A father hugs his newborn baby at a private hospital. Edmond Tang / China Daily

In the midst of an era of declining birth rates, the city finds itself in an incongruous position of having to carefully apportion its available maternity facilities. While maternity care is plentiful on the mainland, mothers from north of the border continue to view the Hong Kong birth certificate as a passport to opportunity for their offspring. Kane Wu reports.

"This is my daughter Dodo." Johnny Yu declared proudly standing before his family. It was Chinese New Year and parents and siblings were gathered for the family's annual reunion feast. "She is 16 months old!" Yu continued, then, he delivered the punch line: "And she is from Hong Kong!"

That was the "Wow" part - the part that set off a thrill that went around the room like an electrical charge.

It cost Yu and his wife Zhou, more than 100,000 yuan to have their daughter born in Hong Kong. That's ten times what they would have paid for VIP maternity service in Shanghai where the couple resides. Still the issue was not about the quality of medical service, it was a matter of "investing in their child's future".

Yu can list off all the benefits of his daughter's being born in Hong Kong from memory: She will be able to travel to over 130 countries without a visa since Hong Kong is truly an international city. "My daughter can have a global career!"

Yu, 27, is an associate departmental director for a financial institution in Shanghai. His wife is an executive at a securities agency. Both belong to the white-collar, well-off class. They own an expensive car and a fine home situated on some of the most expensive real estate on the mainland. When Yu's wife got pregnant, the couple immediately began setting out grandiose plans for their child's future. "We hope that our daughter will be able to speak perfect English and live in an international environment," Yu says. "It takes a lot longer to apply to have a baby in other countries and a lot more complicated, like in the US. Hong Kong is the most feasible."

An expectant mother outside Kwong Wah Hospital in Kowloon. Edmond Tang / China Daily

Still, even in Hong Kong there are obstacles. The city has become so popular as a city for women from the mainland to give birth that services to the local community are being strained and SAR authorities have been forced to impose restrictions on expectant mothers from the mainland.

Thus, planning for a child in Hong Kong can prove an adventure for mainland couples. Yu had done all the homework online - checking government policies on newborns, reviewing the clinics and hospitals. What lay ahead was actually coming to Hong Kong for Zhou's initial checkup.

In April 2009, when Zhou was three-month pregnant, the couple headed south to Hong Kong, feeling some anxiety. "We heard stories about pregnant women who were turned away at the border so we were a little worried," Yu recalls. Zhou was starting to show, so she was dressed in baggy, loose-fitting clothes. "But in the end nothing happened. We made it to Hong Kong," Yu recalls.

In total, 10,050 babies were born to mainland parents in Hong Kong public hospitals in 2009. In 2010, the number rose to 10,696, according to the Hospital Authority (HA).

Among the 88,000 babies born in the city in 2010, 41,000 (47 percent) came from mainland mothers, according to the latest statistics provided by the Census and Statistics Department. In 2001, the figure was only 16 percent.

By 2039, the number of babies born to mainland women in Hong Kong is expected to surge to 50,000, Chief Secretary for Administration Henry Tang said at a press briefing on March 3.

The statistics have raised local concern that Hong Kong women might be denied services to which they have been entitled as a result of the heavy influx of mainland women. The government is looking at raising the Obstetrics Package Fee for pregnant non-local women, Secretary for Food and Health York Chow announced on March 4, citing increases in medication and payroll costs.

The government started to charge the fee and created a booking system for pregnant non-local women in February, 2007. Non-local women, who had made booking to have their babies in Hong Kong, were required to pay a fee of HK$39,000, due at the time of booking. Expectant mothers without bookings were required to pay HK$48,000.

The HA issued a booking confirmation certificate to Non-eligible Persons (NEPs) who arranged bookings and made payments. Only when they have the certificate can pregnant women from the mainland cross the border to deliver their babies in Hong Kong.

"The public hospitals were already full when we made the booking, we were lucky to find a place in a private one," Yu says. "Not long after that, even the private hospitals were full."

Hospitals sometimes require non-local mothers to have a mid-pregnancy checkup in Hong Kong, which means, with the initial visit and delivery, the mothers have to travel to the city three times before their babies are born.

Zhou did all the regular checkups in Shanghai before traveling to Hong Kong on a 14-hour train for the second time, just a week before the baby's expected delivery date.

"When we stayed in a six-person room in the Hong Kong Baptist Hospital, four mothers in our room were from the mainland," Yu tells China Daily. Statistics from the hospital confirmed Yu's observation.

Chinese tradition normally calls for new mothers to stay in bed for a month for post-natal care. Zhou didn't get to rest much after the delivery. After only a few days in hospital in Hong Kong, she took a bus to Shenzhen and caught a train back to Shanghai with the newborn baby. Another 14 hours.

"We didn't have that much money or time to stay in Hong Kong any longer," Yu says. "It was really tough for the mother. But compared with an airplane, the train is actually less turbulent." The mother and the daughter eventually arrived at their Shanghai home safe and sound.

"Two or three years ago most mainland mothers (in Hong Kong) were from neighboring Guangdong province. Now we have clients from everywhere, more from Jiangsu and Zhejiang, and some second- to third-tier cities," a manager at a prenatal services agency surnamed Li tells China Daily. The agency helps clients tend to everything they can think of, from making hospital bookings to providing accommodation and transportation, from post-maternity care to baby certificate applications.

"There is a whole chain of business and we face fierce market competition nowadays," Li says.

The mainland's nouveau-riche take a completely legitimate approach to acquire the Hong Kong identity for their children. The parents see the opportunity to provide a bright future for their children. They also see it as a way to get around the "one child policy" on the mainland.

In most cities, only when the husband and the wife are only children are they allowed to have a second child. If they fail to meet the qualifications and have a child anyway, they can be heavily fined. While the amount differs from one province to another, the fine usually amounts to three to five times the couple's annual salary. Most family planning laws on the mainland, however, fail to specify policies regarding children born outside the mainland.

The Family Planning Committee from Guangdong Province, concerned about the increasing number of cross-border baby boomers, has stipulated in the regulations that any second child of a first-marriage couple, whether born on the mainland or elsewhere, is counted as "additional". Parents who work for the government may lose their jobs if they have a second child, but they will not be fined unless the child is registered in Guangdong province, according to a spokesperson from the committee.

The ambiguous policies provide enough loopholes for those who want bigger families.

Ms Ma from Hangzhou, Zhejiang province had her second daughter at the end of December at the Hong Kong Baptist Hospital, six years after her first was born. She selected a VIP maternity package from an agency, staying in an individual suite for almost two weeks, with her own driver and maid.

"It cost me 160,000 yuan in total. But if I had a second child in Hangzhou, I would have to spend about the same amount getting a birth permit through my connections," the private business owner says.

Mr Hu from Zhuhai also had his second daughter born in Hong Kong a couple of months ago, even though the baby has already got birth permit on the other side of the border. "The cost is not too much. We can well afford it," Hu says. "It's for the kid's long-term benefit."

Having spent some 50,000 yuan for the second child, Hu, a civil servant, feels "extremely satisfied" about the quality of prenatal services in Hong Kong. "You have to give doctors extra money (red pocket) on the mainland to ensure that they take care of your wife and your baby. But in Hong Kong, there are strict regulations. It's all fair," he says. "You can trust them (Hong Kong hospitals) completely."

Expectant mothers from the mainland have contributed a lot to Hong Kong hospitals' business in Obstetrics over the years. It was reported that in 2009, Hong Kong public hospitals earned almost HK$150 million from treating pregnant women from the mainland. The huge demand is good news for the hospitals, but it can be bad news for local mothers.

Even though the HA hasn't received any complaint from local mothers about mainland mothers taking too much space in the hospitals, some hospitals, including both public and private, have launched contingency measures this year to make room for local mothers.

Prince of Wales Hospital and Tuen Mun Hospital both tell China Daily that they are not going to take non-local expectant mothers this year and that only mothers who live adjacent to the respective hospitals can enjoy prenatal services there.

"We always give priority to local mothers. With limited staff members and beds, we only take mothers from New Territories East District," a spokesperson from Prince of Wales Hospital says.

Hong Kong Union Hospital, a private hospital in Sha Tin, New Territories, has a pre-set booking mechanism that ensures 60 percent mainland and 40 percent local mother ratio. Spokesperson from the hospital says they have "no hard time" balancing demand from mainland mothers and local mothers because of the mechanism.

Hong Kong people also worry that these children born to mainland parents will be extra burdens on Hong Kong's social welfare system. "When they grow up, they can just come and collect the Comprehensive Social Security Assistance money without even living in the city," writes a person surnamed Chan in a Facebook group titled "Objection to mainland mothers who come to have babies in Hong Kong". The group has almost 100 members now.

"The biggest challenge we are faced with nowadays is that it's hard to know if these babies born to mainland women will move back to the SAR in the future and, if so, when they will come back," Henry Tang said.

They may relax a little bit. For most mainlanders who spend a lot of money having their babies born in Hong Kong, social welfare is never a part of their plan.

"We are not eating on Hong Kong's welfare money. To the contrary, we boost local consumption in Hong Kong and our children might help solve the aging problem it's facing," Yu reflects. "The most developed cities are those who can embrace immigrants with an open mind, like New York."

"The only advantage of a Hong Kong ID is probably just a passport that can enter most countries in the world," says Ma. "I'm not sending my kid to Hong Kong schools but she will definitely go abroad in the future."

Hu is painting a similar blueprint for his girls. "My wife and I both hope to send our children abroad for education, where they can embrace advanced ideas. But they will go to mainland primary schools first."

Children with a Hong Kong ID are not accepted in the mainland's nine-year compulsory education system. They need to pay a lot more extra - a "sponsorship fee" to enter a mainland school. Neither are they entitled to the mainland's medical care. But nothing seems to matter to the parents who hold great expectations for their children and are making elaborate preparations.

"If I want to place my children into a good school, sometimes I still have to pay extra money even if my children have mainland IDs," Ma says. "There is no difference."

"With a Hong Kong ID you are restricted in so many ways on the mainland. So you have to step outside to the world," Yu envisioned with his whole family at the dinner. "It's an investment with a huge risk and we'll probably know it 20 years from now if it's worth it. All we can do is hope that she will take the path we choose for her."

His baby girl sat in the cradle, crying. It's still going be quite a few years before she can understand what her father meant.

(HK Edition 03/11/2011 page4)