Parliamentary deliberations this fall over Canada’s new citizenship legislation revived debate about “birth tourism” (non-residents who travel here, allegedly with the intention of giving birth, so the child acquires Canadian citizenship). Conservative MP and immigration critic Michelle Rempel Garner proposed an amendment that would replace automatic birthright citizenship with the requirement that one of the parents must be a Canadian citizen or permanent resident.
Bill C-3 was passed by Parliament in November and is now law. Rempel Garner’s amendment was rejected by an all-party parliamentary committee, but not before generating considerable media commentary, largely in favour of more stringent restrictions. Former Liberal immigration ministers Sean Fraser and Marc Miller notably dissented from those calling for a more restrictive policy.
While critics continue to express concern about the impact birthright citizenship has on the integrity of Canadian citizenship, updated data from the Canadian Institute for Health Information (CIHI) suggests that the situation has stabilized.
Rempel Garner and others have reached their conclusions using Statistics Canada figures on live births categorized by place of residence of the mother, however StatsCan uses self-reported data that is less accurate than the empirical data sourced from CIHI.
What the data actually shows
The CIHI figures show that, after dropping by a full 50 per cent during the pandemic, the number of “non-resident self-pay” births (children born to individuals who are temporary residents and are responsible for covering the cost of hospital deliveries) had returned to pre-pandemic levels last year, following a four-per-cent increase over the previous year.
Figure 1 captures the steady yearly increases in “non-resident self-pay” births prior to the pandemic, the sharp fall in 2020-21, and the subsequent recovery.
While the percentage of non-resident births fell from 1.6 per cent of total births in 2019-20 to 0.7 per cent in 2020-22, it rebounded to 1.5 per cent in 2023-24 and 2024-25. The percentage of non-resident births compared to immigrants in 2023 recovered slightly to 1.2 per cent from 0.5 per cent in 2021, but still below the peak of 1.7 per cent of immigrants in 2019.
Table 1, using actual totals rather than percentages, tracks non-resident births in Canada from pre-pandemic levels, through the pandemic years and highlighting the recovery into 2024-25. The 2024 increase to 5,430 non-resident births across Canada — more than double the pandemic average of 2,339 — reflects a rising trend that occurred in every province except British Columbia.
It should be noted that the non-resident self-pay code used in this analysis is broader than simply counting women who arrive on visitor visas, as it includes international students (about half of whom are covered by provincial health plans) and other temporary residents.
A 2022 study by Immigration, Refugees and Citizenship Canada (IRCC) examined Canadian hospitals, excluding those in Quebec, and estimated the percentage of births by short-term visitors to be close to 70 per cent of all non-resident births for the period 2007-08 to 2017-18.
Significant changes in temporary arrivals due to recent policy changes — in 2024-25 international student visas decreased by 31 per cent, while the number of temporary foreign workers fell by 21 per cent — could mean that the seemingly stabilized numbers of non-resident births may in fact indicate an increased birth rate among fewer people who are visitors.
Table 2 provides a six-year overview of how COVID impacted the 10 Canadian hospitals with the highest percentage of non-resident births, contrasting the pre-pandemic year of 2019-20 with 2024-25. Compared to the previous fiscal year, the percentage of non-resident births remained relatively stable with some variation. (As Quebec’s Ministry of Health and Social Services is now providing hospital-level data directly to CIHI, there are four Montreal area hospitals in this top 10 compared to only two in previous reports.)
These 10 hospitals account for about one-third of Canada’s non-resident self-pay births; the top 25 represent about 60 per cent.
A 2022 Quebec government study of 15 urban hospitals in that province (likely a response to concerns over the surge of asylum seekers coming through Roxham Road border crossing 50 km south of Montreal) found that about 35 per cent of all non-covered births were born to asylum seekers, with western Montreal hospitals showing about twice that rate.
Using this approach, certain hospitals are more likely to provide services to Chinese nationals (St. Paul’s & Mount Saint Joseph, Richmond Hospital, and North York General); for South Asian nationals (Humber River—Wilson, Scarborough General and North York General); for Blacks (Humber River—Wilson, Sacré Coeur); for Filipinos (Scarborough General); for Southeast Asians (Humber River—Wilson); and for Arabs (Sacré-Coeur).
What we know — and don’t know — about motivation
While there continue to be qualitative academic studies on non-resident births to better understand the various motivations that may influence non-resident deliveries, the sample sizes are generally small and the specific niche of study can vary. Some of them focus on birth tourism, others have a broader focus on non-residents (not just those on visitor visas), and some studies focus on birth tourism discourse analysis as representing settler and neo-liberal ideologies.
However, an update to the 2022 IRCC study would indicate whether Canada’s percentage of short-term visitor births has changed compared to 2007-18.
As well, ongoing debates and developments stemming from the Trump administration will also likely continue to provoke further Canadian commentary and advocacy. A 2019 Angus Reid survey indicated that about two thirds of Canadians would support such a change for women on visitor visas, although the overall drop in recent years of public support for immigration suggests that opposition to birthright citizenship may have increased.
Unlike the USA with its 14th Amendment to the constitution — which states that “All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside” — Canada has no such guarantee. Should a future government decide to curb the practice, it would simply need to amend the Citizenship Act to require one parent to be a citizen or permanent resident of Canada, as is the case in Australia.
The federal Conservative Party’s renewed interest in birth tourism reflects its longstanding belief that the practice should be curbed, however as the number of non-resident births in Canada is relatively small compared to overall immigration numbers, political discussions and debates will continue to focus on more significant policy and program issues.
A note on methodology
The data is from the CIHI’s Discharge Abstract Database, more specifically the Responsible for Funding Program (RRFP) “non-resident self-pay” category, as well as totals for hospital deliveries.
The RRFP data include temporary residents on visitor visas, international students, foreign workers and visiting Canadian citizens, and permanent residents, with Quebec hospital-level data included this year.
Health coverage for international students varies by province but most are covered by provincial health plans subject to residency and other requirements. Provinces that cover healthcare for international students are British Columbia, Alberta, Saskatchewan, Quebec (requires bilateral social security agreement, e.g. with France and some other European countries, covering about 40 per cent of all international students), New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland and Labrador. Provinces that do not are Manitoba and Ontario.
