Shady Chinese Agencies Promoting U.S. Birth Tourism–Part 2: Hong Kong’s Struggle with the Problem

This series looks at shady Chinese agencies promoting U.S. birth tourism:

• Part 1 is an English translation of an investigative report about these agencies by Yicai, a Chinese financial news website. It focuses on the motivations of the intended parents from Mainland China.
• This Part 2  looks at the scope of Mainland birth tourism to Hong Kong and what measures the city has taken to control it. Hong Kong’s Chief Executive, CY Leung, recently claimed the measures are having an impact.[1]
• Part 3 discusses possible U.S. policy responses.

The Scope and Impact of Mainland Birth Tourism to Hong Kong

In 2011, there were 44,186 births in Hong Kong, 81.3% of them to Mainland mothers:[2]

The numbers had risen steadily since Hong Kong’s handover of its former colony to China in 1997. Since that time, the city has been a Special Administrative Region of China with its own constitution, the Basic Law. That law grants Chinese citizens born there the right of abode, including the right to a Hong Kong passport. A 2001 court case, Director of Immigration v. Chong Fung Yuen,[3] affirmed that this right extends even to the children of Mainland parents who themselves are not residents of Hong Kong.

A second draw to expectant mothers is that giving birth in the city is arguably a loophole to Mainland’s one-child policy, although some have reported being fined or losing jobs in government or state-owned enterprises.[4]

This influx has been politically controversial in Hong Kong. Local advertising campaigns denounced the Mainlanders as “locusts.”[5] C.Y. Leung, who became the city’s Chief Executive in July 2012, campaigned on a promise to solve the problem, saying that he was concerned with its impact on education, housing, and especially healthcare services. [6] It was reportedly difficult for local expectant mothers to book obstetrics services at crowded and understaffed local hospitals.[7]

A thriving industry of agencies promoting birth tourism has exacerbated the problem. The agencies are set up in many first tier cities in the Mainland providing an arrangement of services, including booking hospitals, transportation, prenatal examinations, accommodation, delivery services, postnatal care, birth registering and retrieving different certificates and visas. A key aspect of their business is smuggling expectant mothers across the border.[8]

Measures Taken by the Hong Kong Government

By 2007, Hong Kong was looking to get tough on the issue. The Immigration Department put into place rules that Mainland women 28 weeks or more pregnant who seek to enter must have a confirmed reservation at a Hong Kong hospital for delivery; otherwise, they may be refused entry.[9] Health officials are present at the ports of entry to assist in making the determination.[10]

The city raised hospital rates and put in place an annual quota on the number of reservations that could be made. When the number of births to Mainland mothers continued to rise, the city’s former Chief Executive, Donald Tsang, asked for help from Chinese Premier Wen Jiabao during a 2011 meeting.[11]

Following up on his campaign promises, even before he took office the new Chief Executive-elect C.Y. Leung announced on April 16, 2012, a “zero quota” policy. Effective January 1, 2013, Hong Kong hospitals will no longer book reservations for Mainland women unless married to Hongkongers.[12] He pressured the city’s private hospital association ot agree to the ban.[13]

The Immigration Department has stepped up prosecutions. In April of this year, the 58 Mainland agents and 20 from Hong Kong were under investigation.[14] Seven were convicted and imprisoned between October 2011 and May 2012.[15]

The Hong Kong government is claiming that their efforts are having an impact. The number of birth tourists with hospital bookings is down even before the ban goes into effect. Also, the number of women with no bookings who rush into emergency rooms when they go into labor is also down, from 150 a month in late 2011 to 45 in May 2012.[16]

This measure of success takes the heat of the government to deal with the Basic Law granting the right of abode to Chinese citizens born there the right of abode. It would take an enormous effort to amend Hong Kong’s constitution. And Chief Executive Leung has said he’d rather not ask the Standing Committee of China’s National People’s Congress to issue an interpretation of the Basic Law that would to overturn the 2001 Chong Fung Yuen decision.[17] That would grate on many Hongkongers, who dislike the idea of China’s Congress having the ultimate say on how to interpret the city’s constitution.

Read Part 3 about what lessons the U.S. can draw from Hong Kong’s experience in formulating a policy to respond to birth tourism.

Endnotes

[1] Measures Keep Mainland Pregnant Women at Bay: CE, Hong Kong Information Services Dep’t, Aug. 24, 2012, http://www.news.gov.hk/en/categories/law_order/html/2012/08/20120824_083412.shtml.