canada birth tourism cost

'All about the money': How women travelling to Canada to give birth could strain the health-care system

Birth tourism leads to complaints of compromised care at b.c. hospital.

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Women travelling to Canada to give birth to babies who will automatically become Canadian citizens are prompting concerns about the strain they may be putting on the health-care system, The Fifth Estate has found.

Canada is one of fewer than three dozen countries that follow the practice of citizenship based on birthplace, regardless of parents' nationality or status.

At one British Columbia hospital with a high concentration of such deliveries, complaints have arisen that the influx of these non-resident patients — also known as birth tourists — has led to compromised care for local mothers-to-be and struggles for nursing staff.

Some of these patients fail to pay hospital and doctors bills, leaving taxpayers and individual care providers on the hook.

"Most of them, they get the Canadian passport, and then they leave the country," said Dr. Mudaffer Al-Mudaffer, a B.C. pediatrician and neonatologist who sees babies of non-residents when they need critical care. "It affects the integrity of the fairness of the health system."

No statistics are available regarding how many people are travelling to Canada specifically to ensure their child is born here and will have a Canadian passport.

But figures from the Canadian Institute for Health Information and several Quebec hospitals indicate there were about 5,000 non-resident births across the country in 2018, an increase of nearly 15 per cent over the previous year.

In the fall of 2019, Cathy Shi arrived in Richmond, B.C., from Shandong, on China's east coast, to give birth to her third child. She said through a translator that she wanted her unborn child to have more opportunities.

"My concern is about their education, such as going to university. If the kid wants to live in Canada, it would be convenient for them if they're born here."

Handful of hospitals

At this point, the practice of birth tourism appears to be concentrated in a handful of hospitals in Quebec, Ontario and British Columbia.

At the Richmond Hospital, south of Vancouver, non-residents make up nearly a quarter of all births, according to records obtained from Vancouver Coastal Health, the health authority which runs the hospital. In many ways, that hospital can be seen as a test case for how this issue could play out elsewhere as numbers continue to climb.

The health authority declined a request for an interview with The Fifth Estate and issued a warning directing its staff not to speak to the media.

Despite that, four current and two retired nurses shared their concerns, requesting that their identities be protected.

Watch "Passport babies" on The Fifth Estate on CBC-TV Sunday at 9 p.m.

Since 2013/14, the number of non-resident births has tripled at the hospital. The patients — many from China — pay privately for their care, often in cash, may not speak English and are unfamiliar with the Canadian health-care system. The nurses who spoke to The Fifth Estate say the influx has led to increased workloads and has compromised care.

"There are times when ... the people living here don't get the service that they need," one nurse said.

When the unit was very busy, one nurse said services like prenatal tests to check the baby's health, labour inductions and other tests to check fetal and maternal risk factors would be delayed or cancelled.

"We would often have to decide whose need was greatest and abandon the rest for the next day where we would face the same situation again," she said.

"Our normal scheduled or add-on C-sections lie here all day and then they take the IV out, we send them home and say come back tomorrow. A private pay never goes home — she gets her C-section that day," said another nurse.

"She will be fit in somewhere because nobody wants to lose that $5,000. But our normal people are lying there all day, no food or drink, waiting and nobody's interested in moving them."

Some hospitals, like Sunnybrook Health Sciences Centre in Toronto, have taken steps to limit the number of non-resident births in order to prioritize residents of their own communities. That hospital says it won't treat non-residents patients without Ontario Health Insurance Plan coverage.

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When asked in an email why the Richmond Hospital doesn't have a similar policy, Carrie Stefanson, a public affairs representative with Vancouver Coastal Health, said: "VCH cannot speak for other hospitals or health authorities. VCH will never deny urgent and emergent care based on ability to pay or where a patient is from."

The hospital requests deposits for privately paid births: $10,000 for a vaginal birth and $16,000 for a caesarean. More than $18 million has been invoiced for non-resident births since 2017, according to data released through freedom of information by Vancouver Coastal Health.

Nursing staff say they have not seen this money go into easing their workloads.

"The amount of money that's coming into Richmond from the private pay, it doesn't make our staffing better," said one nurse.

Their union says that is a problem.

"I certainly think adding additional patients into a health-care system that isn't staffed appropriately, isn't funded appropriately, is causing strain," said Christine Sorensen, president of the BC Nurses' Union.

She said the union has regularly heard complaints from nurses at Richmond Hospital but they have not filed a formal complaint with the hospital.

The health authority declined to answer a question about how it has responded to complaints from nursing staff.

Financial incentives within the medical system

Two doctors at the Richmond Hospital have delivered 1,300 of the 2,206 babies born to non-residents there since 2014, according to documents released through freedom of information.

While the health authority will not disclose their names, insiders and birth tourism company representatives say Dr. Xin-Yong Wang and Dr. Brenda Tan, two Mandarin-speaking family doctors, see the majority of these patients for prenatal care and delivery.

Both appear on multiple websites of companies advertising services such as assistance with immigration, travel and housing to women looking to come to Canada to give birth.

Wang said the companies do not have permission to use his name.

Tan did not respond to interview requests and a list of questions sent to her.

Wang and Tan billed the province $272,198.50 and $428,456.17 respectively in the 2018/2019 fiscal year, according to data publicly available through the province. Those billings do not include earnings from non-resident patients because they pay privately.

There are no limits on what physicians can charge outside the public system in British Columbia, but information from birth tourism company websites suggests that these doctors earn at least $100 per prenatal visit and more than $2,500 for a delivery, several times more than could be billed through the public system for the same services.

In an interview, Wang declined to respond to questions about how much he was earning from birth tourism but said he was not motivated financially to take on these patients.

"It's like a dessert — occasional patients like this is fine, and it's pretty financially rewarding … they are a small percentage of our overall income."

Nurses who spoke to The Fifth Estate said the financial incentives within the health-care system are a problem.

"It is all about the money. If there was no financial income for the hospital or physicians, the private pay would have been out of the door a long time ago," said one nurse.

Unpaid bills

While these births are bringing in money, bills owed to both health authorities and individual doctors are not always paid.

According to documents released by Vancouver Coastal Health, more than $2 million is outstanding as a result of non-resident births since 2017 at the Richmond Hospital alone. This does not include any debt that has been written off.

Births at the Richmond Hospital represent 11 per cent of overall non-resident births outside Quebec, according to 2018 data from the Canadian Institute for Health Information.

No national financial data exists on how much revenue is outstanding as a result of non-resident hospital bills across the country.

But some say the health-care system and Canadian taxpayers are losing out.

Al-Mudaffer said having an uninsured baby in neonatal intensive care can cost $10,000 a day just for the hospital bed, not including doctors' fees.

Watch Dr. Al-Mudaffer express concerns about birth tourism:

Dr. Mudaffer Al-Mudaffer

He said he's seen large bills for families with babies requiring multiple nights and even weeks in the NICU.

"You can easily acquire a bill of $100,000 to pay the health authority, and that's why they can't pay it, you know? And they leave the country without paying," said Al-Mudaffer.

He said he has seen hundreds of thousands of dollars in bills go unpaid at the Royal Columbian Hospital where he works, but Fraser Health, which runs that hospital, said it could not confirm this amount.

The Fifth Estate requested provincial numbers on unpaid bills from the British Columbia government but was told these numbers were not tracked provincially.

"Obviously if any bill is unpaid, I'm concerned about that because that's money that we could and should be spending on something else or saving the health-care system so of course we're concerned about it," said B.C. Health Minister Adrian Dix.

Even with little formal research to examine the practical implications of a growing number of non-resident births on the Canadian health-care system, Dix said "we are handling that situation.

"It's two per cent … of total births in British Columbia, so it's an issue but there are other issues."

But it's not only hospital fees going unpaid. Al-Mudaffer said when he sees birth tourists, he only gets paid three out of 10 times.

He is not alone. Dr. Kathleen Ross, president of Doctors of B.C., has personally been affected by unpaid bills and has called for a national conversation on the issue.

"Our federal government needs to find a way to disincentive people coming to the country to have access to citizenship and to our health-care support," she said.

Federal research planned

Marco Mendicino, the newly appointed minister of immigration, refugees and citizenship, declined an interview with The Fifth Estate .

But the department wrote that while "statistics indicate that birth tourism is not widespread, the Government of Canada recognizes the need to better understand this practice."

It said it has started work with the Canadian Institute for Health Information and Statistics Canada to integrate health and immigration data that would allow for a better understanding of the practice of birth tourism by looking at visitor visas and births.

Immigration, Refugees and Citizenship Canada anticipates results from this research will be available in the spring.

Cathy Shi said she hasn't thought much about criticism of birth tourism and isn't receiving any government benefits here.

"We may come here often for travelling around, living or even investing. People are not just looking for status by having a baby here. They will have established a connection to Canada and later on some may apply to immigrate."

For more information, on this story please contact Annie Burns-Pieper [email protected]

ABOUT THE AUTHOR

Annie Burns-Pieper is a freelance investigative reporter and producer. She has a particular interest in themes of gender equality, public safety and health.

@Aburnspieper

The Cost of Having a Baby in Canada: What You Need to Know

The cost of having a baby in Canada falls within the range of $10,000 to $15,000 a year, until they turn 18.

Factors that can affect the cost of having a baby in Canada include the province or territory in which you reside, childcare costs, saving for post-secondary education and more.

Costs Associated with Having a Baby in Canada

Whether you’re eagerly awaiting the arrival of your bundle of joy or simply curious about the financial aspect of starting a family in Canada, understanding the financial necessity is important.

Prenatal Care Costs

Prenatal care costs in Canada are typically covered under provincial health insurance.

This cost includes various aspects of care such as regular check-ups, ultrasounds, and blood tests.

It should be noted that these costs may differ depending on the province or territory in which the care is sought.

More extensive and expensive treatments like In Vitro Fertilization (IVF) can increase the overall cost of prenatal care and are not covered by universal health insurance.

Delivery Costs

Giving birth in a hospital, as well as the costs associated with doing so, is completely free in Canada, covered by the healthcare system.

At most, you may have to pay a few hundred dollars out of pocket.

Universal healthcare does not apply, however, if you are a visitor or non-resident.

The cost of giving birth in a Canadian hospital, if you are a visitor or non-resident will depend on whether you have health insurance or not, and can cost upwards of $10,000.

Additional Expenses

Setting up a nursery with a crib, changing table, and other essential furniture can cost upwards of $1,500.

Strollers, car seats, high chairs, baby monitors, and playpens can also add $1,000 – $2,000.

Outfits, diapers, bottles, pacifiers, and other baby essentials can cost another $1,000 – $2,000 per year.

While most medical expenses related to pregnancy and childbirth are covered by Canada’s healthcare system, there may be out-of-pocket costs for prescriptions, medical supplies, or additional tests or procedures not covered by universal health insurance.

The cost of daycare centers or hiring a nanny varies depending on location and the type of care chosen.

As your child grows, there will be expenses for education, including school supplies, extracurricular activities, and potentially university expenses in the future.

Miscellaneous expenses related to raising a child can also add up, including items such as toys, books and outings.

Financial Assistance and Coverage

There are plenty of support programs that can assist with the financial responsibilities associated with having a baby.

Provincial/Territorial Health Insurance

When it comes to health insurance in Canada, here are some key points to consider:

All Canadian provinces and territories provide health insurance coverage for residents, including maternity care.
The coverage includes prenatal care, delivery services, and postnatal care.
Provincial/territorial health insurance plans differ in terms of specific coverage and services provided.
In some provinces/territories, additional coverage for services like fertility treatments, such as in vitro fertilization (IVF), may be available.

Pro-Tip: Familiarize yourself with the specifics of your provincial/territorial health insurance plan to understand coverage and potential costs.

EI Maternity Benefits

If you are away from work because you are pregnant, have recently given birth, or are caring for a newborn or recently adopted child, you could qualify for EI maternity benefits.

Important factors must be considered:

Eligibility: To receive employment insurance benefits, you must have worked a certain number of hours in the past year and paid into the program. Check if you meet the eligibility requirements before applying.
Types of benefits: Canada offers maternity, parental, sickness, and compassionate care benefits. Each benefit has its own criteria and duration.
Application process: Apply for employment insurance benefits online. Provide accurate information and supporting documents for a smooth process.
Benefit amount: The amount is calculated based on your earnings and the government’s maximum insurable earnings. The current maximum weekly benefit is $650.
Duration of benefits: Maternity benefits last up to 15 weeks, while parental benefits last up to 35 weeks per parent (and 40 weeks total).

Additional Support Programs

A number of free additional support programs exist for new parents in Canada:

Parenting Classes
Parenting Hotlines
Postpartum Support Groups
Lactation Consultants
Maternal Mental Health Programs:
Childcare Subsidies
Government Assistance Programs
Community Centers with resources and programs such as playgroups and workshops.

New parents should explore these additional support programs in their community.

Planning for the Cost of Having a Baby in Canada

When it comes to the cost of having a baby in Canada, budgeting and saving are important. Here are some factors to consider:

Evaluate your current financial situation: Assess your income, expenses, and savings to understand how much you can allocate towards the costs of having a baby.
Research estimated expenses: Familiarize yourself with the average costs of baby essentials and childcare.
Create a baby budget: Develop a comprehensive budget that includes one-time expenses and ongoing expenses for raising a child. This will help you prioritize your spending.
Save for future expenses: Set aside a portion of your income specifically for future expenses like education, healthcare, and maintaining your standard of living. Consider opening a separate savings account or RESP for this purpose.
Explore government assistance programs: Research available financial assistance programs, such as employment insurance benefits and additional support programs, to determine eligibility.
Consider healthcare coverage: Understand your health insurance coverage and how it applies to maternity care, including medical expenses and any out-of-pocket costs.
Seek professional advice: Consult with a family planning financial advisor to make informed decisions and ensure financial preparedness.

Exploring Financial Assistance Options

When it comes to the cost of having a baby in Canada, there are a few financial assistance options to consider:

Provincial/Territorial Health Insurance: Canadian citizens and permanent residents qualify for provincial/territorial health insurance, which covers essential medical services during pregnancy, childbirth, and postnatal care. This reduces out-of-pocket expenses.
Employer Health Insurance: Your employer may offer top up or additional coverage over and above what provincial/territorial insurance will cover. Familiarize yourself with what is available toyou.
Employment Insurance Benefits: Expecting parents may be eligible for employment insurance benefits, including maternity leave and parental leave benefits, which provide a portion of their income during time off work.
Additional Support Programs: Some provinces and territories offer support programs which can include financial assistance for low-income families, childcare subsidies, and support for families with special needs.

Explore these financial assistance options early and determine your eligibility.

Couple in the park pushing baby in stroller

Frequently asked questions

How much does it cost to have a baby in Canada?

The cost of having a baby in Canada falls within the range of $10,000 – $15,000 a year on average. Most of the prenatal, post-natal and delivery costs are covered by the publicly-funded healthcare system for citizens and permanent residents, but tourists and non-residents will have to pay out-of-pocket unless they have international health insurance.

What are the estimated costs of fertility treatments in Canada?

Fertility treatments in Canada can be expensive. The average costs range from $10,000 to $15,000 per cycle for IVF, $2,500 to $7,000 for fertility drugs, and $200 to $1,500 for intracytoplasmic sperm injection. Donor eggs and embryos are legal in Canada, as long as you do not pay for them. Some provinces offer financial assistance for IVF treatments.

Is birth tourism legal in Canada?

Any child born in Canada is granted Canadian citizenship regardless of their parents’ citizenship or residency status. However, it is important to note that parents of a newborn Canadian citizen do not automatically receive Canadian citizenship or a residence permit.

How does the Canadian healthcare system affect the cost of having a baby?

For Canadian citizens and permanent residents, the cost of giving birth in Canada is relatively affordable due to the universal health insurance program. Costs for childbirth are often covered by the publicly-funded healthcare system. Tourists and non-residents may have to pay out-of-pocket or have private international health insurance to cover the expenses.

What are the benefits and financial assistance available for Canadian parents?

Canadian parents can be eligible for EI maternity and parental benefits if they have worked at least 600 hours in the prior year. There are also other tax benefits available, such as the Canada Child Benefit and the Child Disability Benefit.

FIRST READING: Canada’s massive (and easily fixed) birth tourism problem

In some BC hospitals, birth tourists now represent 25 per cent of all maternity ward patients

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FIRST READING: Canada’s massive (and easily fixed) birth tourism problem Back to video

Last week, Macleans’ published an interview with Simrit Brar, a Calgary OB-GYN who is one of Canada’s few medical researchers to actually look into the issue of birth tourism.

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It’s something that’s long been an accepted fact within Canadian birthing hospitals: Hundreds of non-resident women each year are coming to Canada in the final weeks of pregnancy, having their baby in a Canadian hospital and then immediately returning home. The purpose of the excursion being to ensure that the child has Canadian citizenship by virtue of the country’s jus soli laws.

There are companies openly advertising their services as “birth hotels.” Online forums include questions as to the “cheapest” Canadian hospital for a non-resident to give birth. In the last full year before the COVID-19 pandemic, a single hospital in Richmond, B.C. had 502 non-resident births — nearly one quarter of total babies born.

Figures from the Canadian Institute for Health Information show that Canada hosted a record 4,400 foreign births in 2019 — up from 1,354 just nine years prior.

Vancouver’s first baby of 2023, in fact, was born to a birth tourist: Mother Salma Gasser had only recently arrived from Cairo, Egypt, on her first-ever trip to Canada, and told local reporters she did it to secure a Canadian passport for her baby girl.

There’s nothing illegal about birth tourism and birth tourists are all paying handsomely for the service (it costs between $6,000 and $10,000 for an uninsured non-resident to give birth at a Canadian hospital). But for a Canadian health-care system that is constantly on the verge of crisis, the phenomenon is having an impact.

In a two-tier system like Australia, the U.K. or the U.S., an influx of non-residents seeking health-care beds could safely exist on the sidelines without affecting overall health-care access: The system could simply grow organically to accommodate the increased demand.

But Canada rations its supply of doctors and health-care workers, meaning that any extra patient is going to be adding to wait times.

“So even if a birth tourist does pay their bill, if we allow people who have the opportunity to pay to preferentially access beds … that displaces people here,” Brar told Maclean’s.

She added that birth tourism is a “social structure issue.” Ultimately, wealthy people from abroad are able to supplant scarce Canadian health-care resources, with negative results for “disadvantaged” Canadians.

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“The system is too strained for us to ignore these questions,” she said.

Brar’s research examined 102 cases of birth tourists who had their babies in Calgary between July 2019 and November 2020. A plurality (24.5 per cent) were Nigerian and all told, the 102 paid $694,000 to Alberta Health Services in hospital fees.

Notably, most of Canada’s birth tourists are coming from countries that do not offer birthright citizenship. Almost all of North and South America grants automatic citizenship based on birthplace — a principle known as “jus soli,” or “right of the soil.”

In most of the rest of the world, citizenship is determined based on the nationality of one’s parents — known as “jus sanguinis,” or “right of the blood.” If a visiting tourist gave birth in Nigeria, for instance, that child would not be considered Nigerian unless they had a Nigerian parent or grandparent.

It would be remarkably easy for Canada to ban birth tourism, or at least make it less easy.

Provincial health-care systems could dramatically raise fees on “other country” birth services in order to discourage patients not insured under the Canadian system.

Some minor tweaks to the Citizenship Act could nullify instant citizenship if a baby is born to a parent temporarily visiting Canada on a tourist visa.

Refugees, asylum-seekers and other newcomers would still have guaranteed full, automatic citizenship for their Canadian-born children.

Or, Canada could simply begin denying visas to foreign nationals booking short trips to Canada at the tail end of a pregnancy. This is what the United States did in order to curb its own rising rates of birth tourism.

In early 2020, the U.S. Department of State issued an order to deny certain classes of recreational visas to foreign nationals if a consular official believed they were doing it just to give birth.

“The 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,” reads a statement from the time .

U.S. officials have also prosecuted California-based “birthing houses” for counselling foreign nationals to misrepresent their intentions on visa forms in order to enter the U.S. for the purpose of giving birth. Similar charges are feasibly possible in Canada, given that it is illegal under Canadian law to misrepresent one’s intentions for visiting.

Although birth tourism is not addressed or even acknowledged at the federal level, it’s long been deeply controversial in the immigrant-heavy Vancouver communities where it’s most visible.

Jas Johal, MLA for Richmond, has repeatedly denounced birth tourism for turning local hospitals into “passport mills.” Longtime Richmond city councillor Chak Au has often gone on record saying that his constituency — the most Chinese-Canadian in Canada — supports a legislated end to birth tourism.

In 2018, Richmond’s Liberal MP Joe Peschisolido tabled a petition in the House of Commons calling birth tourism an “abuse of Canada’s immigration and citizenship system.”

“The government should say birth tourism is bad. Let’s quantify it and let’s fix it,” he said at the time .

As recently as 2016, Vancouver-area Conservative MPs Alice Wong and Kenny Chiu even led a drive to overturn Canada’s system of birthright citizenship altogether in order to combat birth tourism — although both had reversed course by 2019, when the Conservatives prepared for that year’s election with a platform that mostly side-stepped immigration policy.

IN OTHER NEWS

It’s only been a month since news emerged that Canada promised $13 billion in subsidies to Volkswagen in order for them to build a $7 billion electric vehicle battery factory outside St. Thomas, Ont. And now, there is evidence that Ottawa may pony up another $19 billion for Stellantis – a conglomerate of legacy car brands such as Chrysler and Dodge – to build a similar factory in Windsor, Ont. Both these subsidies are well beyond anything that used to be considered normal government practice. Only six years ago, Bombardier was considered the worst offender for its steady reliance on government subsidies – and they managed just $4 billion in government monies over 40 years.

Five years after the Government of Canada officially changed the lyrics of O Canada to be gender-neutral , an Ontario politician is trying to change them again to be reconciliation-friendly . In 2018, the line “in all thy sons command” was changed to “in all of us command.” And now, Mississauga mayor Bonnie Crombie wants the line “our home and native land” changed to “our home on native land.” Meanwhile, absolutely nobody is calling for alterations to the original French lyrics to the song, which remain a jingoistic Victorian anthem depicting Canada as a sword-wielding Christian soldier prepared to slay anyone who threatens the country’s God-given rights.

A Canadian political issue made its way into the U.S. press! On Tuesday, Washington State’s Komo News ran a segment on how hundreds of B.C. cancer patients would soon be coming across the border to seek care in local clinics . Earlier this month, wait times for radiation treatment became so bad that B.C. health minister Adrian Dix made the unprecedented decision to start sending patients to the United States at provincial expense. “It is a highly unusual, yet not entirely unprecedented effort by the free universal health care system Canadians have long enjoyed,” read a web story . “It will also mean two Whatcom County clinics stand to make millions in payments from the BC government.”

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Global Affairs
Social Policy

Is birth tourism about to return now that travel restrictions have been lifted?

COVID-19 continues to provide the perfect natural experiment to assess the extent of “birth tourism” – when women visit Canada for the purpose of giving birth here and thus obtaining Canadian citizenship for their child. Two years in, the data shows a decrease of almost eight per cent, compared to 2020-21 and almost 52 per cent compared to the pre-pandemic 2016-20 average, in the number of “non-resident self-pay” births in Canada.

As Figure 1 indicates, there was a steady increase of non-resident births prior to the pandemic. But after COVID-related travel restrictions were implemented in 2020, there was a sharp drop, with no recovery in 2021. This provides a very good indication of the extent of birth tourism in Canada. Now that the restrictions are loosening and travel is once again opening up, it’s time for the federal government to revisit its policy on non-resident births and Canadian citizenship.

The decline to 2,245 in 2021 from 2,433 in 2020 occurred in all provinces save Quebec, which remained relatively stable (Table 1). The decline was particularly notable in British Columbia, where most birth tourists pre-pandemic were from China – a country most affected by travel restrictions. The drop is in stark contrast to steady increases over the previous five-year period.

A similar decline in visitor visas and birth tourists has been noted in the United States.

The percentage of non-resident births in Canada fell from slightly less than two per cent of total births in 2019 to 0.7 per cent in 2020 and has remained at that level. Given increased immigration, the percentage of non-resident births also fell during the same period.

As noted in previous articles , the non-resident self-pay code that is the basis for the analysis is broader than that of women who arrive on visitor visas. It includes international students, about half of whom are covered by provincial health plans, and other temporary residents. Visitor visas recovered to only 57 per cent of pre-pandemic levels in 2021-22 while visas for temporary workers have more than recovered from pre-pandemic levels. Visitor visas for Chinese nationals, one of the major groups, have recovered to only 21 per cent of former levels compared to 57 per cent of previous levels for all visitor visas. Chinese government travel-related restrictions are likely a significant factor in the reduced number.

Table 2 provides a hospital-level view of the impact of COVID, contrasting pre- and post-pandemic years in terms of non-resident and total births for the 10 hospitals with the largest percentage of non-resident births. Non-resident births continued to decline in most hospitals. British Columbia’s Richmond Hospital – the epicentre of birth tourism with its supportive “cottage industry” of “birth hotels” – has been the hardest hit. There was a decrease of 95.6 per cent compared to pre-pandemic levels.

This suggests that my initial estimate from 2018 that about 50 per cent of non-resident births were due to birth tourism was conservative, and that the percentage of “tourism births” is about one per cent of all births (or about 0.4 per cent of current immigration levels).

Three federal immigration ministers later, the government has not have followed up on its 2018 commitment to “better understand the extent of this practice as well as its impacts” following the first release of the Canadian Institute for Health Information numbers and related media attention. The 2021-22 decline understandably reduces political interest and pressure in addressing the issue, particularly at a time of government and stakeholder support of increased immigration, as the proportion on “non-resident” self-pay is only about 0.5 per cent of permanent resident admissions, having fallen from 1.7 per cent pre-pandemic.

Given the current focus on increased immigration, it is highly unlikely that the government will take action. The numbers are very small compared to the planned level of 500,000 immigrants to Canada in 2025 and Immigration, Refugees and Citizenship Canada’s current policy and operational challenges. However, given that visitor visas have largely reverted to pre-pandemic levels in 2022, growth in birth tourism can be expected in future years.

The government should address the policy deficit in this area. There appears to be public support for some action. A 2019 Angus Reid survey indicated that the vast majority of Canadians would support removing birthright citizenship for children born to women on visitor visas.

The use of CIHI data to quantify the extent of birth tourism, albeit approximately, highlights the potential in greater linkages between immigration and health data. With respect to birth tourism, the ability to distinguish between non-resident births for visitors, international students and temporary workers would provide greater precision on the extent of the practice.

It would also allow for more informed analysis and understanding of the health outcomes of immigrants and would identify opportunities for improvement.

The policy and operational questions remain as to whether the extent of birth tourism warrants an amendment to the Citizenship Act, visa restrictions on women intending to give birth in Canada, or other administrative and regulatory measures to curtail the practice. Because visa restrictions would be difficult to administer, and because regional administrative and regulatory measures may well encourage hospital and jurisdiction “shopping,” the “cleanest” approach would be an amendment to the Citizenship Act that would make Canadian citizenship dependent on one parent being a citizen or permanent resident, comparable to the situation in Australia .

A note on methodology

The data is from the CIHI ’ s Discharge Abstract Database, more specifically the responsible for funding program (RRFP) “ non-resident self-pay ” category, as well as totals for hospital deliveries. The RRFP data include temporary residents on visitor visas, international students, foreign workers and visiting Canadian citizens, and permanent residents. While Quebec has a slightly different coding system, CIHI ensures its data is comparable.

Health coverage for international students varies by provinces, but most are covered by provincial health plans. This is not the case in Manitoba and Ontario , and for some students in Quebec whose country of origin does not have a social security agreement with Quebec. The pre-pandemic baseline is the five-year average 2016-20.

Mackenzie Health ’ s Woman and Child program moved from Mackenzie Richmond Hill Hospital to Cortellucci Vaughan Hospital when it opened to the community in June 2021 .

You are welcome to republish this Policy Options article online or in print periodicals, under a Creative Commons/No Derivatives licence.

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Young family after giving birth in Canada

Having children in Canada is an opportunity to ensure that your children automatically become Canadian citizens under the principle of «jus soli». This right also applies to foreigners. In order to become a Canadian citizen by right of soil, you must legally enter the country and give birth to a child in Canada.

Despite the fact that giving birth in Canada with obtaining citizenship is a fairly common practice among foreigners and is welcomed by the state authorities, the process of organizing the trip itself involves a lot of nuances. Parents-to-be must obtain a visitor’s visa, confirm that they have the funds to cover all related expenses, and provide the government with proof that they will be returning to their country of citizenship after the baby is born. Even a short trip to Canada requires careful preparation and adherence to many conditions, as described later in this article.

Citizenship by birth given in Canada

The Citizenship Act states that Canadian citizenship by birth is automatically granted to a child born within the state (unless the laws of the countries of which the parents are citizens contradict this). However, the child’s mother must be legally present in the country. Immediately after the birth of a child, parents are not given the opportunity to obtain citizenship. They can only apply for a residence permit when their child is of legal age and acts as a sponsor.

How much does it cost to give birth in Canada

For Canadian citizens and permanent residents, medical care is free, because they pay taxes. Foreigners without a permanent residence permit should take care in advance to have funds to cover not only the doctor’s services, but also accommodation, travel, and other expenses. When all expenses are taken into account, including travel to and from Canada for non-residents, arranging the birth will cost about 40,000 USD.

Delivery and preservation prices depend on the clinic and province/territory chosen by the foreigner. Note also that a multiple pregnancy increases the cost by about 40%.

Average prices for childbirth in Canada

Pros and cons of giving birth in canada.

Canada has the lowest infant mortality rate due to its advanced health care system.

Other advantages of giving birth in Canada:

family members and close friends are allowed to be present during the birth;
anesthesia is administered solely at the request of the woman in labor;
mother and baby can be discharged from the hospital on the same day;
each delivery room is equipped with a separate bathroom and two hours after the birth, the mother can use it;
food is brought directly to the room;
the baby stays in the same room with the mother.

Some of the disadvantages of traveling to Canada to obtain citizenship for a child by birthright include the fairly high cost of medical services and accommodation, as well as bureaucratic difficulties in obtaining a visa.

Childbirth planning

In order to give birth in Canada, it is enough for foreign nationals to open a visitor’s visa, but this requires prior preparation and careful planning of further steps. Parents-to-be must not only justify the purpose of the visit, but also confirm it with documents. To do this, you will need to go through several steps.

Choosing a hospital and doctor

The first step in organizing a birth in Canada is to find a hospital and a doctor. To do this, parents-to-be need to choose a province or territory. Toronto and Vancouver are the most common places for foreigners to give birth, but less well-known Canadian cities also have good clinics and hospitals.

Top 5 maternity hospitals in Canada with good reviews :

Toronto Birth Center . You can find all the information you need about the doctors, nursing staff and services at the Toronto hospital website. One can also book a visit to the doctor of their choice.
St. Paul’s Maternity Care . The hospital is located in Vancouver, British Columbia. On the official website, you can not only choose a doctor and book a visit, but also find useful information for a mom-to-be.
Ottawa Birth and Wellness Centre . The hospital is located in Ottawa, Ontario. On the hospital’s website, you can find a hands-on guide to birth planning as well as a doctor and obstetrician to choose from.
Maternity Care Clinic . The clinic is located in Calgary, Alberta. It provides medical services not only for childbirth, but also for breastfeeding support.
North York General . The hospital is located in Toronto and is the most popular among foreigners who come to Canada to give birth.

Signing a contract with a doctor

There is always a list of doctors on the websites of Canadian clinics. But before signing a contract, parents-to-be need to talk to the doctor in person, because some do not accept foreigners or do not have free time. Obtaining a doctor’s consent and signing a contract is a mandatory requirement when planning a trip to give birth in Canada.

In order to give birth to a child in Canada, parents-to-be must obtain a visitor visa (temporary resident visa). They must create an account on the Immigration, Refugee and Citizenship Canada (IRCC) website and upload the following documents:

visa application;
a valid international passport and a copy;
information about family members;
2 photos 3,5 x 4,5 cm;
proof of financial support (for example, a bank statement);
a signed contract with a doctor that explains the purpose of travel to Canada;
certificate of no criminal record;
proof of good health.

The list can be expanded with other proofs. After uploading the documents, you will also need to pay the state fee for their review.

Relocation to Canada

After opening a Visitor visa, parents-to-be can enter Canada. You should bring all the original documents with you. Before the visit, foreigners also need to take care of the housing for the entire period of stay in the country and confirm it with documents (hotel reservation or rental agreement). Keep in mind, that some airlines refuse to let pregnant women over 28 weeks, so this information should be checked before buying a ticket. Foreigners who do not speak English should use the services of an interpreter, who will accompany them throughout their stay in Canada.

Childbirth and the postpartum period

It is possible to give birth in Canada, either in a hospital or at home. If the second option is chosen, parents-to-be should ask for help from a doula — a specially trained companion. In case the delivery is performed in a clinic, the mother-to-be is admitted to the delivery room when she has contractions. In Canada, partner delivery is widespread, and not only a family member, but also a friend can be present during the process.

A woman and her baby are transferred to the postpartum ward after 2 hours, and her condition is monitored before that. In polyclinics there are general rooms (2-4 people) and «family rooms», where only mother and newborn are staying — the average price of such a room is about 300 USD per day.

Doctors and assistants monitor the condition of the mother and baby at all times — from the moment of admission to the maternity ward until the mother is discharged. If no health problems are detected, you can leave the clinic in 2-3 days after delivery.

Obtaining citizenship for a child

To obtain Canadian citizenship for a child at birth, parents must obtain two documents for the child: a birth certificate and a passport. After birth, foreigners are given a certificate, which contains the data of the child, the parents, as well as the place of birth. The document must be taken to the Registry Office. The birth certificate process takes 1 to 4 weeks.

To become a Canadian citizen, the child needs a passport. The parents need to prepare the following documents:

birth certificate;
passport size photos of the child;
a receipt for the payment of the $44.9 USD state fee;
the application form completed and printed in duplicate on the Government of Canada website.

The passport manufacturing process takes from 10 to 20 days. The document is valid for 5 years.

Are parents eligible for Canadian citizenship

Foreign parents of a newborn baby in Canada cannot immediately obtain citizenship based on the birth. Once the child’s papers are processed and the period of permitted stay in the state has expired, they need to leave the territory of Canada.

Parents can apply for Canadian citizenship when their child reaches the age of majority and can sponsor them under the Family Sponsorship program . In addition, the Canadian authorities give citizenship to qualified personnel and investors, which can significantly reduce the time of obtaining a passport of the country.

The benefits of Canadian citizenship for a child

The Canadian passport ranks among the world’s top 10 most powerful every year, according to Global Passport Ranking. As of 2021, North American citizens can enter 184 countries without a visa. In addition, if a child is born in Canada, he or she will have a number of other privileges:

quality and free medical care;
a high standard of living;
free education in state universities (among the best in the world);
social benefits;
apply for any available vacancy in the labor market;
the right to vote;
the opportunity to hold public office and engage in political activity.

Today Canada is not only one of the most economically developed countries in the world, but also one that is safe and environmentally friendly.

But despite the support of the so-called birth tourism by the government, this way also has its risks. If foreigners do not adequately justify the purpose of their visit to Canada, the authorities may consider it as immigration fraud. To minimize the risks in preparation, many people seek help from licensed professionals.

Express Entry System for Immigration to Canada
Atlantic Immigration Pilot Program (AIPP) is the pilot Atlantic immigration program to Canada
Manitoba Provincial Nominee Program
The Self-employed person immigration program in Canada
Immigration to Canada for programmers and IT-specialists

Alexey Nosovsky

«The market of immigration services is permanently evolving. There is a need for expert evaluation of new proposals, directions and programs. I hope my articles will help you navigate and make the right choice. Regards, Head of Legal Department of iWorld Alexey Nosovsky. »

Email: [email protected]

Thank you for the article.

I am considering which province would be cheaper to have my baby. I know you already gave an average cost but do you have more details as to what the recommended hospitals charge or which province charges less than the others?

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Impact of birth tourism on health care systems in Calgary, Alberta

Simrit Brar 1 ,
Mruganka Kale 1 ,
Colin Birch 1 ,
Fiona Mattatall 1 &
Medini Vaze 2

BMC Health Services Research volume 22 , Article number: 120 ( 2022 ) Cite this article

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Metrics details

Birth tourism refers to non-resident women giving birth in a country outside of their own in order to obtain citizenship and/or healthcare for their newborns. We undertook a study to determine the extent of birth tourism in Calgary, the characteristics and rationale of this population, and the financial impact on the healthcare system.

A retrospective analysis of 102 women identified through a Central Triage system as birth tourists who delivered in Calgary between July 2019 and November 2020 was performed. Primary outcome measures were mode of delivery, length of hospital stay, complications or readmissions within 6 weeks for mother or baby, and NICU stay for baby.

Birth Tourists were most commonly from Nigeria (24.5%). 77% of Birth Tourists stated that their primary reason to deliver their baby in Canada was for newborn Canadian citizenship. The average time from arrival in Calgary to the EDD was 87 days. Nine babies required stay in the neonatal intensive care unit (NICU) and 3 required admission to a non NICU hospital ward in first 6 weeks of life, including 2 sets of twins. The overall amount owed to Alberta Health Services for hospital fees for this time period is approximately $694 000.00.

Birth Tourists remain a complex and poorly studied group. The process of Central Triage did help support providers in standardizing process and documentation while ensuring that communication was consistent. These findings provide preliminary data to guide targeted public health and policy interventions for this population.

Peer Review reports

Definitions

Birth Tourism: the practice of non-residents of a country traveling to a new country with the intention to give birth in the new country.

Birth Tourist : an Uninsured Prenatal Patient who is a non-resident who travels to a new country with the intention of giving birth there. In Canada, Birth Tourists do not qualify for publicly funded health care coverage, even if they are Canadian citizens, because they do not reside in Canada. Occasionally Birth Tourists have private health insurance that partially or entirely covers their medical bills.

Uninsured Prenatal Patient: a patient who does not have provincial healthcare but who resides in Canada. They may not have Alberta Healthcare Coverage (AHC) for various other reasons, including.

Convention Refugee : a person who meets the refugee definition in the 1951 Geneva Convention relating to the Status of Refugees (UN Refugee Agency, 1951). This definition is used in Canadian law and is widely accepted internationally. Health Care costs for Convention Refugees are covered by the federal government.

Refugee Claimant or Asylum Seeker: a person seeking refugee status whose case has not been decided.

Other: A pregnant patient who is neither a Convention Refugee nor Birth Tourist, but resides in Alberta. These patients may have an expired Canadian Work Permit, Visitor Visa, or Student Visa. They may also be undocumented meaning residing in Canada without legal documentation.

Jus soli: the principle of jus soli allows for a child born on Canadian soil to a visiting foreign national to obtain Canadian citizenship (Canadian Citizenship Act, RSC 1985, c.C-29).

The term Birth Tourism refers to the practice of a country traveling to a new country to give birth there for a variety of personal reasons. Such reasons may include: to obtain Citizenship for the infant in that country ( jus soli) ; the notion that the costs of medical care are lower in that country compared to the individual’s home country; the perception that medical care in that country is safer; and potential access to public schooling, healthcare, and sponsorship of other family members in the future. In recent years, discussions regarding Birth Tourism have been more prominent globally [ 1 ]. This has been a relevant topic in the United States, Canada, and in Hong Kong. It is difficult to capture the true extent of Birth Tourism. There is no legal requirement to capture this information nor is this information a prerequisite for a birth certificate [ 2 ].

A 2018 Canadian study showed an increase in both the proportion and absolute numbers of babies born to foreign nationals in nearly all provinces [ 3 ]. However, hospital coding used to capture uninsured patients does not selectively capture Birth Tourists. There are many other circumstances that may result in a nonresident service code including those described in our definitions under the ‘Uninsured Prenatal Patient’ [ 3 ]. Anecdotal reports indicate rising concern about the excess burden placed on the Canadian public healthcare system; many Canadian provinces are facing significant cost overruns within the health care system resulting in limited capacity to provide obstetrical care to local residents [ 4 ]. However, there has never been any large scale data collection regarding the actual numbers of Birth Tourists. There has also not been data collection regarding the payment of bills for service provided by those identified as Birth Tourists [ 5 ].

There are many unique aspects in the care provision of Birth Tourists and Uninsured Prenatal patients. For many providers in Canada, the notion of private payment for medical care is foreign and uncomfortable. Providers may be unsure of how to undertake the conversation with consistency and may not have the time required to do so in a systematic way. Additionally, many pregnant immigrant women without medical insurance often receive inadequate prenatal care [ 6 ]. As Jarvis et al. (2019) reviewed, this population is more likely to present late in pregnancy for care, receive less prenatal testing, and to receive inadequate prenatal follow up. Poor prenatal care has been associated with poor birth outcomes including increased risk of preterm delivery and low birth weight [ 6 ]. This is further compounded by the differences in medicolegal protection for providers when treating uninsured patients. The Canadian Medical Protective Association’s Governing Law and Jurisdiction Agreement was created to assist in ‘establishing Canadian jurisdiction for any potential legal actions that may result from care or treatment provided by Canadian physicians or healthcare organizations to non-residents’ [ 7 ] [ 8 ]. The complexity of all of these issues can be very difficult for care providers to navigate.

Increasing Birth Tourism in Calgary, Alberta, has raised similar concerns about costs to the healthcare system and the access to care for both Uninsured Prenatal patients and Birth Tourists. There was a lack of standardized process to identify and appropriately coordinate medical care for this population. The Uninsured Prenatal patient population is often more complex with multiple social issues. In our opinion, this was a far more complex group to initially establish a consistent streamlined process for. As such, the Department of Obstetrics and Gynecology worked closely with Low Risk Provider groups within Calgary to establish a consistent and streamlined process for Birth Tourists arriving in Calgary. This process would require distinguishing Birth Tourists from other patients without provincial health insurance. Data Integration, Measurement and Reporting (DIMR), which is current standard of data extraction, does not separate birth tourists from non-birth tourists. Subsequently, we hoped these changes would help to better support Uninsured Prenatal patients. However, that process has not been streamlined to the same degree at this time.

Our primary objective was to collect detailed information on pregnant persons without Alberta Health Care (AHC) coverage in order to identify Birth Tourists in Calgary, evaluate their clinical outcomes, and characterize their financial and resource burden on the healthcare system. Our secondary objective was to collate the information collected to contribute to advancing the literature on Birth Tourism as this topic is relevant across the globe.

Procedures for patients without AHC

We developed a centralized intake process for prenatal patients without AHC delivering in Calgary. Starting in July 2019, all prenatal referrals in Calgary for patients without AHC coverage were redirected to a Central Triage (CT) office. This office was consistently run by one administrator with the support of a three member physician team. Patients were administered a questionnaire and subsequently triaged to a care provider based on patient preference, risk profile and city quadrant of residence. Care providers, with the exception of midwifery who had a separate process for billing of patients, then invoiced CT directly. Invoices were required to be consistent with what would have been billed to Alberta Health and were reviewed by the physician leads for the same e.g. excess modifier codes could not be billed. In addition to ensuring standardized payments for services, CT ensured that the Canadian Medical Protective Association’s Governing Law and Jurisdiction form for all providers and Alberta Health Services was reviewed and completed as well as consent for information sharing among providers as well as Alberta Health (AH). Patients stayed in contact with CT with respect to when they would be leaving the country and timing of refund. In situations where English was not the primary language, language line or other translation services (through family or physician) was used. Refunds were issued once all invoices were received (approximately eight weeks postpartum). If a patient refused CT, we endeavored to follow up with how and where the patient received care.

A ‘Central Triage package’ was reviewed and provided to all patients deemed to be Birth Tourists in person, via email, or via registered mail. Within this package, there was full disclosure of the concern regarding potential cost burden of Birth Tourism within Calgary and the rationale for the creation of CT – particularly to deter the process of Birth Tourism. A deposit of $15,000 was collected and held in trust by CT from each Birth Tourist to cover cost of physician service fees. In alignment with both the Alberta Medical Association (AMA) and the College of Physicians and Surgeons of Alberta (CPSA), patients were also able to pay for their fees individually following the service and care was never refused. The physician service fees for Birth Tourists were billed at a rate of five times the rate determined by AH in accordance with the Uninsured Services guidance document provided by the Alberta Medical Association (AMA) [ 8 ]. Service fees for uninsured patients were not above standard Schedule of Medical Benefits (SOMB) rates and deposits ranged from no deposit to $2500. A $300 administrative fee was invoiced to Birth Tourists to pay for administrative services. The physician administrators did not receive any payment for their administrative role. Information regarding the SOMB codes, AMA and CPSA was provided to all of the patients.

The CT system also sought to create a system by which uninsured patients could be identified quickly and thus be provided support letters and advocacy for more timely access to AHC given the impending medical care required. These scenarios were also assessed on a case by case basis allowing for provider discretion. Scenarios involving Uninsured Prenatal patients were found to be more complex with more individuation required which was another reason to not formally include them in the analysis. Our past experience with Uninsured Prenatal patients showed often face significant economic barriers that would make it difficult to pay an advance deposit for medical services. These patients were referred to an appropriate obstetrical provider with full understanding that appropriate medical care would be provided regardless of ability to pay. Physician fees for services provided to Convention Refugees were billed directly to the federal government.

Although a deposit was collected by CT to cover the cost of physician services, a deposit was not collected to cover Alberta Health Services (AHS) site fees for hospital stay which are different for each hospital. AHS site fees are charged based on a daily rate. As part of the CT package, all Birth Tourists were given a copy of the current AHS site fee schedule and were made aware that the AHS finance office would bill them directly at the time of hospital admission.

The questionnaire was developed by the study authors (see Appendix 1 ). It included open ended questions exploring the patient’s reasons for pursuing childbirth in Canada, and specifically in Calgary. We collected information regarding the patient’s country of origin (we utilized the patient’s stated Country or place of current residence), citizenship, date and port of entry to Canada, refugee status, and the type of visa possessed by the patient. For patients who lived in Alberta prior to pregnancy, we asked questions regarding how long they had lived in Alberta/Canada, employment history in Alberta/Canada and whether they previously held AHC insurance or provincially funded health care insurance from another Canadian province or territory. The questionnaire did not screen for specific medical conditions, but we did ask patients whether they had any pre-existing medical conditions or history that would potentially impact delivery. This better allowed CT to triage to the appropriate care provider.

The CT team identified Birth Tourists by questionnaire responses in the following ways: (1) patient self-identifying as a Birth Tourist (2) the Birth Tourist arrived in Canada while pregnant, on a visitor visa, and had no intention to live permanently in Canada immediately following the delivery. Women who were classified as Uninsured Prenatal Patients were excluded. If there was a case that was unclear, the case was brought to the three-member physician team and reviewed sometimes with the support of hospital social work. There were no cases where consensus was not achieved through this method. Most patients were administered the questionnaire during the antenatal period, although, some presented for the first time at the hospital during the time of delivery. In this circumstance, the delivering physician would refer the patient to CT and attempts were made to administer the questionnaire postpartum. Occasionally a deposit was also collected post- partum to streamline invoice payment.

Physicians sent invoices for services provided directly to CT, who then paid physicians from the deposit. An itemized receipt for all physician services was provided to each Birth Tourist and a refund was issued to the Birth Tourist where applicable. Any billing codes used were done so in the standard of the Alberta SOMB and were required to match the service provided. The physician invoices including the billing codes were also used to determine mode of delivery or any additional care required. Comments provided on these invoices or from the patients following delivery to administration at CT were also collected.

We completed a qualitative descriptive analysis using information obtained from the CT patient questionnaires and physician invoices from July 1, 2019 to November 1, 2020. Only questionnaires completed by persons identified to be Birth Tourists were included in the review, with all identifying information removed. A data dictionary was used to collect the variables analyzed (Appendix 2 ). Data on delivery and readmission for Birth Tourists was obtained through provider invoices as well as patient reporting.

A cost analysis of physician service fees and AHS hospital site fees was performed by review of AHS hospital stay financial data as well as review of the physician invoices provided.

A waiver of consent was obtained for this study. Most of the Birth Tourists included in the analysis were no longer in Calgary during the study period and the resources required to contact all patients exceeded the resources available to the study team. No patients or care providers were directly contacted. The study team reviewed existing data, documents and records excluding the hospital chart. Ethics approval for this study was obtained from the Conjoint Health Research Ethics Board at the University of Calgary (REB20-0026). This study was unfunded.

In total, 102/227 patients captured by CT from July 15, 2019 to November 1, 2020 were identified as Birth Tourists. The 125 patients who were not Birth Tourists but instead Uninsured Prenatal patients were not included in the analysis. 89/102 (87%) patients were identified by direct referral to CT. The remaining 14 (14%) Birth Tourists were identified after delivery by invoices from physicians. The average and median maternal age was 32 years (range 20–45, SD 5.5). Of these women, 42% had not had a previous live birth, 42% were multiparous, and parity of 16% was unknown. There were 5/102 (5%) Birth Tourists who self-referred to midwives for home birth or birth center delivery. 83/102 (81%) had an encounter with an AHS Calgary zone hospital. Of the remaining 19 patients (19%), 8 were lost to follow up, 2 delivered elsewhere in Alberta, 3 went back to their home country for delivery (Mexico, Trinidad, and Tanzania, respectively), 3 stated they would seek Midwifery care for home birth within Calgary, and 3 went to Ontario. There were 17 (17%) Birth Tourists that did not have a Regional Health Number.

83% of patients stated they came to Canada with a Visitor Visa. The type of visa for 14% of patients was unknown, 2% had possessed a Student Visa, and 1 patient was a Canadian Citizen who had never lived in Canada. The date of arrival in Canada was known for 77/102 patients; the average time from arrival in Calgary to the expected due date was 87 days (SD 76) with a range of 7 to 502 days. Exact date of departure from Calgary is known for 34/102 patients; for these patients, the average length of stay in Calgary after delivery was 49 (range 18–80) days;

Birth Tourists were most commonly from Nigeria (25%), Middle East (18%) China (11%), and India (8%) and Mexico (6%). There were no birth tourists from Western Europe or Australia. 77% of Birth Tourists stated that their primary reason to deliver their baby in Canada was for the desire for a Canadian baby who would be eligible for Canadian citizenship. 8% stated their reason to deliver in Canada was to access better health care. 40% of questionnaire respondents chose Calgary specifically because they had family and/or friends in the city. We were unable to expand further beyond this on other reasons for delivery in Canada or outside their home countries.

38% of patients delivered vaginally and 35% delivered by cesarean Sect. 29% of deliveries were of unknown type. Two mothers required readmission to hospital within 6 weeks postpartum; one was admitted to ICU for 5 days for cardiac reasons, and another was admitted for severe preeclampsia and stroke. Another patient had severe postpartum preeclampsia but discharged herself against medical advice. Her subsequent outcome is not known. Nine babies required stay in the neonatal intensive care unit (NICU) and 3 required admission to a non NICU hospital ward in first 6 weeks of life, including 2 sets of twins. The average length of stay was 18 days with a range of 1–63 days.

With respect to maternal health history prior to arrival in Canada: 9 had a history of previous cesarean section, 6 patients reported having some form of Diabetes Mellitus, 3 arrived with a cerclage in place, 2 arrived acutely hypertensive, 2 had history of myomectomy, 2 had threatened preterm labour (one actively in preterm labour), 2 had blood borne infection, and 2 had known twin pregnancies. There was one new diagnosis of HIV following arrival in Canada.

There was AHS billing information captured for 83/102 (81%) Birth Tourists (Appendix 2 ). The average amount of fully paid AHS maternal invoices was $6234.92 (Appendix 2 ). The average amount of fully paid AHS neonatal invoices was $4185.91 (Appendix 2 ). There were 8 cases (10%) where AHC was received for the newborn but there was an outstanding invoice for the mother (Appendix 2 ). There were 17 cases (21%) where there was an unpaid neonatal bill and 29 cases with an unpaid maternal bill (35%) (Appendix 2 ). The outstanding fee amount is known for 29 mothers and 17 newborns (including 2 sets of twins) (Table 1 , 2 and 3 ). As of the date of this report, approximately $290,000.00 of fees remain outstanding for the 29 mothers (average $9704.62; range $948- $72,445), and approximately $404,000.00 remains outstanding for 17 newborns (average $23, 747.65) (Table 1 , 2 and 3 ).

Of the Birth Tourists identified through CT, 54/88 (61%) paid the $15 000 deposit for physician services (Appendix 2 ). Of these, 7 had additional invoices above the total deposit amount (range $300- $2760.92). Two of those individuals did not pay the outstanding invoice ($980 and $2219.29). For the majority of these patients (89%), the 15,000.00 deposit was adequate for physician fees, and the patient received a refund (avg. $5484.70). Of the Birth Tourists identified through CT, 34/88 (39%) did not pay the deposit. Reasons provided included: 10 patients indicated that they paid the provider (obstetrician, family physician, or midwife) directly for fees incurred, 20 refused to pay with no other reason provided, one self-referred to midwifery for delivery at home, no reason was provided for the remaining 3 individuals who did not pay the CT deposit.

Of the 227 patients captured by CT, 125 (55%) were deemed to not be Birth Tourists and were classified as Uninsured Prenatal patients. As stated earlier, this group was not included in the analysis. However, we do feel it prudent to state that we feel a process is urgently required to support this population. Since the initiation of this project, the CT team has been able to directly liaise with AHS to help expedite AHC insurance for those that qualify. We would advocate for a similar process that is available to all eligible women across the province. Having a system in place to distinguish Uninsured Prenatal patients is of benefit to the patient and the provider. It provides a means to better identify and support those for whom health care coverage can be optimized and also allows an opportunity to better support the needs of the patient. The additional support required can be difficult for individual community providers to provide in isolation. Our process did not specifically have a role for social work and additional community supports. However, we do feel it would be beneficial to create a dedicated process to support Uninsured Prenatal patients not only in the acquisition of AHC but also the opportunity for the provision of community and social supports that may be required. Women with an undocumented status may delay prenatal care due to concerns of being deported, and as a result increase adverse outcomes. We feel this population would benefit from additional community support and discussion of ensuring safe treatment without the threat of deportation and also creation of a system where cost is not a barrier to accessing care.

Birth Tourists represented 44% of patients seen by CT. Of these, 87% of Birth Tourists were identified by direct referral to CT. There may be a few explanations for non-referral to CT. There is a complex network of care providers in Calgary which likely led to slow dissemination of the information regarding CT. There was some hesitancy from obstetrical providers to refer to CT perhaps due to pre-existing relationships or the feeling of obligation within communities with higher rates of Birth Tourism, the concern that there would not be a distinction between Birth Tourists and other Uninsured Prenatal patients, and the concern that patients may avoid care altogether. Through standardized communication we were able to address a common issue identified by providers: the fact that Birth Tourists were receiving incorrect and often varied messaging regarding costs associated with delivery, not only from their friends and online forums, but also from different obstetric providers in Calgary. Previously, the practice of different providers charging different fees for the same service led to ‘deal making’ between providers and Birth Tourists. Clear communication and collection of a standardized deposit in advance for physician services mitigated some of this problem. Many potential patients contacted the CT office from overseas prior to their arrival in Canada. Physicians did not have to collect payment in hospital or postpartum, which is often very difficult. It is concerning that 39% of patients did not pay the deposit. The reasons for this remain unclear and were not explored in the breadth of this study. Though some of these patients did ultimately pay for the physician service provided following the delivery, it was not clear to CT if all providers were paid and what amount.

83/102 (81%) of Birth Tourists had an encounter with an AHS Calgary Zone hospital. Of the remaining 19 patients (19%), 8 were lost to follow up. That is not insignificant and speaks to the need for greater administrative support to ensure that both mother and baby had access to care in a timely fashion. 5% of Birth Tourists identified that they would be self-referring to midwifery specifically for home birth or birth center delivery. Unfortunately, we were not able to capture the financial data with respect to cost of home birth versus birth center in such scenarios. Midwifery care is unique funding model in that there is a direct contract between AHS and the Alberta Association of Midwifery [ 9 ]. There are only a certain number of allocated ‘spots’ for patients as such there is a wait list for this model of care. It is possible that the number of patients who transferred to midwifery was in fact higher than 5% as Alberta does not have coordinated data for maternity care that includes home births. This may also provide some explanation for the 17 patients with no Regional Health Number. In addition to potentially delivering at home, they could also have delivered outside of the city or province or may have been an error in invoice creation in that it simply wasn’t added. Due to the difficulty in consistent recording, we were only able to obtain information that one midwifery home birth required a subsequent NICU admission. An additional limitation noted in through our process with the separate process of fee collection and assessment by Midwifery. We feel it would be of benefit to all providers in patients to have one streamlined process for all providers as this avoids duplication and improves efficiency.

The majority 76/102 (75%) of visas granted to patients seen through CT were Visitor Visas. Some patients did state they had taken out private insurance. Our process did not have consistent collection of private insurance information or the extent of coverage. This is a limitation of our study and examination of this in further studies may help to better understand the financial options available to patients.

The average time from arrival in Calgary to delivery/EDD was 87 days with a range of 7–502 days (average 87 days). The 502 days reflects an individual who ultimately left and returned to their home country. This is a limitation of our data in that we are not able to capture exactly when all individuals left. This also underscores the difficulty in capturing a subset population of uninsured and undocumented pregnant women. When the time of stay surpasses 365 days, the individual can no longer be considered as a tourist [ 10 ]. The individual who stayed 502 days self-identified as a tourist. We do feel that the data on the uninsured undocumented pregnant women is lacking and further investigation is also required in this area.

The average of 87 days arrival in advance of EDD or delivery demonstrates potentially significant implications in care provision and supports the evidence that many women in this population seek care late in pregnancy. Women who arrive very close to the end of pregnancy or postdates may be in a rush to obtain care. Potential for complications including elevation in maternal blood pressure and stillbirth rise as women approach and pass their due date. This rush for care puts an increased stress of immediate care provision in an already stressed system. Improved education with VISA issuance would be helpful to inform women of the risks they may be taking in traveling to deliver overseas late in pregnancy.

Almost a third of women presenting to CT had a known preexisting medical condition. This included one person actively experiencing preterm labour and three with a cerclage in the current pregnancy. Many Birth Tourists were concerned about hospital stay > 24 h due to the additional daily AHS fee. In some cases this lead to Birth Tourists discharging themselves Against Medical Advice. The potential for increased morbidity is significant. A limitation to our study is that we were not able to assess if advance knowledge of the CT process may have changed the decision to undertake Birth Tourism.

In comparison to the 35% of Birth Tourists delivered cesarean section, the general cesarean section rate in Alberta in 2018 was 31% [ 11 ]. The NICU admission rate in Calgary is approximately 7%; whereas the NICU admission rate among neonates born to the Birth Tourist group was 9%.

The time from delivery to departure was 49 days with a range of 18–80 days. Approximately one third of patients did not specify a date of departure but stated they would be leaving ‘after delivery. Though the data is limited by the fact that 1/3 did not specify an actual date, the average of 49 days to departure is consistent with the definition of a Birth Tourist not permanently staying Canada at that given time. This does have implications for the Canadian born child’s ability to access Alberta Health care. Specifically, a person must make Alberta his/her home and be physically present in Alberta at least 183 days in a 12-month period (not including a tourist, transient or visitor). 17% of children born to mothers identified as ‘birth tourists’ received AHC with a third of those mothers still having unpaid bills for maternal care. This poses the question as to whether or not the criteria for obtaining Alberta Health Care for neonates born to mothers without Canadian Health Care is rigorous enough.

The most common reason stated by the patients in our study for travel to Canada to give birth for ‘a Canadian baby’. A Canadian citizenship is perceived as a valuable item not only in the short term but also long term for health care and education. The long term implications to this are complex and multifaceted and should not be simplified. However, our data does show that the Canadian Citizenship is held in value and is provided as reason for Birth Tourism.

The overall amount owed to Alberta Health Services during the study period is almost $700,000 (Table 4 ). There were two sets of twins during the study period both sets requiring NICU stays. The average length of stay for babies taken to the NICU was 18 days with a range of 1–63 days. One set of twins occupied a NICU bed for 50 and 63 days respectively. NICU bed capacity has been an ongoing concern in Calgary zone with twins contributing to the concern given the need for two beds. The $700,000 amount also did not capture the cost to the system for midwifery care or patients who subsequently left Calgary to deliver in a surrounding area. We are concerned that Birth Tourists may be leaving Calgary to find cheaper care in overburdened surrounding regions. This emphasizes the need for a standard provincial process to provide clear and transparent guidance to both patients and providers. A significant limitation of our study was the inability to account for all possible financial and resources burdens e.g. both outpatient and inpatient imaging and laboratory services, physicians who are funded by Alternate Funding Plans (AFPs), or support from ancillary staff.

Our AHS financial data was not clearly outlined in terms of what costs were paid. We do feel that moving forward a clearly itemized invoice for hospital services should be provided to patients as well as CT. There were a number of people who were issued refunds from CT for physician service fees yet still had outstanding AHS fees owing. We propose to only issue CT refunds once a fully paid hospital invoice is shown. A further limitation of our financial analysis was that we did not include foreign parents hiring Canadian surrogates to carry a child who will leave the country.

Another limitation of our study was that all out of country patients were not identified through the CT. These cases were often recognized through communication from ancillary care providers such as pediatrics asking for clarification on billing. Some out of country patients presented for the first time at delivery. There were also some out of country patients making individual arrangements with maternity care providers that also came to light when additional care providers asked for clarification regarding billing. Given the lack of a robust system of data collection, it is very possible that Birth Tourists and Uninsured Prenatal patients were missed. Unfortunately, we were also unable to assess which women remained in Canada after expiration of their visitor visa. There were many scenarios in the financial data were there were outstanding maternal charges, AHC was obtained for the infant and there was no referral to CT. It is possible that some of these women were not truly Birth Tourists but rather Uninsured Prenatal patients that overstayed a visa and we were not able to capture the specifics of their scenario.

Our analysis overlapped with the Covid-19 pandemic. We had anticipated birth tourism to drop to almost zero with the lack of air travel. However, that was not the case, suggesting that at a time of reduced international travel, birth tourism continued. It would be important to collect data on an ongoing basis as we suspect that rates of birth tourism in past and future years may be higher.

The process of Central Triage did help support providers in standardizing process and documentation while ensuring that communication was consistent.

The process 1) enabled us to differentiate Birth Tourists from non-Birth Tourists, which is something that DIMR data has been previously unable to, and thus identify populations that may need additional support 2) ensure that physicians are more likely to get paid for services rendered 3) standardize a fee schedule across the city for Birth Tourists. We do feel that an area of further investigation that is required is better understanding the non-Birth Tourist population. This group seems to have greater complexity in terms of background and potential need for support.

With increasing strain on healthcare budgets, outstanding patient invoices warrant attention. In a publicly funded system that is often under strain, we do feel that our process of CT did help to improve efficiency and provide more timely access to appropriate care for Birth Tourists. We do believe that having a clearly delineated policy for Birth Tourists would allow for better collection of data, consistency of messaging and communication between all parties involved in health care from the patient to the frontline worker to the administrator. There may be unintended consequences of such policy on the non-Birth Tourist group, in particular the undocumented patient. It would be imperative that the determination of Birth Tourists was very clear and not reliant on self –identification alone.

Availability of data and material

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Simrit Brar, Mruganka Kale, Colin Birch & Fiona Mattatall

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Brar, S., Kale, M., Birch, C. et al. Impact of birth tourism on health care systems in Calgary, Alberta. BMC Health Serv Res 22 , 120 (2022). https://doi.org/10.1186/s12913-022-07522-4

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'Birth tourism' rising fast in Canada; up 13 per cent in one year

Avis Favaro CTV National News Medical Correspondent

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Ryan Flanagan CTVNews.ca Producer

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TORONTO -- Canada’s reputation as a hotspot for birth tourism is rising fast, with new data reporting a 13 per cent increase in one year.

“It’s going up faster than immigration rates, faster than the overall population of Canada,” Andrew Griffith, a fellow at the Environics Institute and the Canadian Global Affairs Institute, said in a telephone interview with CTV News.

WHAT IS HAPPENING?

Birth tourism is the practice by which babies are born in Canada to non-residents so they can receive automatic citizenship without having to go through standard immigration processes. Griffith follows the phenomenon closely as part of his research.

The 13 per cent increase was found in data Griffith collected from the Canadian Institute for Health Information (CIHI), which based it on information from hospitals across the country, excluding Quebec.

Their research shows a steady increase in births to non-residents from 2008 to 2017-18, and then a 13 per cent jump after that. According to CIHI, there were 1,354 non-resident births in 2010 and 4,099 in the 12-month period ending March 2019 – representing 1.4 per cent of all births in Canada during that time.

While some of the reported births involve international students and non-residents transferred to Canada for work, Griffith said he believes the majority of these cases involve mothers who travelled to Canada for the express purpose of giving birth.

“The laws were never intended for people to fly in and fly out,” he said.

Under Canadian law, children born in the country are automatically registered as citizens of Canada. This entitles them to Canadian post-secondary tuition rates, which are lower than what non-resident students pay, and allows them to sponsor their parents to come to Canada.

Brokers advertise Canada as one of the few developed countries in the world that offers unconditional citizen to babies of parents who are not citizens. Some immigration brokers explicitly note that children born in Canada will be able to enjoy benefits such as free education and other social programs, as well as travel to the country visa-free.

WHERE IS IT MOST PREVALENT?

According to CIHI, the 10 hospitals where non-resident births make up the biggest proportion of total births are all in Ontario and B.C.

The Richmond Hospital in Richmond, B.C., topped the charts in 2018-19, with the 454 births to non-resident mothers there representing 23 per cent of all births at the hospital. Three other hospitals were over 10 per cent: Mackenzie Richmond Hill Hospital in Richmond Hill, Ont., Birchmount Hospital in Toronto and St. Paul’s and Mount St. Joseph Hospital in Vancouver.

Dr. Fiona Mattatall, a Calgary-based obstetrician and gynecologist, has noticed a similar trend in her province. CIHI reports that there were 263 non-resident births in Alberta in 2018 – a 13 per cent increase over the previous year, and more than triple the number recorded in 2010.

“(The data) mirrors what we see on the front lines,” she said.

Mattatal said non-resident births lead to ethical disagreements and practical concerns, in part because hospital budget planning does not take these births into account.

“Our system is not built to provide services (for) people (from) out of the country,” she said.

“I’m worried as someone in the health-care system, we are already dealing with cutbacks. (Birth tourism) is causing strain in the system, and we are helpless to do anything about it.”

Sometimes hospitals find themselves unable to collect payment for maternity services, and have to hire collection agencies to go after the mothers.

“This is going to be an issue Canadians are going to have to discuss,” Mattatall said.

WHAT CAN BE DONE?

According to an Angus Reid survey taken in March, 64 per cent of surveyed Canadians say a child born to parents who are in Canada on tourism visas should not be granted Canadian citizenship. Sixty per cent say they want to see laws changed to discourage birth tourism.

In a bid to discourage the practice, Hospitals in Calgary instituted a new policy this summer. Non-residents are now told to pay a $15,000 up-front deposit for prenatal delivery and postnatal care. Additional charges are also levied for hospital services.

Mattatall said the deposit requirement made a difference at the one hospital that tested it out, although she suspects non-resident mothers may have simply moved to other hospitals.

A wider-scale solution could be to end birthright citizenship entirely, as U.S. President Donald Trump has said he will do in the United States. Australia has also introduced more stringent requirements, only granting citizenship when children born in that country have at least one citizen or permanent resident parent – and even then, the child must live in Australia for 10 years after birth.

Canadian Conservative Party members voted at a convention last year to make a ban on birthright citizenship to babies born to non-resident parents party policy, but the issue has not been raised since the election was called.

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Public Opinion Polls and Analysis

Concerns About Birth Tourism Drop Slightly in Canada

More than seven-in-ten Canadians still want the federal government to investigate the full extent of the practice.

Vancouver, BC [November 4, 2022] – Canadians are currently not paying as much attention to the issue of “birth tourism” as they did in 2020, but a sizeable majority believe the practice should still be scrutinized, a new Research Co. poll has found.

In the online survey of a representative national sample, 28% of Canadians say they have followed media stories related to the issue of “birth tourism” in the past year “very closely” or “moderately closely”, down 13 points since a similar Research Co. poll conducted in August 2020 .

British Columbians and Quebecers are significantly more likely to be paying attention to news related to “birth tourism” (36% and 34% respectively) than their counterparts in other Canadian provinces.

“Birth tourism” is the practice of traveling to a specific country for the purpose of giving birth there and securing citizenship for the child in a country that has birthright citizenship. Canada allows expectant mothers who are foreign nationals to gain automatic citizenship for their children born in Canada.

Over the past few years, there have been reports of unregulated “for profit” businesses that have facilitated the practice of “birth tourism” in Canada. More than half of Canadians agree that “birth tourism” can displace Canadians from hospitals (54%, -2) and can degrade the value of Canadian citizenship (53%, -6).

More than three-in-five Canadians (64%, -7) believe “birth tourism” can be unfairly used to gain access to Canada’s education, health care and social programs—a point of view shared by 76% of British Columbians.

More than seven-in-ten Canadians (73%, -5) believe the federal government should establish a committee to investigate the full extent of “birth tourism” in Canada.

“A federal inquiry into the full scope of birth tourism would not represent a political liability for the federal government,” says Mario Canseco, President of Research Co. “Majorities of Canadians who voted for the Liberal Party (82%), the Conservative Party (77%) and the New Democratic Party (NDP) (72%) in the last federal election are on board.”

Almost half of Canadians (48%, -6) think the country should ponder establishing new guidelines for birthright citizenship, while more than a third (37%, +3) would prefer to keep existing regulations.

Support for developing a new framework to birthright citizenship in Canada is highest in Ontario (50%), followed by Manitoba and Saskatchewan (49%), Quebec (48%) and Alberta, British Columbia and Atlantic Canada (each at 47%).

More than three-in-five Canadians (62%, -5) agree with the notion that birthright citizenship may have made sense at one point, but now people have taken advantage of existing rules.

Results are based on an online study conducted from October 24 to October 26, 2022, among 1,000 adults in Canada. The data has been statistically weighted according to Canadian census figures for age, gender and region in Canada. The margin of error—which measures sample variability—is plus or minus 3.1 percentage points, 19 times out of 20 .

Find our data tables here and download the press release here .

For more information on this poll, please contact:

Mario Canseco, President, Research Co.

The Cost of Having a Baby in Canada: With and Without Insurance, 2024

Having a baby is super-exciting, but it can quickly turn stressful, especially when you are having your child in a new country..

Canada sees almost 400,000 babies being born every year, and you are about to be one of these lucky mums. However, it doesn’t come without cost.

What is the Cost to Have a Baby in Canada without Insurance and with Insurance?

Cost of having a baby in canada through in-vitro fertilisation (ivf), the cost of having a baby in canada vs the united states of america (usa), cost of having a baby in canada: list of items you may need, faqs: cost of having a baby in canada, with and without insurance, the bottomline: cost of having a baby in canada.

What is the cost of having a baby in Canada? Cost of childbirth in Canada versus the US – which country has a better service? What items should be on your baby list? This article has all the answers. Read on!

Healthcare for tourists and non-residents in Canada is not free. Although Canada has a publicly-funded healthcare system (Medicare system), you can only get coverage under this system if you are a citizen, permanent resident, or an international student.

So while birth costs for citizens, permanent residents, and international students is only a couple hundred dollars or even completely free, non-residents and tourists, on the other hand, have to handle all the cost if they don’t have international insurance.

The table below shows the side by side comparison of the cost of having a baby in Canada without insurance and with international insurance or coverage under the Canadian healthcare system:

In British Columbia (BC), where birth tourism is more rampant, there are agents that provide services in packages for pregnant women. The services include midwife services, three-month accommodation (plus a month after birth) excluding prenatal care and food.

The average costs for these services are $25,000 CAD (or $18,000 USD). But the total cost will exceed that amount when you factor in food, round trip flight and other expenses. However, in other provinces, the costs may be lower.

Since 1978, when the world’s first baby through IVF was born, there have been medical advancements in IVF and fertility treatments.

If you’re a non-resident, visitor, or tourist in Canada and want to have your baby through IVF, you’ll need to know the cost of having a baby in Canada through IVF. You can visit a private IVF clinic for your treatment. But as we stated earlier you’ll likely have to pay out-of-pocket for the costs without any financial assistance, unless you have international health insurance coverage.

The table below shows the average cost of having a baby through IVF in Canada. Note that IVF is a specialized elective treatment so it may not be cheaper.

Additional Resources on IVF in Canada:

Public Health Agency of Canada – fertility treatment options
Ontario – Fertility treatment and coverage limits
Alberta – Fertility Health Tool
Quebec – Medically Assisted Reproductive program (such as IVF) . Free for residents of Quebec)

The cost of having a child in the US varies from city to city. For example, delivery costs in Los Angeles and New York City are above $20,000 USD; in Miami, it’s between $7,000 USD – $10,000 USD; and it’s within $5,000 USD – $6,000 USD in Salt Lake City.

This cost will surge when you include flights, accommodation, and meals.

Canada’s low rates and high-quality facilities are what made it a destination for many birth tourists.

Having a Baby in Canada vs The US: Where is Better?

Canada has one of the best healthcare systems globally, and the health service can easily compete with that of the US. The standard of living in Canada beats the US in many aspects, like access to education, safety, and more. So having Canadian citizenship is a great idea.

While the birth tourism industry in America is on a grand scale with many providers offering services in packages, Canada’s birth tourism level is also at a record high.

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The list of items your baby needs is very long, but the key to keeping your costs under control is to start with the essentials and budget for predictable costs like baby wipes diapers. Then, you’ll leave a lot of room for extra expenses.

While making your list, you should do extensive research on the items so that you have exactly what you need when the baby comes. To make it easier, we’ve come up with a list of all the essentials you’ll need to have your child in Canada as well as their cost. Let’s go over them below.

A. Nursery Furniture

Your baby nursery is the first thing you’ll have to design. These are the must-haves:

#1. Baby Crib

Cost varies from approximately $60 to $2,600. Our pick is the Dream On Me Aden 4-in-1 Crib . It is only $119.75 on Amazon and it has some incredible features that have made it a number 1 best seller. We’ve listed some of these features are below.

Why We Like It

It is made of New Zealand pinewood which makes it very durable and equally stylish.
The crib is lightweight, easy to move, and sturdy.
It is versatile with a 4-in-1 convertibility feature. You can convert it into a mini daybed, a twin size bed and it also has a convenient three-position mattress support.
The crib is very easy to put together.
With the convertibility option, this crib will grow along with your child.
It is safe and JPMA Certified. So it meets all CPSC and ASTM’s safety standards.
It is compact and occupies a small space.
It is internally spacious.

What Can be Better

Some users have complained that the paint/lacquer finish is weak.

No products found.

#2. Mattress for the Baby Crib

Cost ranges from $30 to over $300. To fit your Aden crib, we recommend the Dream On Me, Holly 3” Fiber Portable Crib Mattress . It costs only $31 and it fits perfectly into the Aden Crib we reviewed above.

It fits the Aden baby crib perfectly.
It is built with quality materials
You can easily wipe it clean with mild soap and warm water.
It has an anti-bacterial, hypoallergenic waterproof cover.
The material is safe and lead-free.
It is inexpensive
The wipe-clean plastic covering is not super firm.

Dream On Me Holly 3” Fiber Portable, Greenguard Gold Certified, Waterproof Vinyl Cover, Lightweight Mini Crib Mattress, White

#3. Baby Changing table

Cost varies from $90 to over $500. The next on our list is a changing table. A changing table that keeps your baby comfortable will make diapering much easier and that’s why we recommend the Delta Infant Changing Table .

It costs only $90 and has amazing perks, which we have listed below.

The table is made of solid wood, and the wood construction is strong and sturdy.
It is easy to assemble.
It is water-resistant.
The changing table comes with two fixed shelves that you can use for open storage.
It comes with safety rails that cover the four sides round the top of the table.
It has a non-toxic finish and is tested for lead and other toxic elements.
The table has lots of storage space.
Some users have indicated minor manufacturer errors.

#4. Changing Pad

The cost starts from $20. A changing pad also makes diaper changing easy. You can have all the wipes, diapers, and creams in one place and maintain organization. We recommend the Summer Contoured Changing Pad and it’s $20.

It is made with a durable quilted vinyl material.
The material is waterproof, and you can easily wipe it clean with a damp cloth.
It comes with a quick-release safety belt and a security strap.
According to some users, while the plastic itself is waterproof, the quilted perforations in the cover may let some liquid soak in.

Summer by Ingenuity Contoured Changing Pad – Includes Waterproof Changing Liner and Safety Fastening Strap with Quick-Release Buckle

#5. Baby Seat/Rocker for Feeding the Baby

Costs range from $40 and above. With a good baby rocker, your baby can sit up and be fed easily without having to be constantly held. Our pick is the Fisher-Price Sit-Me-Up Floor Seat which costs $40.

The seat pad is soft and makes a comfortable environment for the baby.
It comes with two linkable toys for baby playtime.
You can fold it flat, so it takes less storage space and you can easily carry it along with you on your trip.
It gives the baby support to stay in an upright position.
It may get difficult taking your baby out of the seat as they get bigger and approach 17-20 pounds.

B. Feeding:

Breastfeeding.

Even though breastfeeding is free. You still need to buy some items:

#1. Nursing Pillow

$35 to $60. You’ll need a nursing pillow to provide support when you are feeding or holding your baby. It elevates the baby and prevents you from getting a stiff back, shoulder, or neck. We recommend this My Brest Friend Nursing Pillow and with good reasons too. The pillow costs $35.

It is firm and flat, so you don’t have to worry about your baby rolling out of position during nursing.
The clasp makes it stay in position even if you are walking.
The pillow comes with a handy pouch where you can keep your maternity supplies within reach.
It has a wrap-around design, so it surrounds your body safely in an ideal position.
It comes with a cover.
The back padding is good for back/lumbar support.
The designs on the pillow are really cute.

What Can Be Better

It is a little pricey

My Brest Friend Original Nursing Pillow Enhanced Ergonomics Essential Breastfeeding Pillow Support For Mom & Baby W/ Convenient Side Pocket, Double Straps & Slipcover, Navy Bluebells

#2. Nursing Covers

$10 to above $50. Some babies love to be breastfed within the coziness of a nursing cover, and there might be times you’ll find you want a little privacy, and your nursing cover will come in handy.

We like this versatile Nursing Cover . It’s not just a nursing cover; it’s also a baby car seat cover, a scarf, a light blanket, and a stroller cover all in one. Even with all these perks, it only costs $10.

It is a multi-purpose cover. It is fantastic as a nursing cover, and also works as a baby car seat cover, high chair cover, light blanket, stroller cover, and an infinity scarf.
The fabric is lightweight and soft.
It is easy to wear. You can wear it in just five seconds.
It is an ideal unisex baby gift.
The polyester material might trap heat.

Yoofoss Nursing Cover Breastfeeding Scarf - Baby Car Seat Covers, Infant Stroller Cover, Carseat Canopy for Girls and Boys

#3. Breast Pump

Cost varies from $13 for a manual pump to over $500 for an electric pump. Pumping with a breast pump allows you to build your milk supply even before your baby needs more milk, thereby storing the extra milk for later. We recommend this Haakaa Manual Breast Pump . This manual pump costs $13.

It is easy to use. Simply squeeze, attach to the breast, and voila.
It is easy to clean.
This breast pump doesn’t need any pump or assembly.
It is lightweight, portable, and fits into any baby bag.
It is designed to fit all kinds of breasts.
This breast pump is made with high-quality silicone, and it is lead, BPA, PVC, and phthalate-free.
It might hurt a bit for first-timers.

If you prefer an electric pump, we recommend this Handsfree Pumping Bra . The material is comfortable, and it is designed to fit all pumps and hold bottles, and shield in place safely and comfortably.

Hands Free Pumping Bra, Momcozy Adjustable Breast-Pumps Holding and Nursing Bra, Suitable for Breastfeeding-Pumps by Lansinoh, Philips Avent, Spectra, Evenflo and More(Skin,Large)

#4. Feeding Bottles

When you are bottle-feeding your baby, you’ll need safe and high-quality bottles that are designed to mimic breastfeeding. This Comotomo Baby Bottle is a $22 bottle that does just that.

It is designed to closely mimic breastfeeding, thereby reducing bottle rejection and nipple confusion challenges.
It is easy to clean even without a brush.
The bottle is made of 100% Food Grade Silicone.
It comes with dual anti-colic vents that prevent unwanted air-intake and reduce colic.
The bottles take a long time to warm milk in bottle warmers.

Comotomo Baby Bottle, Green, 8 oz (2 Count)

Formula Feeding

The use of infant formula for babies is recommended until they reach a year old. Formula feeding can be quite expensive. Recent research places the cost of formula feeding at $1,200 – $3,800 CAD per annum. You’ll also be needing a lot of bottles in the process.

When You’re Feeding Solids

When you start feeding your baby solids, and the baby can sit on his or her own, you’ll need these items:

#1. Highchair

Cost $60 to over $500. High chairs have been designed particularly for baby feeding time. They keep your baby in place when eating. When choosing one, go for one that offers a high level of safety and convenience, like the Graco Slim Snacker High Chair . It costs $60.

The chair has three recline positions for feeding comfortably.
It is easy to fold.
It can fit in really compact spaces so you can store it easily.
The seat pad cleans easily.
It has a large mesh storage basket where you can keep your baby’s essentials within reach.
It comes with a full-sized tray with a cupholder.
The chair is lightweight and stable.
The straps can get difficult to remove for cleaning.

#2. Baby Cereal

Costs between $5 to $15 for one box, which typically will last for one week. The first thing many babies eat is cereal. The baby cereal can serve as a solid starter that helps you discover food sensitivities & help your baby develop eating skills. A baby cereal containing vitamins C, E, Zinc & 6 B vitamins for healthy development, and calcium for healthy teeth and bones are ideal.

The Gerber Single-Grain Oatmeal Baby Cereal has all these nutrients plus no artificial colours or flavours. It costs $12.48.

C. Travel Gear

#1. car seat.

You can save money by buying a car seat that grows with your child and converts from a rear-facing harness for babies (5-40 pounds) to a forward-facing toddler seat for kids up to 65 pounds. The cost for this kind of car seat usually ranges from about $100 to above $500.

The Graco SlimFit 3 In 1 Car Seat fits into this description, and it costs $180.

It is a multi-purpose 3-in-1 car seat that grows with your child from rear-facing infant seat (5-40 pounds) to forward-facing toddler seat (22-65 pounds) to highback booster (40-100 pounds).
It has a slim design with two integrated cup holders.
The chair is Graco ProtectPlus Engineered, a combination of the most rigorous crash tests that protect your baby in the side, frontal, rear & rollover crashes.
It has a four-position recline.
The seat comes with a push button latch that ensures secure installation.
The harness straps can not be removed for cleaning.

Graco Slimfit 3 in 1 Car Seat -Slim & Comfy Design Saves Space in Your Back Seat, Darcie

#2. A Full-Sized Single Stroller

A baby stroller is another item you need to buy. It is perfect for when you want to take your baby out without tiring yourself or the baby. A full-sized baby stroller usually costs within the $250 to $3,000 range. Our pick is this Baby Trend Expedition Jogger Stroller , and it costs only $110.

The large bicycle tires roll over all surfaces easily.
The front swivel wheel allows easy maneuvering and can lock when it’s time to jog.
It comes with a reclining padded seat and 5-point harness.
The chair comes with child and parent trays plus 2 cup holders.
It is compact and folds easily for travel and storage.
You need to use your two hands to trigger the mechanism that will make it fold.

Infant care

#1. diapers. .

In the first twelve years, the average child uses over 2,700 diapers. Pampers disposable baby diapers size 0 (0-10 pounds) cost $34.28, and this is one month’s supply. Size 1 (8-14 pounds) cost $48.28 and Size 2 costs $24.94 .

Another option is cloth diapers, and they cost around $20 per diaper. The Mama Koala One Size Reusable Cloth Diapers cost $24. It is super absorbent and grows with your child. Your baby can develop a rash due to diaper use, but a safe diaper rash cream can save the day. It costs around $7.

Pampers Swaddlers Disposable Diapers Newborn, Size N, 120 Count, GIANT

#2. Baby Wipes

These are also a major drain. Pampers Sensitive Water-Based Baby Diaper Wipes cost $15.

It is safe, free of alcohol, parabens, phenoxyethanol, perfume, and dyes.
It is also dermatologist-tested.
The pH balancing formula helps to protect sensitive skin.
It is hypoallergenic.
The packaging can be a little difficult to open.

#3. Bathtub ($20 to $40)

We recommend you buy a newborn to toddler bathtub. It grows along with your child, and you save money. Our pick is the First Years Sure Comfort Deluxe Newborn-to-toddler tub , and it costs $20.

This bathtub works for three stages of transition, from when the baby is a newborn to a toddler.
The tub comes with a super comfortable sling that holds the baby during bath time.
The mesh sling is machine washable and dryable.
It comes with a convenient shelf at the bath tub’s foot where you can store bath essentials.
The tub is very easy to drain
The padded sling takes a longer time to dry.

The First Years Newborn to Toddler Baby Bath Tub - Convertible 3-in-1 Baby Tub with Removable Sling - Ages 0 to 24 Months - Sure Comfort - Teal

D. Clothing

This goes without saying. The average cost of baby clothes is $60 or CAD$76 per month.

Any child born in Canada automatically has the right to become a Canadian citizen, irrespective of the parent’s visa or citizenship status. After you register your child’s birth, apply for the birth certificate, which will serve as proof of the child’s Canadian citizenship. When you have this, you can then apply for the baby’s Canadian passport by: • Filling in an application form. • Presenting proof of the child’s Canadian citizenship (birth certificate). • Providing two passport photographs. • Presenting proof of parentage or legal guardianship. • Getting a guarantor. • Paying the stated fees. • Sending all the documents to this address: Government of Canada, Passport Program, Gatineau QC K1A 0G3, Canada.

Canadian parents are eligible to get maternity and parental benefits provided they worked at least 600 hours in the year before. Canada has an 18-month parental leave option, and this lets the parents earn up to 33% of their normal weekly earnings. Another option is the 12-month option that gives the parents 55% of their normal weekly earnings.

The cost of having a baby in Canada is a bit pricey. The estimate is around $15,000 to $20,000 a year. However, if you have international health insurance coverage, you’ll pay much less.

The health care system in Canada is the Medicare system, and it is publicly funded. All Canadian Citizens and permanent residents have free access to this health system. For residents and citizens, the cost of having a baby in Canada is just a few hundred dollars or completely free. In contrast, non-citizens and non-residents have to pay out of pocket for the hospital bills, except they have international health insurance in place.

Yes, you can give birth in Canada as a tourist. The visa given to women to give birth in Canada is called a Temporary Resident Visa (TRV) . This visa allows women to go to Canada to travel or visit friends and family. It also allows them to go to a hospital for assistance in giving birth. However, the woman will not be able to claim the medical and social benefits given to Canadian citizens and residents.

The average cost to have a baby in Canada without insurance is between $5,000 CAD to $8,000 CAD for hospital birth or $10,000 CAD to $15,000 CAD for Cesarean section (CS) at the hospital.

You can afford to have a baby without insurance by doing the following: 1. Double-check your medical eligibility. 2. Negotiate for discounts. 3. Give birth at a birthing center with a midwife instead of at the hospital.

If you’ve decided to have your child in Canada, you are on a fantastic track. Living in Canada has amazing perks , and your child being a citizen would be fantastic.

When it comes to the cost of having a baby in Canada, you need to conduct research and make sure you have all the right information, and that’s precisely why we made this post. So refer back to this post and use it as a guide all through your birth tourism journey.

READ ALSO >> Giving Birth in Canada – Benefits, Cost, Citizenship, Tourism Visa

Charee Oisamoje is the founder of CanadaWiz. She leads the editorial team, which is comprised of subject matter experts that aim to create well-researched, highly detailed content related to studying, working, immigrating, and settling/living in Canada as a newcomer.

Charee's personal experiences as a Canadian immigrant and her professional competencies make her uniquely qualified on the subject matter.

Learn More >> About Page

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Birth tourism showing post-pandemic rebound in B.C.

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In 2022, B.C. saw an 83.4 per cent decline in non-resident paid births, from its pre-pandemic five-year average of 661. But in 2023 there was a 105 per cent rebound.

Data most closely associated with birth tourism shows the practice is back on the rise in B.C. and across Canada following a sharp decline amid pandemic-related travel restrictions.

But in B.C., where “self-paying non-resident” births took the biggest tumble since 2020, such births have yet to recover as much as elsewhere, as one city in particular has lost the moniker of being the “epicentre” of the controversial cottage industry.

Between April 1, 2019 and March 31, 2020, 868 non-residents of Canada paid to give birth in local B.C. hospitals, in turn garnering automatic citizenship for their newborns. Over the five years before the pandemic, B.C. saw an annual average of 661 such births.

Across Canada, such births numbered 4,656 annually, on average, during the five preceding years, while reaching 1.6 per cent of all Canadian births by April 2020. (In 2010, the rate of such births was only 0.5 per cent — see figure above.)

But those numbers dropped to 2,339 in Canada and 152 in B.C., in 2021-2022. Where B.C. saw a 77 per cent decline, Ontario witnessed only a 51 per cent decline and across Canada the rate of decline was 50 per cent.

However, last year (2022-2023) the numbers began to rise again, to 3,575 across Canada (1.0 per cent of total births) and to 312 in B.C., according to immigration policy expert and researcher Andrew Griffith, former Director General for Citizenship and Multiculturalism .

“The question now is, how quickly does it start to pick up? After two years, you start to see a pickup, albeit not back to previous levels — that will take time,” said Griffith, who described the COVID-19 pandemic as “the perfect natural experiment to assess the extent of birth tourism in Canada.”

Decline in B.C. corresponds with lower Chinese tourism

The sharp decline in B.C., Griffith hypothesizes, is likely a result of a more pronounced decline in tourist visas from China and the corresponding geopolitical tensions between the nations.

Of B.C.’s 868 “self-paying non-resident” births the year before the pandemic, 502 took place at Richmond Hospital , the Canadian city with the largest proportion of immigrants from China and one where a booming industry of short-term rentals , or de facto birth hotels, servicing pregnant Chinese nationals once existed.

Whereas Chinese nationals once represented 24 per cent of all births in the city, they only numbered four per cent last year, Griffith found via data supplied by the Canadian Institute for Health Information.

“In Richmond, there as you see the number of visas issued to Chinese nationals decrease, the number of birth tourists in Richmond decreased. So it’s no longer the epicentre; now it’s one of the Toronto hospitals,” said Griffith.

The researcher points out that while visitor visas overall have largely recovered after pandemic air travel restrictions lifted, to 93 per cent of former levels, and the number of temporary foreign workers increased significantly, visitor visas for Chinese nationals have only recovered to 18 per cent of former levels.

Last August , China left Canada off its government-approved list of approved countries for group travel amid geopolitical tension, including: diplomatic rows stemming from allegations of foreign interference, undue foreign influence in Canadian diaspora communities, cyberwarfare and the detention of Huawei CFO Meng Wanzhou and subsequent retaliatory imprisonment of Michael Kovrig and Michael Spavor.

“This suggests a variety of Chinese restrictions and tensions between China and Canada played a role in reducing the interest of Chinese nationals to travel here to give birth,” said Griffith.

What are the concerns and will there ever be a solution, if warranted?

Since there was more significant media coverage on the matter prior to the pandemic, Griffith notes the federal government has not done anything to curb the issue , despite public debate, while B.C. Minister of Health Adrian Dix has dismissed concerns about problems such as Canadian mothers being diverted from hospitals such as Richmond.

Griffith says, “given the current and planned increases in immigration, it is highly unlikely that the government will act as the numbers are a rounding error compared to overall immigration of 500,000 by 2025.”

But to Griffith, stopping the practice is more a matter of principle.

“I still think it’s important on principle and for the value of citizenship; it’s one of those things that can irritate, with people going around the system, taking advantage of the system,” said Griffith, who believes amendments to the Citizenship Act — requiring one parent to be a citizen or permanent resident to grant the baby citizenship — are warranted.

Several polls on the topic show significant support for amendments. In 2019, Angus Reid Institute, for example, reported "two-thirds (64%) say a child born to parents who are in this country on tourist visas should not be granted Canadian citizenship, and six in ten (60%) say changes to Canada’s citizenship laws are necessary to discourage birth tourism."

Some critics of proposed changes contend people are unfairly targeting disadvantaged foreign women.

University of Carleton associate law professor Megan Gaucher was provided $223,328 from the federal government in June 2021 to research “how constructions of foreignness undermine the longstanding assumption that formal legal citizenship is an uncontested condition for membership to the Canadian state and explore how political and public discourse around birth tourism ultimately reproduces settler-colonial imaginaries of ‘good’ familial citizens.”

Gaucher says proposed measures "risk being driven by polarizing narratives about borders and citizenship rather than by evidence."

Griffith has contested such views, noting birth tourists are “not disadvantaged women; they are people who have money to travel here and pay all the related expenses.”

In B.C., refugees and temporary foreign workers would not be categorized as self-paying births. And figures in B.C. also do not count international students, who are covered by the province's Medical Services Plan. Hence, the "non-resident self-pay" numbers are a more accurate depiction of the practice, Griffith notes.

Conversely, others such as Michael Juneau-Katsuya, CSIS's former chief of the Asia-Pacific, have shared contrasting opinions on the emerging phenomenon.

Juneau-Katsuya told Glacier Media he sees birth tourism as a national security threat. He suggests the People’s Republic of China may document and monitor returning children and utilize them as agents of the communist state should they return to Canada as adults.

Still, others have expressed concerns that there may be a cumulative impact on returning citizens who may utilize Canada’s social safety nets and reap benefits of citizenship without investing time in the country. Those concerns are in addition to the added stress birth tourism places on the health-care system .

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China easing travel bans could breathe life into B.C. birth tourism, says immigration expert

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The Future of Birth Tourism in Canada

The outlook of birth tourism in Canada has changed dramatically since the pandemic, understand what those changes are.

What is Birth Tourism?

Birth tourism refers to non-resident parents coming to a country outside of their own to give birth for the purpose of obtaining citizenship or health care for their newborn(s). Canada is one of the only two remaining G7 countries that still have birthright citizenship. As per the Canadian Citizenship Act, all babies (with the exception of children of foreign diplomats) born on Canadian soil are automatically granted citizenship.

Furthermore, Canada is one of few developed countries in the world that still offers unconditional citizenship to children born in the territory. This means that regardless of their parent’s origin, babies born in Canada are entitled to reside in or visit to Canada at their own discretion and enjoy free healthcare and education among the other social benefits.

Challenges Around Birth Tourism?

That said, there are challenges associated with birth tourism that make the process of doing so complex, and for some, inaccessible.

Generally speaking, Canadian obstetricians are not interested in accepting patients from outside the country as doing so complicates liability and insurance coverage issues for Canadian hospitals which therefore makes it difficult for doctors to accept them as patients. While immigration consultants who work with foreigners looking to deliver their child in Canada do exist, their efforts to find temporary housing accommodations and secure referrals to Canadian doctors who are willing to treat foreign patients are not always successful. Additionally, the cost for foreigners to deliver a baby in Canada can range anywhere between $10,000 – $20,000 and that number does not factor in transportation or housing costs which in the market are not insignificant

How Birth Tourism Has Changed Since The Pandemic

In recent years, the COVID’19 pandemic has made it so that international mobility was difficult or impossible and accordingly birth tourism rates in Canada plummeted. Since the reopening of borders and abolishment of most travel restrictions that rate has started to increase. In fact, birth tourism rates in Canada are currently going up faster than those of immigration rates and overall population rates. In the last year, there has been a 13 per cent increase as reported by the Canadian Institute for Health Information (CIHI).

Births in Canada by Mothers whose Place of Residence is Outside Canada

Aside from situational factors that have interfered with the feasibility of birth tourism, some Canadians reject the idea entirely. As of recently, many petitions as seen on Canada.ca have been created to defy birthright citizenship and unconditional citizenship. Said differently, many people hope to restrict granting citizenship by birth on Canadian soil to all but those children who have at least one parent who is either a citizen or permanent resident of Canada. Therefore, with the increasing barriers of birth tourism, it is difficult to say how much longer the opportunity for birth tourism will last.

Benefits of Birth Tourism

While the benefits of birth tourism heavily outweigh the costs for the child, that does not necessarily hold true for the parents. Birthright citizenship and unconditional citizenship do not extend to the parent(s). While the child born in Canada reaps the benefits and privileges that come with Canadian citizenship status, the parents do not and they are not awarded any special treatment to obtain permanent residence or visa such that most have to return home after the birth.

Birth tourism is a safe haven for many and while it is inaccessible for some, it is possible for many with forward planning and the effective use of available resources. For anyone seriously considering delivering a baby in Canada, below are some tips to help you plan:

Choose a City: Large cities (like Toronto, Montreal and Vancouver) will usually offer a wider range of medical services to foreigners in comparison to smaller, more rural cities.
Deciding on When to Come: According to Statistics Canada, February is the least popular month for baby deliveries in Canada. Specifically, between the years of 2017 and 2021 (inclusive), there were on average 20% less births in February than the highest month (July). This means that planning to deliver a baby in February will translate into more readily available medical care and other related services.
Types of Housing/Accommodation Availability: According to skyviewsuites.com (a leading Canadian furnished rentals company), temporary furnished accommodation are significantly less expensive (by as much as 20% – 30%) during the winter. Of course, the downside is that you will have to brave the infamous Canadian Winter!

Frequently Asked Questions Around Birth Tourism

Q: Can a visitor give birth in Canada? A: Yes. Giving birth in Canada does not represent a violation of any terms or conditions that may be applied to a temporary resident. Such a child may live in or travel to Canada as they please without a visa and are eligible to receive free health care, education, and social benefits. Q: Can a child born in Canada become a Canadian permanent resident or citizen? A: If a child is born in Canada, the child automatically receives Canadian citizenship status. Q: How does birth tourism impact the parents? A: The concern with birth tourism is not just economic. Physicians sometimes face difficulties providing necessary pregnancy and after-birth medical care for birth tourists, particularly those who choose to spend less time on the post-partum ward compared to local patients. The lack of follow-up care is said to increase health risks for the mothers and their babies who might not receive adequate care from maternity hotels after leaving the hospital. Q: What are the costs associated with birth tourism? A: The medical costs can range from $10,000 – $20,000. Among other factors, transportation costs will vary depending on where and how far you are coming from. Housing costs will vary depending on which city you choose to travel to. Those looking for housing accommodations in Canada can visit svsrelo.com . SVS Relo is a Canadian company that services all the major cities in Canada and offers housing accommodations.

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Temporary residents: Persons wishing to enter Canada for the purpose of giving birth

This section contains policy, procedures and guidance used by IRCC staff. It is posted on the department’s website as a courtesy to stakeholders.

Under paragraph 3(1)(a) of the Citizenship Act, persons born in Canada are Canadian citizens. This right applies to all persons born in Canada, irrespective of the status in Canada of their parents, other than persons born to accredited diplomats.

There are no elements of the Immigration and Refugee Protection Act (IRPA) that refer to this right. Giving birth in Canada does not represent a violation of any terms or conditions that may be applied to a temporary resident. Thus, there is no provision in the IRPA to refuse a temporary resident visa (TRV) solely on the basis of the intent of the applicant to give birth in Canada.

When it is known that an applicant is pregnant, assessment of the application should focus on the requirements applied to all applicants for a TRV. The fact of the pregnancy may be an element in the assessment but only insofar as it affects the assessment of the primary requirements for issuance of a TRV:

Do applicants have sufficient funds?
Will they leave Canada at the end of their period of authorized stay?
Are they admissible?

Consideration of the pregnancy and the stated or apparent intent to give birth in Canada must relate back to one of these essential requirements for TRV issuance.

Guidelines for persons coming forward for medical treatment may provide officers with assistance in assessing applications from persons who are known to be pregnant and intending to give birth in Canada at the time of the TRV application. However, it is important to note that pregnancy would not normally present concerns regarding medical inadmissibility.

With the introduction of the Temporary Public Policy Regarding Excessive Demand on Health and Social Services on June 1, 2018, the health-care costs related to a high‑risk pregnancy (prenatal care and delivery) do not exceed the excessive demand threshold. An assessment of excessive demand on health or social services do not apply to the future child, who will become a citizen at birth. Concerns regarding the demands that may be placed on health and social services by the child after birth in Canada may not be used in assessing the medical admissibility of the TRV applicant.

In applying the guidelines on temporary residents seeking medical treatment in Canada, officers should focus on available financial support as part of their assessment of admissibility.

A medical examination should be requested only in exceptional cases, where the information from the examination would be material to the assessment of the application.

The application form for a TRV asks the applicant if they or any accompanying family members have any physical or mental disorders that will require social or health services during their stay in Canada. Answering “No” to this question should not normally be considered misrepresentation in the case of a pregnant applicant, given the terminology used. Pregnancy may not normally be viewed as a “medical condition.”

However, pregnancy or the intent to give birth in Canada may be material facts in the assessment of the application, which, if we are not advised of the pregnancy, may go unexamined; such facts may be material to the assessment of arrangements for treatment, of the financial ability to cover the costs of treatment or of the intent to depart from Canada, for example. Therefore, in some cases, the intentional concealment of intent to give birth in Canada may lead to an examination of admissibility under section 40 of the IRPA.

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Stormy Daniels Takes the Stand

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Jonah E. Bromwich , who covers criminal justice in New York for The New York Times.

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Childbirth in Canada
'Birth tourism' rising fast in Canada; up 13 per cent in one year
Birth Tourism in Canada Much Higher Than Official Figures: Study
What to Know About "Birth Tourism" in 2024 and Canadian Immigration
Birth Tourism in Canada Much Higher Than Official Figures: Study
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COMMENTS

'All about the money': How women travelling to Canada to give birth
In the fall of 2019, Cathy Shi arrived in Richmond, B.C., from Shandong, on China's east coast, to give birth to her third child. She said through a translator that she wanted her unborn child to ...
Giving Birth in Canada
As a visitor/tourist in Canada, deciding to give birth to a child in Canada has some associated costs ranging from $5,000 CAD to $20,000 CAD. The cost is based on various factors, such as: The health care costs in the province you decide to have your child (some provinces have higher health costs than others).
Birth tourism in Canada dropped sharply once the pandemic began
The COVID-19 pandemic provides a perfect natural experiment to assess the extent of birth tourism in Canada now that we have 2020-21 hospital delivery data from the Canadian Institute of ... given the correlation between visitor visa data and the sharp drop in birth tourism. Moreover, given the cost of coming to Canada for the purpose of giving ...
The Cost of Having a Baby in Canada: What You Need to Know
The cost of having a baby in Canada falls within the range of $10,000 - $15,000 a year on average. Most of the prenatal, post-natal and delivery costs are covered by the publicly-funded healthcare system for citizens and permanent residents, but tourists and non-residents will have to pay out-of-pocket unless they have international health ...
Canada's massive (and easily fixed) birth tourism problem
There's nothing illegal about birth tourism and birth tourists are all paying handsomely for the service (it costs between $6,000 and $10,000 for an uninsured non-resident to give birth at a ...
Birth tourism is rising again post-pandemic
Birth tourism is rising again post-pandemic. The government needs to get serious about better understanding the extent of non-resident births and consider amendments to the Citizenship Act. The COVID-19 pandemic provided the perfect natural experiment to assess the extent of birth tourism in Canada. Dramatic declines of 50 per cent compared ...
Is birth tourism about to return now that travel restrictions have been
This provides a very good indication of the extent of birth tourism in Canada. Now that the restrictions are loosening and travel is once again opening up, it's time for the federal government to revisit its policy on non-resident births and Canadian citizenship. The decline to 2,245 in 2021 from 2,433 in 2020 occurred in all provinces save ...
Canadian doctors say birth tourism is on the rise. It could hurt the
Birth tourism is far from the only factor straining the health care system, but we knew it was an additional cost, and that we didn't have the data to understand it. We saw an opportunity.
Birth tourism
In comparison to U.S. health costs, medical tourism patients can save 30 to 60 percent on health costs in Canada. Mexican women sometimes engage in birth tourism to the United States or Canada to give their children U.S. or Canadian citizenship. While some non-legal obstacles exist, Canada is one of only a few countries without legal ...
Childbirth in Canada: cost, how to give birth and obtain Canadian
passport size photos of the child; a receipt for the payment of the $44.9 USD state fee; the application form completed and printed in duplicate on the Government of Canada website. The passport manufacturing process takes from 10 to 20 days. The document is valid for 5 years.
Impact of birth tourism on health care systems in Calgary, Alberta
Birth tourism refers to non-resident women giving birth in a country outside of their own in order to obtain citizenship and/or healthcare for their newborns. We undertook a study to determine the extent of birth tourism in Calgary, the characteristics and rationale of this population, and the financial impact on the healthcare system. A retrospective analysis of 102 women identified through a ...
Here's what you need to know about birth tourism in Canada
Listen to this article. 00:01:42. So-called "birth tourism" is when pregnant, non-Canadian women fly into Canada in order to give birth and secure citizenship for their babies. In addition to receiving benefits, like healthcare and education, when the children become adults, they can also sponsor their parents to immigrate to Canada.
Canada Visa for the Purpose of Giving Birth
The fees for the visa to give birth in Canada are the same as all Temporary Resident Visas. You will have to pay CAD$100 for the application and an additional CAD$85 if you have to give your biometric information. Finally, if your visa is approved, you will have to pay around CAD$45 for the passport processing.
'Birth tourism' rising fast in Canada; up 13 per cent in one year
Birth tourism is on the rise in Canada, with new data suggesting that 1.4 per cent of all births in the country involve non-resident mothers. ... Cost of eating disorders in Canada surging: report ...
Concerns About Birth Tourism Drop Slightly in Canada
Vancouver, BC [November 4, 2022] - Canadians are currently not paying as much attention to the issue of "birth tourism" as they did in 2020, but a sizeable majority believe the practice should still be scrutinized, a new Research Co. poll has found. In the online survey of a representative national sample, 28% of Canadians say they have ...
Cost of Having a Baby in Canada
The cost of having a baby in Canada depends on whether you have insurance or not. It is estimated at $18,000 CAD to $24,000 CAD without insurance. ... Canada's birth tourism level is also at a record high. The Cheapest Way to Transfer Money to Canada. Paying for your childbirth costs in Canada just got simpler. Wise (formerly TransferWise) ...
Study shows birth tourism much more prevalent in Canada than reported
What he found was that the level of birth tourism nationally in Canada is at least five times greater than the 313 births recorded by Statistics Canada in 2016, sitting at 3,223.
Birth tourism showing post-pandemic rebound in B.C.
Between April 1, 2019 and March 31, 2020, 868 non-residents of Canada paid to give birth in local B.C. hospitals, in turn garnering automatic citizenship for their newborns. Over the five years before the pandemic, B.C. saw an annual average of 661 such births. Across Canada, such births numbered 4,656 annually, on average, during the five ...
The Future of Birth Tourism in Canada
In fact, birth tourism rates in Canada are currently going up faster than those of immigration rates and overall population rates. In the last year, there has been a 13 per cent increase as reported by the Canadian Institute for Health Information (CIHI). ... What are the costs associated with birth tourism? A: The medical costs can range from ...
'Birth Tourism' Is Legal in Canada. A Lawmaker Calls It Unscrupulous
A nonresident, Yan Xia, gave birth there, racked up a bill of 312,595 Canadian dollars in maternity and neonatal care for her newborn because of complications, and then absconded without paying ...
Temporary residents: Persons wishing to enter Canada for the purpose of
Under paragraph 3 (1) (a) of the Citizenship Act, persons born in Canada are Canadian citizens. This right applies to all persons born in Canada, irrespective of the status in Canada of their parents, other than persons born to accredited diplomats. There are no elements of the Immigration and Refugee Protection Act (IRPA) that refer to this right.
Impact of birth tourism on health care systems in Calgary, Alberta
Definitions. Birth Tourism: the practice of non-residents of a country traveling to a new country with the intention to give birth in the new country. Birth Tourist: an Uninsured Prenatal Patient who is a non-resident who travels to a new country with the intention of giving birth there.In Canada, Birth Tourists do not qualify for publicly funded health care coverage, even if they are Canadian ...
Stormy Daniels Takes the Stand
4. Hosted by Michael Barbaro. Featuring Jonah E. Bromwich. Produced by Olivia Natt and Michael Simon Johnson. Edited by Lexie Diao. With Paige Cowett. Original music by Will Reid and Marion Lozano ...