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Richmond is Canada’s epicentre for a booming, unregulated birth tourism industry emerging from China.

Wealthy Chinese nationals are showing up at local doctor offices, cash in hand, with the intent of giving birth to obtain Canadian citizenship for their newborn babies.

“They are here for that Canadian passport,” said Xi An, the founder of the Vancouver Post-natal Care Association and the owner of the Richmond-based Icy Consulting firm, which helps provide services for women giving birth, including maternity care, arranging appointments and filing various paperwork.

What once was a shadowy, underground practice is now increasingly more open, as dozens of so-called “baby houses” have emerged in the city. Many operators are advertising online, here and in China, that the practice is legal. However, several concerns have emerged related to quality of care, healthcare access and the integrity of the citizenship process.

According to Vancouver Coastal Health, in the 2016-2017 fiscal year, there were 379 births to foreign nationals at Richmond Hospital. Close to one in five moms (17.4 per cent) entering the maternity ward are not Canadian residents. In 2015-2016 there were 299 births and in 2014-2015 there were 335 . From 2004 to 2010 the hospital helped birth, on average, 18 new Canadians per year from non-resident mothers. Nationality isn’t routinely tracked but a tabulation by hospital officials in 2016 showed Chinese nationals accounting for 98 per cent of such births.

Some women use baby houses while others go on a “DIY trip,” by renting an apartment locally while giving birth here, said An.

“They usually have friends or family here, who helped them book a two-bedroom apartment in advance.”

Agencies such as An’s also help mothers-to-be book doctor appointments, hospital rooms and car services, as well as apply for birth certificates and passports for the baby.

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Feature: Richmond Hospital becomes passport mill