<P> Reports surfaced of Chinese women giving birth to their second child overseas, a practice known as birth tourism . Many went to Hong Kong, which is exempt from the one - child policy . Likewise, a Hong Kong passport differs from China mainland passport by providing additional advantages . Recently though, the Hong Kong government has drastically reduced the quota of births set for non-local women in public hospitals . As a result, fees for delivering babies there have surged . As further admission cuts or a total ban on non-local births in Hong Kong are being considered, mainland agencies that arrange for expectant mothers to give birth overseas are predicting a surge in those going to North America . </P> <P> As the United States practises birthright citizenship, all children born in the US will automatically have US citizenship . The closest US location from China is Saipan in the Northern Mariana Islands, a US dependency in the western Pacific Ocean that allows Chinese visitors without visa restrictions . As of 2012, the island was experiencing an upswing in Chinese births, since birth tourism there had become cheaper than to Hong Kong . This option is used by relatively affluent Chinese who often have secondary motives as well, wishing their children to be able to leave mainland China when they grow older or bring their parents to the US . Canada is less achievable as their government denies many visa requests . </P> <P> The policy is controversial outside China for many reasons, including accusations of human rights abuses in the implementation of the policy, as well as concerns about negative social consequences . </P> <P> The Chinese government, quoting Zhai Zhenwu, director of Renmin University's School of Sociology and Population in Beijing, estimates that 400 million births were prevented by the one - child policy as of 2011, while some demographers challenge that number, putting the figure at perhaps half that level, according to CNN . Zhai clarified that the 400 million estimate referred not just to the one - child policy, but includes births prevented by predecessor policies implemented one decade before, stating that "there are many different numbers out there but it doesn't change the basic fact that the policy prevented a really large number of births". </P>

Who started the one child policy in china