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Birth tourism affects Canadian health system

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By Mercy Kelani

Patients cite birthright citizenship as major reason for giving birth abroad.

According to a Calgary study, unpaid hospital bills of birth tourists could cost the Canadian system hundreds of thousands of dollars. A birth tourist refers to a non-resident of Canada who comes to the country for the sole aim of having their baby in the country without qualification for publicly funded health care. A Calgary obstetrician gynecologist, Dr. Colin Birch, asserted that the impact of birth tourists is mostly felt by cities with international airports. However, during the pandemic, when air travel was shut down, there was a noticeable decrease in the trend.

The Calgary study, co-authored by Dr. Birch, affirmed that there are many reasons why Canada is a destination for birth tourists. The retrospective analysis examined 102 women between July 2019 and November 2020. 77 percent of the patients emphasized birthright citizenship as their major reason. In Canada, anyone born in the country is granted automatic citizenship by the system. Nigerians marked one-quarter of the birth tourists, while travelers from Middle East and China ranked second and third most common respectively.

16 months unpaid fees to Alberta Health Services estimated $700,000.

Alberta’s health system and many others across the country is experiencing intense strain. This has made physicians question the impacts of birth tourism on the system. With the current healthcare system, there is a lack of space for accommodation of these tourists. The doctor further asserted that these people cause displacement of local patients, making them go through delivery in a different hospital with a different healthcare provider. Calgary has implemented a system that distinguishes birth tourists from other uninsured patients with the aid of a centralized triage service.

Currently, Calgary is the only city in the country that has attempted putting the situation into a process. Outside Calgary, doctors always have to attempt to recoup fees on a case-by-case basis. However, Dr. Birch’s research revealed that deposits are not always paid. The study also showed that unpaid fees to Alberta Health Services for the 16-month period of the research is an estimated $700,000; these are separate hospital costs. The number of non-residents who gave birth in the province multiplied by three between 2010 and 2016.

SOGC to form a committee to look into this type of tourism.

Andrew Livingstone, is Alberta Health spokesperson who emphasized the concern of the Albertan government on birth tourism and its impacts on Alberta’s health system and its residents. Majority of these tourists are non-vulnerable patients who have access to quality health care services in their resident countries, they are not refugees or asylum seekers. Livingstone affirmed that there would always be provision for emergency or urgent care but individuals who lack provincial health coverage would be required to pay.

At an SOGC conference in Banff, the Society of Obstetricians and Gynaecologists of Canada (SOGC) decided that further investigations are needed into these types of tourism. SOGC president and professor emeritus at the University of Calgary’s Cumming School of Medicine, Dr. Douglas Wilson, stated that the SOGC seek involvement in the situation and would be conducting research. To begin with, the society would form a committee to research on such tourism and related issues, while collecting data from the provinces.

Elimination of birthright citizenship as solution to birth tourism.

SOGC committee would look into some provincial and federal discussions. This is because while delivery is provincial, immigration is federal. A major concern that should be the focus of health care systems is ensuring safe care as majority of these patients have other health problems like diabetes and hypertension. As solution to birth tourism, Dr. Birch suggested elimination of such citizenship and implementation of a universal system, similar to Calgary’s, that would ensure collection of hospital fees.

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