Teresa got one close look at her newborn son, with his head full of hair and eyes settling on her face, before the nurses whisked him away to the neonatal intensive care unit.
It was 10 years ago that the first-time mother from Ciudad Juárez gave birth at Del Sol Medical Center in El Paso, where her son spent a week in the NICU after breathing in meconium, also known as the first stool, during a long labor and emergency caesarean delivery.
It was not the birth experience she envisioned and it pained her that she couldn’t immediately hold her baby. But Teresa said she felt grateful to leave the hospital with a healthy son, which she credits to “the best medical treatment in El Paso.”
Teresa asked that her last name not be used for fear of the U.S. government revoking her visa.
At least a few thousand foreign nationals give birth in El Paso every year. In the binational community of El Paso and Ciudad Juárez, it’s common for residents to cross the border in both directions to access healthcare – from cheaper medications and medical services in Juárez to vaccinations in El Paso during the COVID-19 pandemic.
While federal law permits non-U.S. citizens to give birth in the United States, both President Donald Trump and Texas Gov. Greg Abbott this year signed executive orders to crack down on what they call “birth tourism.” The practice refers to foreign nationals who travel to the United States to give birth and obtain U.S. citizenship for their child.
Texas has the most births to non-resident, foreign-born mothers, which made up less than 1.3% of all Texas births and less than than 0.2% of all births in the United States in 2023, according to a data analysis from the Pennsylvania State University. Researchers shared with El Paso Matters a breakdown of the top 10 counties in Texas where those births occurred. El Paso County led the state with about 2,600 births to non-resident, foreign-born mothers in 2023.
“El Paso has always been part of my everyday life,” Teresa said. “When I was pregnant, I considered the medical options available to me and I felt more comfortable receiving care in El Paso.”
It helped that both her obstetrician-gynecologist and nursing staff in El Paso also spoke Spanish, she said.
“Of course, I understood being born in the United States could give my son certain opportunities in the future,” Teresa said. “As a mother I thought about that. My decision was about giving my son the best opportunities I could while also choosing the medical service right for us.”
In May, the federal House Committee on Oversight and Government Reform launched several investigations into businesses that offer obstetric services to international patients, including two El Paso health care practices: International Maternity Services, run by Dr. Julio Novoa, and Doctores Para Ti, run by Rodolfo Gamez, who appears to work with OB-GYNs affiliated with private hospitals.
It’s unclear if births to foreign-born mothers will remain a focus for the federal and state governments after a shakeup from the recent midterm elections, which will result in Abbott’s exit as Texas governor and Democrats taking a commanding majority of Congress. The Republican chairmen leading the House oversight committee and task force “exposing international abuses,” U.S. Reps. James Comer of Kentucky and Brandon Gill of Texas, were both reelected, however.
The House committee did not respond to requests for comment.
Committee letters addressed to Novoa and Gamez claim that “willfully misrepresenting one’s intentions to enter the country on a temporary visitor visa is a violation of current law and visa fraud.”
Novoa, an OB-GYN, did not respond to repeated requests for comment. Gamez declined an interview, citing the ongoing federal inquiry.
“I can say that Doctores Para Ti has always operated within the law and is committed to providing medical services in accordance with applicable U.S. laws and regulations,” Gamez said in an email. “We also believe it is important that patients understand their own responsibilities regarding immigration and travel requirements, and we do not provide immigration or visa services.”
‘People forget what life on the border is’
Carina Heckert, an anthropologist in El Paso, said probing businesses and hospitals opens the door for the government to target individual people.
“If they’re saying you can’t advertise this (international births), OK, not a big deal, but if they start policing providers and hospitals, telling hospitals to check the visa status – I mean, how do you determine if someone is only crossing to give birth?” Heckert said. “From a care perspective, your goal is to get patients care and asking all these questions detracts from that goal.”
In August, the U.S. State Department established a task force to revoke tourist visas from people who engage in or facilitate “birth tourism.” U.S. immigration attorneys began to warn Mexican mothers who have given birth in the United States about the risks of reentering the country.
Heckert, who researches maternal health on the border, said these types of policies don’t take into account the characteristics of communities such as El Paso, where families are spread across both sides of the border and have mixed immigration statuses.
“What does that mean for people who don’t see themselves as birth tourists, who have transnational families?” Heckert said. “There could very well be ripple effects in terms of how many people with different types of statuses, different types of visas, different family dynamics across the border. … My fear is this could turn into, ‘Oh, we’re only going after people who are coming just to give birth,’ but you could actually manipulate that to go after a much broader population.”
Teresa has relatives in El Paso and used to come to El Paso about every other week to shop at Cielo Vista Mall, Walmart and Sam’s Club. She has had a tourist visa since she was a baby and it was normal for her to enter El Paso in the morning, returning to Juárez at night.
In 2016, Customs and Border Protection officers at the international bridges would wave her through when she said she was going to El Paso for her prenatal appointments, Teresa said.
But reports of CBP taking away people’s visas spread all over Facebook this fall, she said. For now, Teresa and other mothers are choosing to not cross the border.
“It’s a fear we never experienced before with this situation,” Teresa said. “I think people forget what life on the border is. Ciudad Juárez and El Paso I know are in two different counties, but they are also two communities that are deeply connected. For us, crossing the border isn’t this necessarily huge, extraordinary event.”
Though her U.S.-born son could eventually sponsor her green card, giving her permanent residency in the United States, Teresa said she has no intention to move.
Attack on birthright citizenship
Researchers said the spotlight on “birth tourism” is part of the federal government’s larger attempts to deny citizenship to babies born in the United States. In September, a federal judge blocked Trump’s attempt to limit birthright citizenship – a right guaranteed since 1868 under the 14th Amendment.
“I do feel like a lot of political rhetoric conflates birth tourism with births to either undocumented or long-term residents who are on non-immigrant visas,” said Nicole Kresiberg, a sociologist at the Pennsylvania State University. “Measuring birth tourism in its true empirical definition – someone giving birth, who does not intend to stay in the United States, but intends to go back to their country of origin – and that number is really, really, really small.”
Kreisberg co-authored recent studies on the impact of ending birthright citizenship and the demographics of “birth tourists.” Those studies dispel some of the misconceptions the Trump and Abbott administrations have disseminated to the public.
“The benefits of U.S. citizenship are a unique privilege,” reads House committee letters addressed to Novoa and Gamez. “However, as foreign expectant mothers traveling for this purpose come predominantly from China and Russia, there are concerns that the birth tourism industry is giving rise to potential national security and election integrity threats posed by adversarial nations that challenge U.S. interests.”
But the vast majority of all U.S. births from 2014 to 2024 to non-resident, foreign-born mothers were to Hispanic mothers, according to a 2026 Penn State study. Births to Asian visitors made up less than 0.2% of all Asian births in the United States.
Ending birthright citizenship would disproportionately impact Latino and Asian immigrants – residents, not tourists – and expand the population of children without legal status, according to a 2026 study by Kresiberg and Penn State sociologist Jennifer Van Hook.
Van Hook said the House committee misrepresented research in its letters to Novoa and Gamez, claiming 70,000 births and rising are attributed to temporary visitors. The cited sources did not refer specifically to tourists, but counted undocumented immigrants and residents who overstayed temporary, nonimmigrant visas, she said.
“People talk about moms coming over to give birth to citizens who drain the welfare system,” Kreisberg said. “‘They’re going to be anchor babies.’ One, that’s not even the definition of birth tourism … two, that’s not even borne out of the data of who is coming.”
Who is coming to give birth in El Paso?
Most non-resident, foreign nationals who give birth in Texas are Mexican.
A study by Kreisberg and Penn State graduate student Natalee Chin found that Mexican “birth tourist” mothers are more educated than Mexican mothers living in the United States and have education levels similar to mothers giving birth in Mexico.
Visitors who choose to give birth in the United States also have the financial means to travel and pay for medical services out of pocket.
Doctores Para Ti advertises online packages for self-pay patients that cost more than $6,000 for a vaginal birth and more than $8,000 for caesarean birth. The provider charges $900 per day for mothers requiring additional monitoring and $1,300 per day for babies requiring specialized care.
Teresa said she works at a private school in Juárez where she estimates as many as half the students were born in El Paso. These come from families with high incomes, parents who want their children to attend the University of Texas at El Paso, she said.
The opportunities go in both directions, however, she added. Her niece, whose parents are U.S. citizens, was born in El Paso and has dual citizenship. She attends medical school in Monterrey, Mexico where education is far less expensive.
Teresa said she wants her son to have options, too.
“Like being able to work in the United States in a legal way, or perhaps he would choose to stay here in Mexico,” she said. “I think as a mother you want the best for your children.”
The post Trump targeted foreign-born mothers who gave birth in El Paso. Will the midterm election results change that? appeared first on El Paso Matters.
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