DALLAS: Texas has launched one of its toughest measures yet against what state officials describe as “birth tourism”, with Governor Greg Abbott signing Executive Order GA-57 to authorise a broad investigation into healthcare providers and organisations suspected of facilitating foreign nationals seeking to give birth in the state so their children acquire US citizenship.
The order is expected to affect hospitals, physicians and immigrant communities across Texas, particularly visitors from Pakistan, India, Bangladesh and other South Asian countries who travel to the United States on visitor visas.
Announcing the order, Abbott declared that “American citizenship is not for sale” and said Texas would no longer tolerate schemes that, in the state’s view, exploit the country’s immigration system.
The executive order authorises six state agencies, including the Texas Department of State Health Services, the Health and Human Services Commission, the Texas Medical Board and the Texas Board of Nursing, to investigate birth tourism operations within the healthcare sector. State regulators have also been instructed to coordinate with federal authorities where potential violations of federal law are identified, while disciplinary measures could include licence suspension or revocation, exclusion from state contracts and other administrative penalties.
The order follows Abbott’s earlier directive this month instructing the Health and Human Services Commission to investigate hospitals advertising maternity packages to foreign nationals. State officials subsequently referred two Texas hospitals to the Attorney General after promotional material targeting women in Mexico offered childbirth packages near the US-Mexico border, with advertised prices of $3,950 for natural delivery and $5,525 for Caesarean sections.
The move comes only weeks after the US Supreme Court concluded its 2025-26 term by leaving intact the constitutional principle of birthright citizenship under the Fourteenth Amendment, effectively preventing President Donald Trump from restricting automatic citizenship for children born in the United States.
Austin immigration attorney Kate Lincoln-Goldfinch said the Texas order appeared to be an attempt to regulate activities surrounding a practice that remains constitutionally protected under federal law. She argued that the state was pursuing alternative enforcement mechanisms after the Supreme Court reaffirmed birthright citizenship.
The executive order has drawn particular attention among South Asian communities, where some families have historically viewed childbirth in the United States as a pathway to securing American citizenship for their children. Members of the Pakistani community in Dallas and Houston told Jang/Geo they knew families that had planned to travel on visitor visas for childbirth but were now reconsidering those plans following the governor’s announcement.
According to the Migration Policy Institute, fewer than 30,000 of the more than 3.5 million births recorded annually in the United States involve women travelling on tourist visas, representing well under one percent of all births nationwide.
Legal experts nevertheless believe the new enforcement measures could result in increased scrutiny of pregnant visitor visa applicants. US consular officers already have authority under State Department policy to refuse visitor visas if they conclude that the applicant’s primary purpose is to give birth in the United States.
Immigration attorneys in Dallas told Jang/Geo that pregnant applicants should seek legal advice before applying for visitor visas and avoid making inaccurate statements during visa interviews, warning that visa refusals or allegations of misrepresentation could affect future travel. They also said individuals who previously gave birth in the United States while visiting could face additional questions during future visa renewals.
Lincoln-Goldfinch cautioned, however, that organised birth tourism remains relatively uncommon, noting that women in advanced stages of pregnancy are frequently denied boarding by airlines or refused entry at US ports of entry. She said highly visible pregnancies often attract closer scrutiny from border officials long before childbirth occurs.
The order is also expected to create significant compliance challenges for healthcare providers throughout Texas. Hospitals, obstetricians and maternity clinics may face greater regulatory scrutiny while attempting to balance legal obligations with ethical responsibilities to provide medical care. Houston immigration attorney Gordon Quan said healthcare professionals could increasingly find themselves under pressure to verify patients’ immigration circumstances before treatment, although he stressed that pregnant women remain entitled to necessary medical care regardless of immigration status.
Several Pakistani and Indian physicians practising obstetrics and gynaecology in Dallas, Fort Worth and Houston told Jang/Geo they were concerned about the practical implications of the new policy. They said denying treatment could expose physicians to medical liability, while treating patients later suspected of participating in birth tourism could also trigger regulatory investigations.
Legal experts say healthcare providers should immediately review marketing materials, strengthen compliance procedures, train staff on the new regulatory environment and maintain detailed patient records to demonstrate compliance if investigations occur. Some hospitals previously criticised for advertising maternity services to foreign nationals have already withdrawn those promotional materials, saying they do not support unlawful activity.
Civil rights advocates argue that birth tourism represents only a small proportion of births in the United States and warn that heightened enforcement may discourage immigrants from seeking timely medical care. They note that federal law continues to require hospitals to provide emergency medical treatment regardless of a patient’s immigration status, while emphasising that pregnancy alone does not prevent someone from travelling to the United States as a tourist
2026-07-23 12:49:00
