The tropical islands of the Commonwealth of the Northern Mariana Islands (CNMI), a U.S. territory located northeast of Guam, have become a bustling maternity destination for pregnant women from China. These women travel to the islands specifically to give birth, thereby granting their newborns automatic American citizenship. This phenomenon has transformed the remote archipelago into a “birth tourism” hotspot.
This trend began in earnest in 2009 when former President Barack Obama implemented a visa-waiver program for Chinese nationals, allowing them to stay for up to 45 days without a visa. Analysts estimate that around 1,000 companies in China now facilitate these trips, not only to the CNMI but also to other U.S. territories and the mainland. The scale of the industry is significant, with China-watchers claiming that 1.5 million U.S.-born babies are currently being raised in China by parents who utilized this strategy.
Concerned about the long-term implications, a group of Republican lawmakers sent a letter on March 9th to three members of the Trump Cabinet. In the letter, they demanded a federal accounting of the number of children born through this practice. The lawmakers expressed frustration, stating that while a profitable industry clearly exists, the government lacks official data on its size.
The primary concern among critics like Chmielenski is the potential for “chain migration.” As these children reach adulthood, they can sponsor their parents and siblings for green cards once they turn 21. Given that 77% of new green card holders in 2024 gained entry through this method, the lawmakers warn that this could lead to a significant influx of immigrants. Furthermore, they argue that families wealthy enough to afford the expensive packages can likely also afford to establish permanent residence in the United States.
Dr. Geoffrey Fraiche, the head of Obstetrics and Gynecology at Saipan’s only hospital, offered insight from his perspective on the island. While he cannot pinpoint the exact motivation for every mother, he noted that for many, American citizenship is a powerful status symbol. Parents often cite access to prestigious American universities as a key reason. However, Dr. Fraiche stated that some couples take extreme risks for this goal. He recalled a case involving a wealthy couple whose fetus showed signs of a serious anomaly. Despite his warnings that the local hospital lacked the necessary resources for high-risk cases, the couple insisted on delivering there. Ultimately, they arranged an air ambulance to evacuate both mother and child to China immediately after birth. Dr. Fraiche stated the baby would not have survived had it remained in the CNMI.
While the initial policy was designed to boost the local economy—which relies heavily on tourism—the birth tourism industry has provided a significant financial lifeline. The expectant mothers pay for all medical services in cash, avoiding the discounts given to U.S. citizens. This has been a boon for the hospital during economically difficult times.
Chinese companies have created a luxury market around the “Yankee factory” in the South Pacific. For example, Shanghai-based “Global Baby 8” markets the experience as a way to “create beautiful memories.” Their basic “Economy” package starts at $14,000, providing a simple apartment. The premium “Supreme Type” package, beginning at $45,000, offers a private villa, a personal escort, weekly shopping excursions, a celebratory one-month birthday party, and a full-time postpartum nanny. An additional $10,000 secures a hospital delivery, with options for a C-section for an extra fee. Brokers also handle the complex paperwork for the child’s citizenship for $1,000.
Similarly, the “China Mifubaby Group,” with offices across the U.S. and China, caters to clients from Korea and Japan, advertising “expedited visas” and a “short direct flight distance” to a “luxurious resort.”
U.S. authorities have begun cracking down on these operations. In 2019, Dongyuan Li admitted guilt for running a major birth tourism business in Southern California and received a 10-month sentence. More recently, in May, Chinese businessman Guojun Xuan was discovered living in a $4.1 million California mansion with at least 26 children, the result of a surrogacy operation. While he and his partner were released on bond, the case remains under investigation.
The debate over the legality of birthright citizenship has reached a critical juncture. On his first day back in office, President Trump signed an executive order to deny citizenship to children born to non-citizen, temporary visitors, but federal courts have blocked the measure. The case is now headed to the Supreme Court, with oral arguments scheduled for April 1st.
The issue is so prominent that the first American baby born in 2025, known as “Baby New Year,” was delivered in Saipan to a 30-year-old tourist from Shanghai.
The political landscape in the CNMI has also been affected. Former Governor Ralph Torres faced an FBI investigation regarding alleged dealings with Chinese firms totaling millions of dollars. Although impeached and facing ongoing criminal charges, he was ultimately acquitted by the Senate. Current Governor David Apatang has acknowledged receiving the lawmakers’ letter and plans to respond, though he declined to elaborate further.
