For medical reasons, many airlines have policies that restrict women’s travel in the later stages of pregnancy, whether they’re going to the U.S. or someplace else. These policies vary greatly among different carriers and can also be different for international versus domestic flights.
In addition, pregnant women traveling to the U.S. must meet U.S. immigration requirements.
Under U.S. immigration law, pregnancy is treated much like any other medical condition. If you are entering the U.S. for any sort of medical treatment, as is allowed under a B-2 visa, you must be able to pay for it with your own funds or with private health insurance. (See the DOS Foreign Affairs Manual at 9 FAM 402.2-4(A)(2).)
It can be extremely expensive to give birth in the U.S., especially if any complications arise. Even a birth without complications can cost around $10,000, and many insurance plans do not provide coverage outside the policyholder’s home country.
Therefore, if you are close to your due date or planning a long stay in the U.S., immigration officials and possibly airline personnel might put up hurdles to your traveling.
International airlines prescreen passengers to determine whether they meet the basic entry requirements of the destination country. This is because the airline is responsible for paying and arranging your return travel if you are denied entry into the destination country (though they might send you the bill later.) Airlines face hefty fines for failing to adequately prescreen passengers.
Therefore, if you are visibly pregnant and traveling to the U.S., the airline might ask you for documentation to prove you can either pay for the birth in the U.S. or that you will be returning home well before your due date.
The airline is especially concerned about the risk of you going into labor during the flight. But the airline is also concerned with the difficulties of arranging urgent return travel for you if you are denied entry.
U.S. Customs and Border Protection (CBP), the agency whose officers meet visitors upon arrival to the U.S., looks closely at a pregnant visitor’s ability to pay for the birth if she goes into labor while visiting the country. The higher the likelihood that you will go into labor during your visit, the more CBP will be focused on your ability to pay.
If, for example, you are six months pregnant, have an apparently normal pregnancy, and plan to stay two weeks in the U.S., the chances you will go into labor while visiting are pretty low, and CBP would be more likely to allow you to enter (especially if you have always respected the terms of your visa on past U.S. visits.)
If, however, you are eight months pregnant and plan to stay three weeks in the U.S., CBP would probably want proof that you or your insurance can pay for the birth.
You should also know that CBP prescreens passengers in some foreign cities, such as Toronto. This means that passengers actually go through U.S. immigration screening by U.S. officers before boarding the flight to the United States. If you are leaving from a city with CBP pre-clearance, expect this screening to take place before you board your flight.
When pregnant women cross into the U.S. via a land border, CBP considers the same factors as at the airport, but can be strict when women are close to their due date.
At international airports, it is less common for CBP to see travelers who are within days of their due date; such women would have likely already been refused boarding by the airlines.
At the land border, however, a woman might just want to go to the U.S. for the day to shop or visit family, even when close to her due date. It is also easier for CBP to deny entry at the land border because it doesn’t have to worry about the special concerns of detaining pregnant women, given that most arrive by car and can quickly be processed.
When considering whether to travel to the U.S. during the later stages of pregnancy, you should take into account the potential long-term consequences of being denied entry to the United States.
If you are entering the U.S. from a visa waiver country, such as Australia or the U.K, you will no longer be allowed to use the Visa Waiver Program after being denied entry.
If you are entering the U.S. on a visa (such as a B-2 visitor visa) and are denied entry, you will likely need to apply for a new visa (which might not be approved because of your recent entry denial) and might be barred from entering the U.S. for the next three years.
If you previously had a baby in the U.S. and are seeking entry while pregnant, CBP will be more inclined to ask for proof that you paid for your prior birth and if you did not, to deny you entry.
Because the consequences of being denied entry can have such a profound impact on your future ability to travel to the U.S., consider postponing travel in the later stages of your pregnancy; unless you are sure you can demonstrate that you have the resources to pay for the birth, regardless of what complications might arise and exponentially increase the cost.
Some women travel to the U.S. with the specific purpose of giving birth, in some cases so that the children obtain U.S. citizenship. This is sometimes called “birth tourism.” Such women typically prearrange the delivery with a hospital or birthing center.
There are no laws prohibiting women from traveling to the U.S. to give birth, as long as they can cover all the costs and do not misrepresent the purpose of travel.
If you have prearranged to give birth in the U.S, the U.S. hospital or birthing center should be able to provide you with the documents you need to enter the U.S., such as a letter from the doctor who will be accepting you as a patient, proof of payment, and so forth. Even if you have prepaid for your delivery, CBP might ask you to prove you could pay for any complications that arise.
You should also be aware of a series of scams involving travel agencies that book birth tourism packages. If you are considering prearranging a birth in the U.S., there are legitimate hospitals and birthing centers you can work with directly to arrange your birth. Be wary of any provider that will not provide you with the documents you need to enter the U.S. or that instructs you to hide your pregnancy or apply for public benefits.