Crackdown on birth tourism: US territories is the latest battleground over birthright citizenship

 By Jayvee Vallejera

The effort to restrict birthright citizenship in U.S. territories continues to gain momentum in Washington. First came a bill in the U.S. House of Representatives. Then President Donald Trump issued an executive order. Now, a Republican senator has introduced companion legislation in the U.S. Senate.

Sen. James Lankford, R-Okla., recently introduced Senate Bill 5667, the "Ending Birthright Citizenship in U.S. Territories Act," marking the latest attempt to limit who can acquire U.S. citizenship by birth in America's territories.

The proposal comes as the Trump administration and its congressional allies continue searching for ways to narrow birthright citizenship despite a recent U.S. Supreme Court ruling that blocked efforts to redefine who is entitled to citizenship under the Constitution.

In Trump vs. Barbara, the court upheld birthright citizenship and made clear that neither the president nor Congress can unilaterally alter constitutional guarantees of citizenship.

Trump's Aug. 6 executive order targets birth tourism as a ground for restrictions. On Aug. 12, the State Department created the Birth Tourism Prevention Task Force tasked with reviewing the activities of U.S. visa holders "to identify instances of birth tourism, take action to revoke visas of those who engage in or facilitate it and dismantle the networks that profit from this abuse."

A federal court in Maryland has temporarily blocked enforcement of the president's executive directive pending litigation.

Taking a cue from the presidential directive, Lankford's bill would redefine birthright citizenship for U.S. territories by excluding those whose mother is "not lawfully present in such territory" and whose father is not a United States citizen or lawful permanent resident.

The Senate proposal also follows a similar House bill introduced earlier this year by Rep. Morgan Griffith, R-Va. Unlike Griffith's measure, which would take effect next year if enacted, Lankford's bill would become effective immediately upon passage.

"Birth tourism still exists on Guam. Some may argue that birth tourism on Guam is small, so let's not worry about it," said Dr. Thomas Shieh, a Guam obstetrician/gynecologist. "It's like 'human trafficking' on Guam is tiny, so let's ignore it."

Shieh said birth tourism, no matter how big or small, must be addressed. 

Birth tourism can be lucrative for physicians, he said, "because it's easy: one, two visits and done."

"I don’t actively engage in birth tourism. My focus is on our local moms. If there are tourists who come in without the intent to deliver and I get called by hotels to help, I will help, but I do not actively engage in birth tourism," he said.

Birth tourism can grow as an industry, but at the expense of local mothers. "Our resources on Guam for maternal care are bad. The issue at hand is the lack of access to prenatal care on Guam," Shieh said. "If I wanted to do just birth tourism, none of my patients would have access to prenatal care."

Shieh said the Trump administration's crackdown on birth tourism should not be framed as an attack on U.S. territories or the rights to citizenship for those who come legally.

"My parents immigrated to the U.S. legally and did it the right way," Shieh said. "Those who criticize have not offered good solutions. That said, let the debate continue, and I will get back to my mission here on Guam for our moms and their babies."

In the CNMI, the Senate and House legislation raise questions about the applicability of the Covenant between the United States and the Northern Mariana Islands. The Covenant requires mutual consent for any changes affecting the political relationship between the CNMI and the federal government, but it was unclear whether territorial leaders were consulted before the bill was introduced.

As of this writing, Guam Del. James Moylan and CNMI Del. Kimberlyn King-Hinds have not responded to requests for comment.

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Supporters of the legislation have pointed to concerns about birth tourism in U.S. territories, where foreign nationals travel to give birth so their children can obtain U.S. citizenship.

Much of the political rhetoric surrounding the issue has focused on reports of Chinese mothers traveling to Saipan for that purpose. Lawmakers in Washington have repeatedly cited alleged loopholes that brokers exploit to bring pregnant women into the territory.

Data from the Commonwealth Healthcare Corp., which operates the CNMI's only hospital, shows tourist births have declined dramatically in recent years.

According to CHCC, there were only 47 tourist births in the CNMI in 2025, down approximately 92 percent from 581 births recorded in 2018. Tourist births now account for only a small fraction of total deliveries in the territory.

The numbers stand in sharp contrast to estimates from researchers at Penn State University, who place the number of births linked to birth tourism on the U.S. mainland between 5,000 and 26,000 annually.

Even so, it is the much smaller number of births in U.S. territories that has drawn heightened scrutiny from lawmakers and prompted legislative efforts in both chambers of Congress.

"This effort to redefine who is a citizen by birth in U.S. territories is a disturbing trend built on the assumption that citizenship rights for those born in U.S. territories are not constitutionally protected the same as for those born in other parts of the United States," said Neil Weare, co-director of the advocacy group Right to Democracy.

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