an American Baby airs on PBS on 11 December

• Documentary
• US television

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NHS maternity care for women from abroad (in England)

This page is relevant to:

Am I entitled to free NHS maternity care?

The ordinary residence test, eea/eu nationals, where to go for more help.

*Updates to this information sheet coming soon – please check back*

This information sheet outlines the entitlement to free NHS maternity care in England for women from abroad (or UK citizens returning to England after living abroad).

NHS maternity care is provided free of charge to women who are;

• considered to be ‘ordinarily resident’ in the UK, or
• exempt from charges (including people who have paid the health surcharge).

If you do not fall into any of these groups you may be asked to pay for your care, but  you cannot be refused care if you cannot pay  at the time you receive care.  It is very important for your health and your baby’s health that you attend for maternity care even if you are unable to pay. Maternity care includes all antenatal, birth and post-natal care.

If you are uncertain about your immigration status, you should seek specialist immigration advice – see organisations listed at the end of this information sheet.

Who will decide if I am going to be charged for my maternity care?

All NHS hospitals must make reasonable enquiries to determine who is not ordinarily resident and charge overseas visitors for their NHS care. This will normally be carried out by Overseas Visitors Managers (OVM) at the hospital. Government guidance on charging for NHS care states that hospitals should follow these steps:

• Patients should be asked if they are insured by another state,
• “All patients must be assessed against the test for ordinary residence in the UK…If the patient is ordinarily resident in the UK they must not be charged”.
• Patients who are not ordinarily resident in the UK, and are not insured by another country must be assessed against the exemptions.
• Patients who are subject to charges must be charged. Maternity care must not be withheld or delayed if you are unable to pay in advance.

Do I have to pay the charges upfront?

No. There is no upfront charging for maternity care. For more information, see: Upfront charging and NHS maternity care information sheet .  Your maternity care must never be refused or delayed if you cannot pay for treatment in advance.

Is there any information on my NHS records about whether I have to pay for care?

Hospitals have a duty to put a ‘flag’ on a patient’s record to state whether the patient is chargeable or exempt and the date that they made that determination. The NHS has a duty to carry out ‘reasonable enquiries’ before charging a patient. This duty applies every time that the NHS applies charges to your treatment. If your immigration status or residence status changes you should provide new evidence to the NHS.

If you believe you have been wrongly charged for your maternity care, please contact us for advice.

Who is ‘ordinarily resident’ in the UK?

Individuals who are considered to be ‘ordinarily resident’ in the UK are entitled to free NHS care. In law, a person is ordinarily resident here if they are:

“living lawfully in the United Kingdom voluntarily and for settled purposes as part of the regular order of their life for the time being, whether of short or long duration.”

For more information, please see: Residence rules and entitlement to NHS maternity care in England.

I am not a UK Citizen.   Am I ordinarily resident?

Under the 2015 charging regulations, people who require leave to remain in the UK, must have  indefinite leave to remain (ILR) , in order to be considered ordinarily resident.

If you have Indefinite Leave to Remain, you must still be able to demonstrate that you are ordinarily resident here and not just visiting.

If you are in the UK on a short term visa (e.g. a spouse or student visa), you cannot be classed as ordinarily resident even if you have been in the UK for more than 6 months and can show that you are settled here.  You may not have to pay for NHS maternity care if you are covered by one of the exemptions below or you pay the health surcharge when renewing your visa.

You are not considered to be living lawfully in the UK if you have overstayed your Visa or your claim for asylum and any subsequent appeals have been refused but you may not have to pay for NHS maternity care if you are covered by one of the exemptions below.

You are entitled to some NHS care if you are from a country that has a reciprocal healthcare agreement. For more information, contact us for advice.

I am from an EU/EEA country.  Am I entitled to free NHS care?

Please see our information sheet: NHS charges for EU nationals.

Which services are exempt from charges for NHS care?

The following services are exempt from charges for everyone that needs them, whatever your immigration or residence status is.  If you are an EEA national, the NHS can ask for your EHIC/PRC in order to claim reimbursement from another EEA country but you cannot be charged.

No charges may be made for the following services:

• Accident and emergency (A&E) services up until the point that the person is accepted as an inpatient. A&E services provided at an outpatient appointment are chargeable
• Services provided outside of an NHS hospital, unless the staff providing the services are employed by or working under the direction of an NHS hospital
• Family planning services (not including pregnancy termination). Temporary EEA nationals can use an EHIC for termination of a pregnancy as long as it is necessary before you return to your own country
• Diagnosis and treatment of certain contagious diseases e.g. TB or HIV
• Diagnosis and treatment of sexually transmitted infections
• Treatment of a physical or mental condition caused by torture, female genital mutilation (FGM), domestic violence or sexual violence when the patient has not travelled to the UK in order to seek treatment, see below for more details.

How much will maternity care cost?

The amount you will be asked to pay will depend on the care that you and your baby need. Charges can be based on a local price system or the National Tariff Payment System and overseas visitors are charged 150% of the cost. Maternity care is divided into antenatal care, birth and postnatal care; approximate charges for these services start from £7,500.

If you are in the UK in the early stages of pregnancy but are planning on having your baby abroad, you should only be charged for the care that you actually receive.  Hospitals have three charging options: they can charge for a whole package, a proportion of a package and per appointment.

If you are asked to pay, you should ask for an itemised bill so you can see what you have been charged for. If you disagree with the amount you have been charged you should talk to the hospital’s Overseas Visitors Manager.  You can also speak to the OVM about repayment options (for example, whether you can set up a repayment plan) and, if necessary, you should get advice.

What should I do if I am asked to pay and I am unable to do so?

If you are unable to pay for your maternity care, then you should inform the hospital.  Ideally, this should be done in writing. You can ask to repay the debt through regular monthly payments.  The amount you pay should be based on your income and expenses so even a small monthly repayment (e.g. £5) should be accepted if that is all you can afford.

Hospital trusts have a duty to recover charges, but should not go beyond what is reasonable when pursuing charges.  If the trust or a debt collector is aggressively pursuing payment, then you can make a formal complaint to the trust.

You can also get specialist debt advice, including advice about debt collection, from the organisations listed below.

The NHS can write off debt if :

• the patient has died and the debt is not recoverable from their estate
• the patient is not traceable
• it is not cost-effective to continue to pursue the debt because of the patient’s financial circumstances, for example, the patient is destitute or genuinely has no means to pay it, or
• reasonable steps have been taken and there are no further means to recover the debt.

Can the NHS tell the Home Office about the debt?

Yes, the NHS can tell the Home Office if the debt is:

• over £1000 (that are more than three months old) from 1/11/11 to 5/4/16 or 23/11/16 (depending of type of leave)
• over £500 (that are more than two months old) from 6/4/16 and from 24/11/16 (depending on type of leave).

The Home Office is able to take this into account when considering future immigration applications for leave to enter or remain in the country.

The NHS cannot notify the Home Office of outstanding debts in any of the following circumstances:

• The NHS must  not tell the Home Office of outstanding debts if you are challenging the decision to charge you, for example, where there is a dispute about your immigration status or whether you are ordinarily resident
• The NHS must  not  tell the Home Office if you have an agreed payment plan in place and you are sticking to it
• The NHS must  not  inform the Home Office of outstanding debts where the debt has been cancelled.

The NHS does not have to tell you that they are going to notify the Home Office or that they have already notified the Home Office about an unpaid debt but it is good practice to tell you and to explain why.

How do I make a complaint about a decision to charge me for my NHS care?

Government guidance on charging says that NHS staff must not discriminate when implementing the charging rules, for example, they must not target particular racial groups. You also have a right not to be treated in an intimidating, hostile, degrading or offensive way. This means that enquiries about your residence status and payment should be made privately and discreetly. If you have been treated unfairly or discriminated against you can make a complaint.

If you are unhappy about the hospital’s decision to charge you, for example, they have rejected evidence that you are ordinarily resident or they have refused to provide maternity services until you pay for treatment you can make a complaint. If it is later found that the charges should not have been applied, the debts can be cancelled.

Firstly, you should try to resolve complaints informally by speaking to the hospital. If you have not been able to resolve it with the hospital you can make a complaint using the NHS England Complaints procedure.  england.nhs.uk/contact-us/complaint/#unhappy

If you are still unhappy you can raise the matter with the Parliamentary and Health Service Ombudsman. See below for contact details.

You can also get specialist legal advice about challenging charging decisions or refusal of treatment. Judicial review claims must be brought promptly and within three months of the decision you are complaining about. You must have completed all complaints and appeals available.

Some of the organisations listed below may be able to advise you and help you to make a complaint.

If yours or your baby’s health is affected by delays to your treatment because of charging decisions or because you were deterred from seeking treatment because of fear of charges, you should get legal advice.

This factsheet was produced by Maternity Action in April 2022. It is always important to get up-to-date advice.

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NHS maternity care and charges

Maternity Action www.maternityaction.org.uk

Maternity Care Access Advice Service : Complete this online form  or  phone our advice line on 0808 800 0041 (Freephone)  if you need advice on NHS charging for maternity care. Call at any time and leave a voicemail. One of our legal advisors will then call you back.

Email enquiries: [email protected]

For more information on NHS maternity care charging see:

www.maternityaction.org.uk/advice-2/maternitycareaccess /

Migrant Women’s Rights Service : Second tier advice on financial support and housing options for migrant women and access to NHS maternity care. – 020 7251 6189 Email enquiries:  [email protected]

This is a second tier advice service for midwives and advisers

Debt advice/repayment plans/write-offs  

Debt Advice Foundation

Free debt advice and help with debts.

Tel no. 0800 043 40 50

www.debtadvicefoundation.org

www.stepchange.org

Free debt advice and help with debts. Callers must be resident in the UK.

www.stepchange.org/Contactus.aspx

Citizen’s Advice Bureau

www.citizensadvice.org.uk/debt-and-money/

Free advice on dealing with debts.

To find your nearest CAB:  www.citizensadvice.org.uk/about-us/how-we-provide-advice/advice/search-for-your-local-citizens-advice/

National Debt line

Free online debt advice and tools. Tel no. 0808 808 4000.  www.nationaldebtline.org

Trafficking and the National Referral Mechanism

Salvation Army

If you think you are a victim of trafficking or modern slavery and would like advice and support you can call the Salvation Army 24-hour confidential Referral Helpline

0300 303 8151

Open 24 hours, seven days a week

Healthcare and access to healthcare

Children’s Legal Centre

www.childrenslegalcentre.com/?sfid=132&_sft_resource_topic=healthcare

Freedom from Torture

Care and treatment for victims of torture

London Centre Tel: 020 7697 7777

West Midlands Centre Tel: 0121 314 6825

North East Centre Tel: 0191 261 5825

North West Centre Tel: 0161 236 5744

Scottish Centre Tel :  0141 420 3161

Helen Bamber Foundation

Care and treatment for survivors of torture and violence

www.helenbamber.org

Tel No 020 3058 2020

Healthwatch England

A consumer organisation that can help with complaints against health care providers.

03000 68 3000

[email protected]

www.healthwatch.co.uk/about-us

Parliamentary and Health Service Ombudsman

If you are unable to resolve a complaint with an NHS body you can make a complaint to the Ombudsman:

Helpline 0345 015 4033 Monday to Friday 8.30 – 5.30

www.ombudsman.org.uk/make-a-complaint

Patient Advice and Liaison Service (PALS) Help in resolving problems with the NHS.  You can find your local PALS through the website.  www.nhs.uk/service-search/patient-advice-and-liaison-services-(pals)/locationsearch/363

Doctors of the World Free healthcare for vulnerable and excluded people.

Clinic advice line: 020 7515 7534. This line is open from 10am to 12 midday, Monday to Friday www.doctorsoftheworld.org.uk/projectlondon

Marie Stopes International

Charity who offer a range of reproductive healthcare and advice, including abortions. www.mariestopes.org.uk

0345 300 8090

Immigration advice

You can search for accredited immigration advisers in your area at: https://www.gov.uk/find-an-immigration-adviser

Rights of Women  www.rightsofwomen.org.uk Free legal advice on sexual violence, immigration and asylum law. Helpline 020 7490 7689.

Civil Legal Advice If you are eligible for legal aid you can get free legal advice on 0345 345 4 345 (offers translation service). To check your eligibility see  www.gov.uk/civil-legal-advice

To search for specialist legal advisers or solicitors in your area see  find-legal-advice.justice.gov.uk

What is birth tourism and is it legal?

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Birth tourism isn’t a term we hear everyday, but it is in actual fact a real thing! Want to learn all about it? Read on…

What is birth tourism?

Anchor babies, future life improvement, two-child policy, right of abode, birth tourism scrutiny in the us, changing citizenship laws, jus sanguinis , birth tourism in north america, birth tourism in hong kong, birth tourism- further reading.

As the name suggests, birth tourism is the action of travelling to a different destination for the purpose of giving birth. There are various reasons as to why pregnant people decide to take this course of action, which I will go into below. It is not a new phenomenon, nor is it something which people are particularly secretive about when they engage in it. It is more common in the US, Canada and Mexico as these countries famously offer birthright citizenship.

It is worth nothing that birth tourism is completely unrelated to the concept of a babymoon, which you can read about here !

Why does birth tourism happen?

So, why does birth tourism exist? One reason is that people may want to give birth where it’s free or at least much cheaper than their home country. They also may feel like other countries are able to provide better (and/or safer) medical care during and immediately after the birth. Childbirth is a terrifying process for many, and people want to feel as confident as possible as they bring a new life into the world.

But the main reason for birth tourism is citizenship purposes. People will travel to a different country to give birth there so that the child has birthright citizenship, also known as jus soli. There are many reasons why someone may want their child to have citizenship in a different country…

An anchor baby is a child born in this country for the purpose of helping their parents obtain permanent residency in this country. Due to the baby having birthright citizenship, it should then be easier for the parents and other family members such as siblings to gain legal and permanent residency. This term is considered to be offensive by some. It often comes into play during immigration arguments, especially in the US.

Canadians use the term ‘passport baby’ in the same way.

Another reason for giving birth to a child in a foreign country, therefore giving them birthright citizenship, is in order to ensure they have access to solid healthcare and a good education in the future. This is to benefit the child themselves.

In the past, people have engaged in birth tourism to get around the Chinese two-child policy – and the one-child policy before it. China now actually has a three-child policy, due to falling birth rates (presumably because of the two-child policy in place). Iran, Singapore and Vietnam have also all had two-child policies in place at one time or another. Birth tourism was a way of circumventing this issue.

This relates specifically to Chinese citizens travelling to Hong Kong to give birth. Doing so gives the child ‘right of abode’ – also known as permanent residence – to live and work in Hong Kong in the future. They would have all the same rights as anyone else born in Hong Kong. This phenomenon has led to tensions between the people of China and the people of Hong Kong, with the latter even taking to the streets to protest the rise in birth tourism.

Is birth tourism illegal?

For the most part, globally, there are no actual laws against travelling to a different country to give birth there. And the reasons which people do it aren’t technically illegal either. This is not to say that it isn’t legally tricky, or frowned upon by the law…

During the Trump administration in 2020, the president imposed new visa rules for pregnant women travelling to the US to give birth there. This did not stop all heavily pregnant women being able to gain visa entry into the US, because they might be travelling to visit an ‘ailing relative’ or for work purposes. 

The rule will not apply to foreign travelers coming from any of the 39 mainly European and Asian countries enrolled in the Visa Waiver Program, which allows citizens of those countries to come to the U.S. without a visa for temporary stays. The rule will only apply to applicants for so-called “B” class visas that permit short-term stays for business or pleasure, said AP News.

They went on to say: The practice of traveling to the U.S. to give birth is fundamentally legal, although there are scattered cases of authorities arresting operators of birth tourism agencies for visa fraud or tax evasion. And women are often honest about their intentions when applying for visas and even show signed contracts with doctors and hospitals.

The State Department “does not believe that visiting the United States for the primary purpose of obtaining U.S. citizenship for a child, by giving birth in the United States — an activity commonly referred to as ‘birth tourism’ — is a legitimate activity for pleasure or of a recreational nature,” according to the new rules.

Because of the rise in birth tourism, some countries have changed their citizenship laws. Instead of birthright citizenship being offered to anyone born in the country, the following nations only grant this at birth if at least one parent is a citizen themselves or a legal permanent resident who has lived there for a number of years:

• Australia  
• Germany 
• New Zealand
• South Africa
• United Kingdom

As opposed to jus soli, the concept of jus sanguinis relates to citizenship being designated by the nationality or ethnicity of one or both parents – despite where the child is born. So for example, a couple who are British and French respectively could give birth to a child in neither of these countries. If the country of birth operated under jus soli, the baby would automatically be a citizen of this country. However, if the birth country uses the process of jus sanguinis then the child would take either British or French citizenship. Originally this would automatically be the same as the father’s – but with equality on the rise, it is now that of either parent.

Popular birth tourism destinations

I have already touched on some of the common places for birth tourism, but below you’ll find some more detail…

As mentioned earlier, the North American countries all offer automatic birthright citizenship, with dual citizenship also allowed. However, this may not always be a positive thing. For example, citizens of the United States are taxed worldwide even if you are not a resident. So you could be born in the US, either through birth tourism or perhaps a premature birth, then leave as a baby and never set foot in the US. You would, in the future, still be liable to pay taxes in the US unless you pay the eye-watering $2350 renunciation fee.

The Center for Immigration Studies say they estimate that there are 33,000 births annually as a result of birth tourism in the US. They also say that the most common countries people travel from for birth tourism are China, Taiwan, Korea, Nigeria, Turkey, Russia , Brazil, and Mexico.

People also travel to Brazil for birth tourism purposes. Children born here, in the largest country in South America , are granted Brazilian citizenship at birth under jus soli – meaning they are Brazilian regardless of their parents’ nationalities. Parents can then apply for ‘residency of the indefinite term’ due to the child having Brazilian citizenship.

International Wealth say: After obtaining residency by submitting your child’s birth certificate and copies of passports, you will be eligible to apply for citizenship after one year. 

This fast-track naturalization process is desirable for a parent to obtain a relatively “cheap” second citizenship for you and your family. Your child will benefit from being a citizen of the Mercosur region, allowing them to live, study and work anywhere in the area. 

Of course, I touched upon this earlier – but many Chinese parents travel to Hong Kong to give birth so their children can enjoy ‘right of abode’ in the future. This came as a result of the 2003 Individual Visit Scheme which allowed people from Mainland China to visit Hong Kong on an individual basis. Before this, residents could only visit as part of a group tour or on a business visa.

This new rule provided an opportunity for pregnant people to head to Hong Kong and give birth there, thus securing ‘right of abode’ for their offspring. But of course, this resulted in a shortage of resources (hospital beds, midwives, medical equipment and so on) for local residents. They did not take kindly to this, with protests and potential policy changes occurring in more recent years.

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• Social Policy

The risk of oversimplifying the birth tourism debate

Did the CBC Fifth Estate really demonize pregnant migrant women in its investigative report into the number of non-resident births in Canada? That is the argument made by Megan Gaucher and Lindsay Larios, writing recently in Policy Options . A letter of complaint was also submitted about the report to the CBC Ombudsperson by 30 organizations, including groups representing migrant workers. Is discussion of birth tourism essentially a form of xenophobia given its focus on visible-minority foreigners? Or are the underlying concerns of the critics less about birth tourism and more about gaps in healthcare coverage for temporary residents?

Critics of the Fifth Estate report take issue with an analysis I did in 2018 using hospital financial data from the Canadian Institute of Health Information (CIHI) and the financial code “non-resident self-pay.” Using my data, the Fifth Estate reported that there are 5,000 non-resident births every year in Canada. I estimated that roughly half of all non-resident births were due to birth tourists. (I provided my CIHI-based analysis to the Fifth Estate and its journalists updated the Quebec hospital numbers.)

The essence of the current criticisms and earlier critiques is that the “non-resident self-pay code” in the hospital data includes all temporary residents (students and foreign workers, for example), not just those on visitor visas. Any change to birthright citizenship would affect not only those on visitor visas but also other categories of temporary residents.

Let’s be clear – the data should be more precise.

My 2018 analysis prompted the November 2018 announcement of joint work by Immigration, Refugees and Citizenship Canada, CIHI, and Statistics Canada to integrate healthcare and immigration data. This should allow for separation of the numbers of those here on visitor visas from other categories of non-residents (international students, temporary foreign workers and those using the International Mobility Program ). Data on visitor visas will not distinguish between those here for birth tourism versus other non-resident births, but it will provide the most accurate indication possible, along with information on countries of origin, which has been largely anecdotal.

Having a better sense of the demographics of women coming for birth tourism could help broaden the discussion. Given the recently announced change by the US government to make birth tourism grounds for visa refusal, this more precise data will also facilitate analysis of whether the US restriction leads to more birth tourists choosing to come to Canada.

But more-precise data is likely to simply reaffirm that birth tourism is not significant in relation to total births nationally, though it is pronounced in specific communities – such as Richmond, BC, where more than one in five births is believed to be part of birth tourism. This suggests that regulatory approaches would be more appropriate than a change to birthright citizenship. Regulatory approaches could include higher deposits and medical insurance requirements for non-Medicare covered deliveries, scheduling preference given to Canadian residents, and municipal zoning regulations regarding birth tourism residences. A change to birthright citizenship would be costly and more complicated for all Canadians.

There is an argument that says raising birth tourism concerns by singling out women who are visible minorities is xenophobic or contributes to anti-immigrant discourse. This is debatable. Certainly, there are some xenophobic elements to this discussion. But questioning the extent of birth tourism, the nature of the clientele, the supporting “cottage industry” (consultants and pre- and post-birth residences), as the Fifth Estate episode does, does not demonize all visible-minority pregnant women. Birth tourism services cater to wealthy women who can afford the associated travel and accommodation costs and medical fees, typically packaged by consultants for a price tag of about $60,000 .

Similarly, raising the question of the possible need for legislative or regulatory changes to reduce the practice is not necessarily xenophobic or anti-immigrant. After all, Chinese-Canadians make up the majority of residents in Richmond, the epicentre of birth tourism in Canada, which means their access to perinatal care is most affected by the impact of birth tourism.

Perhaps it would be better to frame birth tourism as more of a class or equity issue. It is wealthy foreign women who essentially have an “express lane” to citizenship for their children using costly consulting and other services, whereas less affluent immigrants have to comply with citizenship requirements. Birth tourists are not vulnerable, marginalized women.

Critics say the discussion about birth tourism overshadows broader and legitimate concerns about gaps in healthcare coverage for all temporary residents, since coverage depends on the category, province of residence, duration of work permit and other factors. Those who are here using the lower-skilled Temporary Foreign Worker Program are more vulnerable than those who have come through the International Mobility Program or are international students.

These differences and gaps of healthcare coverage for temporary residents apply to all healthcare services, for men as well as women, with perinatal care being a minor portion of non-resident healthcare services. Expansion of health care to address these gaps as advocated by the analyses by Gaucher, Larios and the Migrant Workers Alliance for Change, would, of course, raise much broader issues than those related to birth tourism, particularly issues of affordability for governments given the financial implications of extending Medicare to all or most temporary residents.

Future research will benefit from isolating the number of children born to non-resident visitor visa holders from other temporary residents and by isolating data by country of origin. Rather than labelling concerns about birth tourism almost automatically as xenophobic, and all temporary-resident women as vulnerable, more nuance and differentiation is required to advance understanding and discussion of the extent of birth tourism, whether or not government action is needed to reduce the practice and, if so, what are the strengths and weaknesses of the various options available.

Photo: Shutterstock, By  sukanya sitthikongsak

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Sarah Chudleigh

March 22nd, 2021, race over resources: the american controversy over ‘birth tourism’.

1 comment | 11 shares

Estimated reading time: 10 minutes

The 45 th American president made headlines with his unconstitutional promises to end birthright citizenship, as part of a series of angry tirades against “birth tourism”. While it never came to fruition, his administration did put forth an unprecedented ruling in January of 2020 that barred pregnant visitors from travelling to the U.S on temporary visas. Arguments in favour of the ban focus on resource allocation and security, but anti-“birth tourism” is an openly racist movement.

“Birth tourism”, a term usually employed to evoke negative reaction, describes short-term migrants who temporarily enter a country to give birth. “Birth tourism” occurs only in countries with unrestricted birthright citizenship policies, in which any babies born on state territory automatically acquire citizenship, regardless of their parents’ nationalities. The U.S. has one of the highest rates of “birth tourism” and by extension, the most vocal political controversy.

It is important to note that “birth tourism” is entirely legal. Claims of its illegality by politicians refer to zoning violations caused by ‘maternity hotels’ (houses in which pregnant visitors may stay, often for a hefty price) in residential areas, but are often framed to wrongfully imply that these births themselves are illegal. Despite the legality, anti-“birth tourism” advocates often rely on the notion that “birth tourism” is a national security threat. ‘National security’ was the sole justification given for the 2020 U.S. restrictions on pregnant visitors, though in multiple interviews , State Department officials were unable to give examples of security threats that had occurred as a result of “birth tourism”.

Anti-“birth tourism” advocates often lean on two key arguments. The first is that the practice takes resources away from American citizens. There is currently no estimate to how much “birth tourism” costs the U.S. each year. The more immediate resources are medical – a hospital bed or time with doctors. But the American policy response doesn’t reflect this concern. The 2020 restrictions only targeted those entering on visitor visas to give birth, leaving all other medical procedures exempt. If the outrage was a matter of medical resources, public debates would extend to all medical tourists, not just pregnant ones.

The resource argument extends further into the future, when these American children later receive the right to vote, attend cheaper post-secondary education, and acquire visas for family members. Some U.S. politicians have framed this as ‘cheating’ the immigration system, leading into their second argument – that “birth tourism” damages the integrity of American citizenship. Scholars note the U.S. “birth tourism” discourse is often framed as “ an attack on the sanctity of American citizenship ” ; for example, a White House statement claimed the ruling was needed to “enhance the integrity” of the immigration system. This side of the controversy more openly reflects the racist roots of the fear over “birth tourism”.

“Birth tourism” discourse in the U.S. is heavily racist in its rhetoric. Acting U.S. representatives have referred to pregnant migrants entering the country with offensive and derogatory phrases that include “dropping babies”, “rats [who] multiply”, “anchor babies”, “invasion by birth canal”, and “terror babies” . While running as a presidential candidate, Jeb Bush infamously declared that his use of the term ‘anchor baby’ was not directed at the Hispanic population, but “ frankly . . . Asian people ” . He is certainly not an outlier. One study found that one of the defining characteristics of birthright citizenship discourse amongst U.S. Republican candidates was the targeting of Latina and Asian women as threats to American society and values. The racialisation of “birth tourism” conforms to a long pattern of criticizing racialised women for ‘unethical’ reproductive decisions, often the idea that women have children to gain state resources.

Unlike the argument for protection of medical resources, American racism is reflected in the year-old ruling. The ban on pregnant travellers on B-visas does not extend to those from the 38 countries in the Visa Waiver Program, most of which are majority-white and European. The restrictions still allow for pregnant visitors from these states, affecting primarily non-white visitors.

While some may justify the ruling on the grounds that the U.S. has the right to patrol its own borders, this ban actively harms the mobility and agency of vulnerable migrants. Not all so-called “birth tourists” enter the United States in search of citizenship for their child, as the ruling suggests. Some mothers travel for health care that may otherwise be unavailable to them. The 2020 restrictions have no exemptions for those who seek American healthcare for their own safety and wellbeing. A State Department official commented on these mothers in an anonymous interview : “People will die because of this.”

We must recognize that, though racist controversies over “birth tourism” are the loudest in the United States, they are not unique to it. In 2018 , the Canadian Conservative Party passed a non-binding resolution to end birthright citizenship due to concerns over rising “birth tourism” at their annual convention. Ireland operated under birthright citizenship until a constitutional amendment in 2004 , one that was said to be motivated by the increases in immigration and ‘baby tourism’. Both of them were home to similar, racially-charged language in their public “birth tourism” debates.

The American controversy over “birth tourism”, thinly masked as concern for resources, security, and national integrity, has resulted in harmful legislation to vulnerable migrants. Though the Biden administration has announced the “ boldest immigration agenda . . . in decades ”, it has yet to address if the often-villainised group, pregnant medical tourists, will be included in its reforms.

Note: This article gives the views of the authors, and not the position of the Social Policy Blog, nor of the London School of Economics.

About the author

Sarah Chudleigh is an MSc candidate in International Social and Public Policy at LSE. She previously completed a liberal arts degree from Quest University Canada. She is interested in interdisciplinary research on migration, race, and gender.

It says on “OfficialESTA.co.uk” website “ Travelling to the U.S. while pregnant” two contradicting things:

First it says Q. “Will the changes affect all pregnant travellers?”

A. “People travelling to the U.S. on previously obtained visas are also exempt, as are citizens of countries participating in the Visa Waiver Programme.”

It then goes on to say

Q. “ What are the potential long-term consequences of entry to the United States being denied because of pregnancy?”

A. “Being denied entry to the U.S. during pregnancy can have significant consequences.

If you are travelling to the United States from a VWP country, you will no longer be able to use the Visa Waiver Programme.”

So which is it??

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What is ‘birth tourism’ and why is the US trying to stamp out the practice?

State Department gives visa officers new powers to block pregnant women from entering the country

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The Donald Trump administration has unveiled new rules designed to deter pregnant women from travelling to the US to give birth.

Pregnant women applying for a US visitor visa may now have to prove they have an identifiable reason for going there other than having their baby on US soil - which is not “a legitimate activity for pleasure or of a recreational nature”, according to a State Department spokesperson.

So what triggered the crackdown on so-called “birth tourism” and why is it so controversial?

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What is birth tourism?

Birth tourism is the practice of travelling to another country for the purpose of giving birth there, usually to obtain citizenship for the child, using birthright citizenship laws.

What is the US citizenship question?

As far back as the early 1980s, The New York Times was reporting on Mexican mothers travelling to the US in an attempt to secure American citizenship and a chance of a better life for their children.

Demand for help in gaining access to the US is increasingly being fed by illegal “maternity tourism” operations. In 2015, federal authorities in southern California conducted widespread searches as part of an investigation into businesses suspected of charging women up to $60,000 to pave the way for them to give birth in the country.

And a Chinese woman last year pleaded guilty in the US to federal charges of running a birth tourism scheme for Chinese nationals who paid a total of more than $3m (£2.3m) in wire transfers.

Just how how great is the problem?

No official data is available for how many birth tourism babies are born in the US. The State Department has said only that “thousands of children” are born in the county each year to people who are either visiting or conducting business on non-immigrant visas.

However, various groups have offered estimates. According to the BBC , latest figures from the US Centers for Disease Control and Prevention suggest that around 10,000 babies were born to foreign residents in 2017.

Meanwhile, the Center for Immigration Studies, which campaigns for tight immigration laws, estimates that about 33,000 children were born to women on temporary tourist visas in the year from mid 2016.

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Why is the US cracking down?

The White House says birth tourism is putting additional pressure on hospital resources. In a statement this week, press secretary Stephanie Grisham said the new ban would “defend American taxpayers from having their hard-earned dollars siphoned away to finance the direct and downstream costs” associated with such cases.

The State Department also claims that some of the countries linked to birth tourism “have very sensitive relationships with the United States” and might use the practice “for purposes that would threaten the security” of the nation. The department did not clarify the nature of the potential threat or which countries might be involved.

The renewed opposition to birth tourism may also be linked to the upcoming presidential election.

The NPR news site reports that Trump “has been a frequent critic of birthright citizenship”. The 2015 reports of birth tourism operations in California prompted the then White House hopeful to call for eliminating birthright citizenship entirely.

Trump also “revived the discussion just before the 2018 midterm elections - and his administration is taking it up again now, ahead of the 2020 presidential vote”, the site notes.

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Giving Birth In The US On A Tourist Visa: A Detailed Guide

Each year, the United States become birthplace of 33,000 babies while their mothers visit the country as tourists — on top of hundreds of thousands more born by women on temporary visas and illegal aliens.

This alarming statistic has led to legal changes for giving birth in the U.S. on a tourist visa.

We’ll explain what birth tourism is and cover the legal consequences of having your baby in the U.S. as a tourist. We’ll also share the most recent legislation updates regarding tourist visas for pregnant women.

Contact Spar & Bernstein

Table of Contents

What Is Birth Tourism?

Birth tourism is the practice of traveling to another country, specifically to give birth in that country. Birth tourism often occurs on a temporary visa, such as a tourist visa.

Considered one of the best countries to give birth in, the U.S. is an attractive place for birth tourism. The motivation behind birth tourism in the U.S. includes:

• Perceived stability : Accepted as a stable and prosperous country, the U.S. is an attractive place to give birth and raise a child.
• Citiznship benefits : Giving birth in the U.S. makes your child a U.S. citizen, which gives the child access to education, healthcare and potential career opportunities.
• Family reunification: Giving birth in the U.S. can be used as a pathway for you and your spouse as a U.S. citizen’s parents to obtain legal immigration status in the U.S.

However, birth tourism in the U.S. is viewed as a potential threat to national security , because:

• It can lead to the fraudulent acquirement of U.S. citizenship, bypassing the traditional immigration pathways and security screening procedures
• It can strain healthcare and public services, impacting the well-being and security of citizens and legal residents

As a result, birth tourism has provoked numerous discussions about tightening regulations to ensure that those who enter the U.S. come to the country for legitimate reasons and are not compromising national security.

What Happens If You Give Birth In The US On A Tourist Visa?

Giving birth in the U.S. on a tourist visa can have certain legal consequences for both mother and child.

1. Legal Implications For The Mother

Giving birth in the U.S. on a tourist visa does not automatically grant you the right to stay in the country based on the birth of your child.

Your visa status remains unchanged and you will be typically expected to leave the U.S. before your visa expires. If you do not leave the country after the expiration of your visa, this will be considered as overstaying a visa , which may result in future travel restrictions or challenges when applying for a visa for subsequent visits.

In addition, if your primary purpose for entering the U.S. was to give birth and you did not truthfully represent your intentions to immigration officials, you can be charged with visa fraud due to willful misrepresentation of a material fact (that you were planning to have your baby in the U.S.) or face visa denial for future visa applications, due to credibility concerns.

While giving birth in the U.S. does not directly grant you any type of immigration status, there may be pathways that can help you remain in the U.S. permanently.

These alternatives can include family-sponsored visas, employment-based visas or other immigration categories. Talk to an experienced immigration attorney to understand your options.

2. Legal Implications For The Child

If your child is born on U.S. soil, they will acquire U.S. citizenship through the principle of jus soli (birthright citizenship).

• In addition to citizenship, being born in the U.S. allows your child to:
• Apply for a U.S. passport

Hold dual citizenship, depending on your home country’s laws

Apart from benefits, however, U.S. citizenship also comes with certain obligations. If your child is born in the U.S. and therefore is a U.S. citizen, your child is likely to:

• Have residency obligations, such as potential taxation on global income and the need to enter and exit the U.S. using a U.S. passport
• Face immigration challenges, as they may need to navigate U.S. immigration regulations, even if they choose not to reside in the U.S.

Because each situation is unique, the legal implications can vary based on the specific circumstances. We recommended seeking professional advice from a reputable immigration law firm, like The Law Offices of Spar & Bernstein.

With five decades of immigration experience, our team at The Law Offices of Spar & Bernstein has supported thousands of people in various immigration situations, from getting married on a tourist visa or navigating a visa overstay to removing conditions on a Green Card and facing the challenges of divorce after Green Card .

Schedule a consultation with our caring and tenacious team for professional guidance and advice in your situation. We will explain the legal implications for yourself and your child and share our advice on next steps.

New Rules For Giving Birth On A Tourist Visa In The US

As per the U.S. government, traveling to the U.S. and giving birth with the intention to obtain U.S. citizenship for your child is not an acceptable reason for granting a B nonimmigrant visa.

According to the updated temporary visa regulations , which became effective as of January 22, 2020, the consular officers have the authority to deny a B nonimmigrant visa to individuals they believe intend to travel solely for the purpose of obtaining U.S. citizenship for their child through birth.

However, the U.S. government recognized that foreign nationals may wish to travel to the U.S. for medical treatment while pregnant , which is different from birth tourism.

If you need to visit the U.S. for medical treatment while pregnant, you must submit your visa application along with:

• A legitimate reason to travel to the U.S. for medical treatment, such as a condition requiring specialized medical expertise, availability of advanced medical technology, chronic disease management, participation in a trial or experimental treatments that are not available in your country, or seeking a second opinion
• A confirmation by a medical practitioner or facility stating that they agreed to provide treatment
• An estimated duration of stay in the U.S.
• A projected cost of treatment
• Proof that you can cover your medical treatment, transportation and living expenses, either on your own or with pre-arranged assistance from other parties

The new rule restricting tourist visas to pregnant women does not affect :

• F-1 academic visa applicants
• M-1 vocational student visa applicants
• H1-B work visa applicants
• Those seeking lawful permanent residence in the U.S.

If you are considering visiting the U.S. on a tourist visa, especially if you are pregnant, talk to legal experts to review the latest updates and get professional recommendations on next steps.

Need Legal Advice? Contact Spar & Bernstein

With a long-standing history and commitment to serving clients with care and compassion, our experienced team at The Law Offices of Spar & Bernstein provides a guiding hand in key areas of immigration, from nonimmigrant visas and marriage-based visas to family immigration and waivers .

Giving birth in the U.S. on a tourist visa can be extremely overwhelming. To help you in this life-changing situation, our knowledgeable and compassionate lawyers will:

• Provide personalized advice based on your specific situation
• Assess your visa status
• Explain your rights and obligations as a foreign national in line with the changing policies and regulations that might affect your situation
• Provide insight into the implications of U.S. citizenship for your child
• Explore various legal options for you and your child, such as addressing potential overstays, adjusting your visa category or seeking pathways for obtaining legal immigration status
• Review your documentation to ensure accuracy and compliance with immigration regulations
• Submit your application for extending your stay or changing your visa category, along with all necessary documents
• Handle the communication with immigration officials on your behalf
• Represent you and advocate on your behalf in case of visa denial, overstay issues or other problems
• Provide peace of mind while you focus on caring for and bonding with your child

With Spar & Bernstein, you can rest assured that you and your child are in good hands.

Schedule a consultation

Giving Birth In The US On A Tourist Visa: Key Takeaways

Giving birth in the U.S. on a tourist visa can have a number of legal implications for both you and your child.

You will likely be denied a visa if your intentions to travel to the U.S. are only related to birth and the potential benefits that offers.

However, you can still be eligible for a visa if your medical condition requires treatment in the U.S. and you are expecting a child.

If you have questions about birth tourism or need to get a visa for medical treatment in the U.S. while pregnant contact our experienced and compassionate immigration lawyers at Spar & Bernstein.

We will help you navigate this complex situation by taking care of all the documents and procedures needed to maintain your legal status and pursue pathways to maintain in the country, if desired.

Work with our immigration attorneys

Bradford H. Bernstein

This article was written and reviewed by Bradford H. Bernstein, a second-generation leader at Law Offices of Spar & Bernstein, P.C., who has helped over 100,000 clients with immigration and personal injury issues. Brad joined the firm in 1993, became a partner in 1997, and assumed leadership in 2000 after Harry Spar retired.

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US imposes visa rules for pregnant women on ‘birth tourism’

FILE - In this Sept. 2017 file photo, a flag is waved outside the White House, in Washington. The Trump administration is coming out with new visa restrictions aimed at restricting a practice known as “birth tourism.” That refers to cases when women travel to the United States to give birth so their children can have U.S. citizenship. (AP Photo/Carolyn Kaster)

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WASHINGTON (AP) — The Trump administration is imposing new visa rules aimed at restricting “birth tourism,” in which women travel to the United States to give birth so their children can have U.S. citizenship. The regulations, which take effect Friday, address one of President Donald Trump’s main political priorities.

The regulations seek to chip away at the number of foreigners who take advantage of the constitutional provision granting“birthright citizenship” to anyone born in the United States, a particular peeve of Trump’s. Under the new rules, pregnant applicants will be denied a tourist visa unless they can prove they must come to the U.S. to give birth for medical reasons and they have money to pay for it or have another compelling reason — not just because they want their child to have an American passport.

Officials said that consular officers will not be asking all female visa applicants of child-bearing age whether they are pregnant or intend to get pregnant. Rather, they said consular officers would ask the question only if they had reason to believe the applicant is pregnant and likely or planning to give birth in the U.S.

Visual cues such as appearing to be pregnant or listing “medical treatment” as a reason for wanting to travel to the United States might trigger such questioning, the officials said. Even if a woman is found to be pregnant and likely to deliver her child in the United States, she could still be granted a visa if she was able to demonstrate a valid reason for the travel such a visiting an ailing relative or attending a business meeting or conference, they said.

Officials said the rule will not apply to foreign travelers coming from any of the 39 mainly European and Asian countries enrolled in the Visa Waiver Program, which allows citizens of those countries to come the U.S. without a visa for temporary stays. The rule will only apply to applicants for so-called “B” class visas that permit short-term stays for business or pleasure.

“Closing this glaring immigration loophole will combat these endemic abuses and ultimately protect the United States from the national security risks created by this practice,” White House press secretary Stephanie Grisham said in a statement. “It will also defend American taxpayers from having their hard-earned dollars siphoned away to finance the direct and downstream costs associated with birth tourism. The integrity of American citizenship must be protected.”

The practice of traveling to the U.S. to give birth is fundamentally legal, although there are scattered cases of authorities arresting operators of birth tourism agencies for visa fraud or tax evasion. And women are often honest about their intentions when applying for visas and even show signed contracts with doctors and hospitals.

The State Department “does not believe that visiting the United States for the primary purpose of obtaining U.S. citizenship for a child, by giving birth in the United States — an activity commonly referred to as ‘birth tourism’ — is a legitimate activity for pleasure or of a recreational nature,” according to the new rules, which were published Thursday in the Federal Register.

Birth tourism is a business where companies for a steep fee offer foreign women the chance to come the U.S. on a tourist visa, have a baby, get medical care, get citizenship, have a place to stay with their newborn, and then leave. It’s distinct from what Trump and his allies deride as “anchor babies,” referring to poor women who enter the U.S. illegally at the U.S.-Mexico border to give birth to a child and then stay in the U.S. illegally. But the end result is the same: a coveted U.S. passport.

The Trump administration also has turned away pregnant women coming over the U.S.-Mexico border as part of a broader immigration crackdown. Those women were initially part of a “vulnerable” group that included others like small children who were allowed in, while tens of thousands of other asylum seekers have been returned to Mexico to wait out their cases.

The Trump administration has been restricting all forms of immigration, but the president has been particularly troubled by birthright citizenship. Trump has railed against the practice and threatened to end it, but scholars and members of his administration have said it’s not so easy to do.

Birth tourism is a lucrative business in both the U.S. and abroad. Companies take out advertisements and charge up to $80,000 to facilitate the practice. Many of the women travel from Russia and China to give birth in the U.S.

The U.S. has been cracking down on the practice since before Trump took office.

“An entire ‘birth tourism’ industry has evolved to assist pregnant women from other countries to come to the United States to obtain U.S. citizenship for their children by giving birth in the United States, and thereby entitle their children to the benefits of U.S. citizenship,” according to the State Department rules.

Elena Balmiler, the founder of the Florida firm AIST USA, which caters to Russian mothers-to-be, said she did not expect the new rules would stop her business. She said her business gets about 60 queries a month and had 45 clients last year, because Trump has been unable to end birthright citizenship.

“So far it has resulted in nothing but intentions, guesses, publications and projections,” she said. “Not a single person has changed their mind to fly to the USA because Trump plans to stop (birthright) citizenship.”

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. and then left the country.

“This rule will help eliminate the criminal activity associated with the birth tourism industry,” according to the rules. “The recent federal indictments describe birth tourism schemes in which foreign nationals applied for visitor visas to come to the United States and lied to consular officers about the duration of their trips, where they would stay, and their purpose of travel.”

Associated Press writer Ellen Knickmeyer contributed to this report.

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The birth of the Blue Rider group

The first comprehensive exhibition of the group’s works in Britain since 1960 shows how Wassily Kandinsky, Gabriele Münter, Franz Marc, Paul Klee and others revolutionised painting.

By Michael Prodger

The period immediately preceding the First World War was the time of the “-isms”. Before industrial warfare made highfalutin artistic concerns seem both distasteful and irrelevant, a series of modern movements and styles sprouted across Europe, all addressing the need to create new art for the new century: fauvism, cubism and Orphism flourished in France, alongside futurism in Italy, vorticism in Britain, and suprematism and constructivism in Russia. Germany’s contribution to this febrile creative moment was expressionism, a style of rich colour and rudimentary forms that gave precedence to sensation and emotional truth over observable reality.

The most notable expressionists belonged to one of two groups: Die Brücke (The Bridge), founded in Dresden, or Der Blaue Reiter (The Blue Rider), founded in Munich. Both pursued broadly similar aims but it is the latter – less a formal group than an affiliation of like-minded artists, patrons, poets and musicians – that is the focus of “ Expressionists ” at Tate Modern. It is the first comprehensive exhibition of Blue Rider works in Britain since 1960.

The collective was short-lived, lasting only from 1911 to the outbreak of war, and at its heart were the Russians Wassily Kandinsky, Marianne von Werefkin and her partner-protégé Alexej von Jawlensky, and the Germans Gabriele Münter (Kandinsky’s partner) and Franz Marc. Other Blue Rider figures included Paul Klee (Swiss), Lyonel Feininger (American), Erma Bossi (Austro-Hungarian), August Macke (German) and the composer Arnold Schönberg (Austrian). Both this internationalism and gender equality were important to them: in the preface to their experimental manifesto-magazine The Blue Rider Almanac , published in 1912, Kandinsky and Marc proclaimed: “The whole work, called art, knows no borders or nations, only humanity.”

As this grand statement hints, art was the shared medium but the Blue Rider members were ultimately concerned, as Marc put it, with “a rebirth of thinking”. Aesthetically, their influences were wide-ranging – gothic and Oceanic artefacts, children’s pictures and folk art, as well as contemporary European work (both Picasso and Braque were included in the second, and last, Blue Rider exhibition in 1912). The “riders”, with their concern for an art in which the material and the spiritual coalesced, were drawn to works in which they were, in Münter’s words, “feeling the content of things”.

There was, as this vivid exhibition confirms, no single Blue Rider style; each artist took their own route towards the symbolic and expressive. All, however, used colour non-naturalistically, eschewed finicky detail and aimed for spontaneity – the lighter the throttling grip of the academy on their paintings, the better.

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As with the Bloomsbury Group, much of the theorising took place in the countryside. In 1908, Kandinsky, Münter, Werefkin and Jawlensky spent the summer in Murnau, a small subalpine town some 40 miles south of Munich, and the following year Münter bought a modest house there which she and Kandinsky set about decorating. It would become a meeting place and talking shop as well as a home. In 1912, Münter painted a charming picture of Kandinsky, in short trousers, sitting at the table there with Bossi. He, ever the pedagogue, gesticulates while she leans forward attentively. It was, Münter said, “a wonderful, interesting, enjoyable time with lots of conversations about art”.

Murnau was where the group went bicycling, skiing and swimming; Kandinsky designed a garden for the house and painted in the basement. The place brought out the best in them. The village’s church, coloured houses and surrounding mountains appear time and again in their work and also in a simple, colour-infused painting by Jawlensky, Landscape Near Murnau , made on a visit in 1909. The “riders” – Münter and Jawlensky in particular – were, however, better artists than their Bloomsbury peers­.

How quickly Kandinsky’s art developed under this stimulus can be seen in a pair of paintings made just eight years apart. In 1903 he painted Münter outdoors at her easel (although it could be a camera, since she was an accomplished photographer), a post-impressionist picture that captures a specific moment in time. By 1911 this genteel style was history. In Impression III (Concert) he depicted his memories of a concert by Schönberg he had attended with other Blue Rider painters. The scene becomes near-abstract with a dominant swathe of yellow, a black lozenge for the piano and dark arcs for the audience. Franz Marc recalled that his wife, Maria, noted that Schönberg “works with completely unresolvable sound-mixtures, without any tonal colour, only expression, gesture”. Kandinsky, he said, “was very inspired by it: that is his aim”.

Kandinsky became increasingly occupied with pure abstraction and exploring synaesthesia – experiencing music as colour – producing pictures such as his Improvisation paintings in which he sought visual equivalents to the emotive power of musical notes. 

Marc’s own interest, meanwhile, focused on animals. From 1912 he stopped painting the human figure and instead made pictures of tigers, deer, cows and foxes. He sensed a spiritual connection with these creatures and seems to have regarded them as symbols of innocence. Marc enlisted as a cavalryman on the first day of the war and slept with the horses in the stables, keeping warm under their blankets, and sending drawings of his charges back from the front. In 1916, shortly before he was due to be withdrawn from active service so he could paint in safety, he was killed by a shell splinter at the Battle of Verdun.

As an enemy alien, meanwhile, Kandinsky returned to Russia where he met and married Nina Andreevskaya but neglected to tell Münter. She found out through a third party only in 1922 when Kandinsky returned to Germany to teach at the Bauhaus. A legal case was to follow when Kandinsky sued her for the return of pictures she had kept safe during his absence.

So the paintings in the exhibition record not just developments in modern art but a friendship between artists with, as Münter put it, “a common passion for painting as a form of self-expression”, who were also interested “in the health and happiness of the others”. The passion for art survived, the care for one another did not.

Expressionists: Kandinsky, Münter and The Blue Rider Tate Modern, London SE1, until 20 October

[See also: Caspar David Friedrich and the mystery of eternity ]

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This article appears in the 01 May 2024 issue of the New Statesman, Labour’s Forward March

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