How will the new Executive Order on “birth tourism” affect tourist visas?

The State Department’s treatment of “birth tourism” has changed repeatedly over the last decade or so, and I think the August 6, 2026 Executive Order entitled “Ending Birth Tourism is best understood against that background.

The August 6, 2026 Executive Order aimed at “birth tourism” directs the Departments of State and Homeland Security to take action against foreign nationals who use nonimmigrant visas to enter the United States for the purpose of giving birth, including by denying or revoking nonimmigrant visas, refusing entry, and taking action against those facilitating birth tourism.

As a former consular officer, I see the way the State Department has addressed “birth tourism”- now defined by Executive Order as “the entry of any foreign national into the United States via a nonimmigrant visa for the purpose of giving birth on American soil” or “any effort by any foreign national to facilitate” such an entry- as a policy area where the formal rule has changed repeatedly, but the practical interview problem has stayed consistent.

Consular guidance around birth tourism has varied wildly over the past ten or so years, and the pendulum swings have been difficult for officers to follow. It’s also been challenging for visa applicants. Not knowing whether their plan to give birth in the U.S., whether for better medical care, the eventual benefits for their child of a U.S. passport, or other reasons, is permissible, many applicants simply hide their intentions.

I likely interviewed tens of thousands of nonimmigrant visa applicants during my time at State. Not once did I see “birth tourism” or “to give birth” listed as the purpose of U.S. travel. At the visa window, I saw applicants hide visible pregnancies behind coats or large folders. I saw pregnant applicants appear for interview with spouses and both sets of parents, groups who had never traveled together before and were suddenly taking their first trip together to the United States. It was hard to ignore the obvious, and those interviews were awkward. Anyone who has stood behind a visa window will tell you that applicants lie about all sorts of things, but there is nothing quite so awkward as asking a visibly pregnant woman planning imminent U.S. travel, “Are you intending medical treatment in the U.S.?” and inevitably hearing “No.” The question often became: do I issue a visa to an otherwise qualified applicant who appears to be lying about her purpose of travel?

Consular guidance didn’t help. In 2015, the State Department issued guidance to consular officers reiterating that “travel to seek medical treatment, including giving birth, is legally permissible using a B visa.” The guidance instructed officers that tourists “traveling for the purpose of giving birth should be evaluated in the same manner as applicants traveling for other medical purposes.” This would have seemed to make the interviews easier, but it meant officers needed to evaluate medical travel that applicants did not openly admit. While in theory, this meant that birth tourists no longer had to misrepresent the purpose of their visit, in reality, the awkward dance of how to address what was obvious without risking insult continued.

In 2017, the State Department added language to the FAM directing consular officers to evaluate a visa applicant’s means to pay for medical treatment when determining visa eligibility. The following year, a 2018 Department cable expressly included birth tourists in the group whose ability to pay required review. Consular officers were now asking applicants whether they intended to seek medical treatment, including giving birth, in the United States and looking at their ability and plan to pay. But this again assumed that applicants even admitted their birth tourism plans. Interviews remained tense, with many officers unsure exactly what to ask and what to do with an answer they didn’t believe.

Then, in 2020, the pendulum swung the other way. A new rule confirmed “travel to the United States with the primary purpose of obtaining U.S. citizenship for a child by giving birth in the United States is an impermissible basis for the issuance of a B nonimmigrant visa.” This felt like a complete shift, but, on the ground, it didn’t make interviews any easier. Now those applicants who may have been inclined to talk openly about their U.S. birth plans and discuss how they intended to cover costs clammed up.

The current FAM guidance makes clear that B-2 travel “does not include travel for the primary purpose of obtaining U.S. citizenship for a child by giving birth in the United States.” 9 FAM 402.2-4(A)(8). It instructs officers to “evaluate the credibility of the applicant’s claimed purpose of travel by asking all necessary questions” but specifically forbids asking “a visa applicant whether they are pregnant unless you have a specific articulable reason to believe they may be pregnant and planning to give birth in the United States.” Officers “must not, as a matter of course, ask all female applicants (or any specific sub-sets of applicants) whether they are pregnant or intend to become pregnant.”

Now that the August 6 Executive Order has instructed the State Department to deny nonimmigrant visas to “birth” tourists, but guidance around what a consular officer can ask has not changed, I wonder how interviews will play out. To me, it seems likely that those most frequently denied B visas will be renewal applicants who gave birth in the United States in the past. And, anecdotally, that is what immigration practitioners are hearing: applicants who previously gave birth in the United States on B visas are being refused under INA section 214(b).

This is frustrating for applicants who have not violated the terms of their visas, were issued those visas at a time when birth tourism was not disallowed, have paid for their medical treatments, or whose children may now be attending U.S. high schools or universities. Birth tourism was explicitly permitted from 2015 to 2020, and since then has been prohibited only when “the primary purpose of travel” was “obtaining U.S. citizenship for a child.” The guidance has been confusing for consular officers and applicants alike. The likely result now is that renewal applicants may find themselves refused and distrusted based on past conduct that was once expressly treated as permissible, even when they can show that they paid for their U.S. births.

At the same time, the new Executive Order does not make it easier for consular officers to conduct interviews where they suspect birth tourism. In fact, it may further cement the feeling of mistrust between interviewing officer and visa applicant. And applicants who have given birth in the U.S. in the past will likely experience extra scrutiny, may be asked more directly about how they paid for medical care, and may still be refused 214(b) anyway.