The Trump administration unveiled a new rule Thursday intended to curtail what the administration calls “birth tourism.” It would give the government more power to deny certain visas to women if officials have “reason to believe” they intend to travel to the U.S. for the primary purpose of giving birth to a child in the U.S., thereby obtaining U.S. citizenship for the child. 

According to the State Department rule in the Federal Register, pregnant women who are traveling to the U.S. for medical treatment have to provide their treatment arrangements and demonstrate their ability to pay for the treatment and any other associated costs. 

The practice of traveling to the U.S. to give birth is fundamentally legal, although there are scattered cases of authorities arresting operators of birth tourism agencies for visa fraud or tax evasion. Women are often honest about their intentions when applying for visas and even show signed contracts with doctors and hospitals.

The State 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,” according to the new rule, which goes into effect Friday.

Since his presidential campaign began, President Trump has railed against what he called “anchor babies” and birthright citizenship, the guarantee under the Constitution that anyone born in the U.S. is considered a citizen. He has threatened to end the practice, but scholars and members of his administration have said it’s not so easy to do.

Regulating tourist visas for pregnant women is one way to get at the issue, but it raises privacy concerns about how officers would determine whether a woman is pregnant and whether a woman could get turned away by border officers who suspect she may be pregnant just by looking at her.

Consular officers do not have the right to ask during visa interviews whether a woman is pregnant or intends to become so. But they would still have to determine whether a visa applicant would be coming to the U.S. primarily to give birth.

Birth tourism has been a lucrative business in both the U.S. and abroad for years. Companies take out advertisements and charge up to $80,000 to facilitate the practice, offering hotel rooms and medical care. Many of the women travel from Russia and China to give birth in the U.S.

The U.S. has been cracking down on the practice, targeting businesses that bring hundreds of pregnant women into the U.S.

“An entire ‘birth tourism’ industry has evolved to assist pregnant women from other countries to come to the United States to obtain U.S. citizenship for their children by giving birth in the United States, and thereby entitle their children to the benefits of U.S. citizenship,” according to the State Department rules.

It’s not known exactly how many foreign women travel to the U.S. specifically to give birth. The Center for Immigration Studies, a group that advocates for stricter immigration laws, estimated that in 2012 about 36,000 foreign-born women gave birth in the U.S. and then left the country.

“This rule will help eliminate the criminal activity associated with the birth tourism industry,” according to the rules. “The recent federal indictments describe birth tourism schemes in which foreign nationals applied for visitor visas to come to the United States and lied to consular officers about the duration of their trips, where they would stay, and their purpose of travel.”

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