Why I Left Pakistan to Give Birth in the U.S.

LAHORE, PAKISTAN: When I saw two pink lines slowly emerge on the home pregnancy kit I keep hidden in a cupboard in my bedroom, I sat down on the bathroom floor in shock. Within minutes, I realized the lines weren’t going to disappear no matter how intently I stared at them. Rushing to our bed, I shook my husband awake, placed my mouth close to his ear, and shrieked, “I’m pregnant.” And then, after a pause, “We can’t have the baby here.”

When other excited first parents would have become engrossed in preparing a nursery and shopping for baby clothes, my husband and I began getting our visas sorted out, making travel arrangements, and applying for time off from work. We were headed to America to have a baby.

As Pakistan’s military desperately fights Taliban in the north, and the rest of the country suffers through frequent suicide bombings and security threats, those with money have silently begun purchasing residences abroad. Others have started applying for Canadian or U.K. citizenship. And upper- and middle-class Pakistani mothers, desperate to provide their children with exit options, have started indulging in what’s commonly called birth tourism. Almost every pregnant Pakistani woman I know is scheduling a trip abroad in her sixth month of pregnancy, so that she can stay and deliver the baby in a country that allows your child to become a citizen if he or she is born there. As of 2009, only a handful of countries permit birth-right citizenship. The most prominent are Canada, Mexico, and the United States.

“It’s like an avalanche,” says Dr. Muhammed Tayyab, an obstetrician who takes care of dozens of pregnant women in Lahore every year. “I have never seen so many expecting women planning trips abroad before. The only ones not going are those who can’t afford it or can’t travel for health reasons.” (Most women travel no later than the 24th week of pregnancy, because it decreases your chances of encountering risks, and makes it easier to find a doctor in the States, where doctors are reluctant to take on a patient after six months.)

Fiza Mustanzir, 25, is one of Tayyab’s patients. When she became pregnant after seven months of marriage, she was overjoyed. “I’m very traditional this way. My dreams revolve around a caring husband, a nice home, and beautiful children.” After Fiza broke the news to her mother, she began making plans with her family for the baby shower and setting up the baby’s room. But her husband, Mustanzir Javed, had a surprise in store for her: He informed her about his plan to take her abroad in her sixth month and have the delivery in the United States of America. “I was like what? Why? Why do we have to do that?” she says, remembering her reaction. “I couldn’t imagine going through the process without my mother at my side.” (Her mother did not have a U.S. visa and was unlikely to obtain it in such a short time frame.) Mustanzir, who had studied in the U.S., explains that if they had the delivery in America, their child would be entitled to a U.S. passport. “I wanted my child to have all the advantages of being a U.S. citizen,” he says.

Though Pakistan is a relative newcomer to birth-tourism, women from South Korea, Hong Kong, and Taiwan have been flying into Los Angeles to give birth for many years. A mini-industry has cropped up there: Agencies sign up expectant mothers and assist them in obtaining medical care, navigating the immigration system, and traveling to and from America. One Korean website advertises its services with the slogan "from birth to citizenship."

Current U.S. federal policy is to confer American citizenship automatically on any child born within its borders. The only exceptions are children of foreign diplomats stationed in the United States, who become citizens of their home country regardless of where they are born. The legal status of the parents is deemed irrelevant. Immigration foes in Congress have been lobbying for years to stop this practice; Their efforts have failed so far because the right to citizenship of an American born child is guaranteed by the 14th Amendment to the Constitution, which was added after the Civil War to allow descendants of slaves to become citizens.