Texas has implemented some of its most stringent measures yet against what officials call “birth tourism,” with Governor Greg Abbott signing Executive Order GA-57. This order authorizes an extensive investigation into healthcare providers and organizations suspected of helping foreign nationals have babies in Texas so their children can gain U.S. citizenship.
The move is anticipated to impact hospitals, doctors, and immigrant communities across the state, especially visitors from Pakistan, India, Bangladesh, and other South Asian countries traveling to the U.S. on visitor visas.
During the announcement, Abbott emphasized that “American citizenship is not for sale,” declaring that Texas will no longer tolerate schemes that, in its view, exploit the country’s immigration laws. The executive order empowers 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 practices within the healthcare sector. These agencies have been instructed to coordinate with federal authorities if potential violations of federal law are uncovered. Disciplinary actions could include license suspensions or revocations, exclusion from state contracts, and other administrative penalties.
This order follows Abbott’s earlier directive in the month for the Health and Human Services Commission to examine hospitals promoting maternity packages to foreign nationals. Following that, two Texas hospitals were referred to the Attorney General after promotional materials targeting women in Mexico offered childbirth packages near the U.S.-Mexico border, with prices advertised at $3,950 for natural births and $5,525 for C-sections.
This initiative sees the Supreme Court recently ruling to uphold birthright citizenship under the 14th Amendment, effectively preventing then-President Donald Trump from restricting automatic citizenship for children born in the U.S. in the recent term.
Kate Lincoln-Goldfinch, an immigration attorney based in Austin, observed that the Texas order seems aimed at regulating activities surrounding a practice that remains protected under federal law. She explained that the state appears to be seeking alternative enforcement measures after the Supreme Court reaffirmed the constitutionality of birthright citizenship.
The order has garnered particular attention among South Asian communities, where some families have historically viewed having children in the U.S. as a pathway to citizenship. Residents of Dallas and Houston from the Pakistani community, speaking to Jang/Geo, indicated awareness of families that had planned to travel on visitor visas for childbirth but are now reconsidering those plans following the governor’s announcement.
According to the Migration Policy Institute, less than 30,000 out of over 3.5 million births annually in the U.S. involve women traveling on tourist visas—less than one percent of all births nationwide.
Legal experts warn that these new enforcement efforts might lead to more scrutiny of pregnant women applying for visitor visas. U.S. consular officers already have the authority under State Department policies to deny visas if they believe the primary purpose is to give birth in the U.S.
Dallas immigration attorneys advised pregnant applicants to seek legal guidance before applying and to avoid making false statements during visa interviews, as misrepresentations can lead to visa denials or future travel restrictions. Women who previously gave birth during visits may also face additional questions when renewing visas.
However, Lincoln-Goldfinch noted that organized birth tourism remains relatively rare. Pregnant women in advanced stages of pregnancy are often turned away by airlines or detained at ports of entry. Visible pregnancies tend to attract heightened scrutiny from border officials well before delivery.
Healthcare providers across Texas are also likely to face significant compliance challenges. Hospitals, obstetricians, and clinics may experience increased regulatory oversight while balancing their legal obligations with the ethical duty to deliver medical care. Houston attorney Gordon Quan pointed out that providers might feel compelled to verify patients’ immigration status before treatment, although legally, pregnant women are still entitled to necessary healthcare regardless of immigration status.
Doctors practicing obstetrics and gynecology in Dallas, Fort Worth, and Houston expressed concerns about the practical implications of the new policy. They highlighted that denying treatment could open them up to legal liabilities, while providing care to patients suspected of participating in birth tourism might trigger investigations.
Legal experts recommend healthcare facilities review their marketing materials, bolster compliance procedures, train staff on the new regulations, and maintain detailed patient documentation to demonstrate adherence if investigations emerge. Some hospitals that previously promoted maternity services to foreign nationals have already pulled those advertisements, emphasizing they do not support unlawful activities.
