HONG KONG & SHENZHEN, China – Anchor babies. Birth tourism. Cross-border births.

It’s a growing global phenomenon driven by Chinese with wherewithal and wealth.  Chinese from a China that – even as it continues to grow and open up to the rest of the world – still faces a restrictive enough present and an uncertain enough future that they choose to give birth outside of China.

Some do it to avoid the one-child policy.  Many do so for the benefits the child will receive as a citizen of the country into which it’s born: free or better education, the freedom to travel, good social services, a safe haven.

The United States is overwhelmingly the most popular destination for wealthy Chinese, a phenomenon covered by NBC News.

But a close second is Hong Kong, the tiny former British colony of 7 million people.

---

Since its return to Beijing’s oversight  in 1997, and as China has made it easier for its people to travel, tens of thousands of mainlanders regularly head over the border to book up maternity wards at Hong Kong’s good quality and affordable public hospitals.

Of the 88,000 births in Hong Kong in 2010, roughly 45 percent were delivered by mainland Chinese women, according to Hong Kong's government.

The growing number of cross-border births isn’t just straining health care resources and the local population’s goodwill.  It’s also helped to provoke an identity crisis that 15 years after the handover has alienated local residents from their northern neighbors.

A business catering to pregnant mainlanders
For four years, Gordon Li has been running a business from Shenzhen, southern China, arranging travel to Hong Kong for pregnant mainland Chinese women. 

(*Gordon Li is not his real name; he did not want to divulge his identity.  Just last week, another agent from mainland China pleaded guilty to breaching Hong Kong immigration laws for helping mainland women give birth in the city.  It was Hong Kong’s first prosecution of its kind and, given the current mood, may not be the last.)

“We work like a travel agency [and] the fee depends on the client –whether they want to stay in a luxury hotel or a small hotel, etc.,” said Li, who charges his clients between a few thousand yuan and 20,000 yuan ($3,200) to navigate the system.  Most of his customers are from the mainland’s wealthiest regions like Guangdong, Zhejiang, Beijing, and Shanghai.

Li estimates that he has helped at least a few hundred mainland women to have babies in Hong Kong.  “Last year was the most,” he said. 

His early clients were trying to get around the mainland’s strict one-child policy, but today most of his new customers travel to Hong Kong because, Li says, there are “a lot of conveniences.”

The public health system in freewheeling capitalist Hong Kong is considered better and safer than it is in its communist neighbor.  Maternal mortality ratio statistics collected by organizations like the World Health Organization support Hong Kong’s reputation for good quality health care for mothers and newborn babies.

Other benefits for newborns include being automatically eligible for “the right of abode” in Hong Kong, which means becoming permanent residents.  Which in turn means unfettered access to free public education considered superior to that in the mainland; political freedoms; and ease of travel anywhere in the world.

And they are entitled to all of this without giving up their China citizenship.

In fact, more than 10,000 mainland Chinese children who were born in Hong Kong, but live in China, go across the border every day to attend school in the former British colony.

Hong Kong is fed up
Huang Lijuan is a 27-year-old kindergarten teacher from Guangdong Province.  She and her husband, Tsing Ho Nan, a 32-year-old engineer from Hong Kong, met in Shenzhen and moved to Hong Kong after getting married.

“I’m three months pregnant, and the due date is August 5,” Huang told NBC News one afternoon in a community center in Tsuen Wan, Hong Kong.  “But I haven’t been able to book a hospital bed in a maternity ward.  All of the public hospitals are fully booked.”

“There are 80 to 100 [mainland women married to Hong Kong men living here] who are pregnant, but they failed to book any hospitals to deliver their babies,” said Koon Wing Tsang, an organizer with the Mainland-Hong Kong Families Rights Association.  Like Huang, they are all casualties of recent restrictions on non-local women.

Under popular pressure, the Health Authority (HA) in Hong Kong has instituted quotas for non-local residents.  Currently, only 3,400 births by non-local women are permitted at public hospitals this year – down from 10,000 in 2011.  Private hospitals are allowed 31,000 births by non-local women.

“The government and the HA are committed to ensuring that local pregnant women will be given priority in the use of the services over non-Hong Kong residents (non-eligible persons, NEPs),” said a Health Authority spokesman in a written response to NBC News requests for an interview.

But even the new quotas may not be enough.  As Huang found out, all the maternity wards in Hong Kong’s public hospitals – and many private clinics – are fully booked until September. 

Moreover, the quotas don’t prevent mainland women from using the emergency wards as a last resort.  More than 1,600 such births last year were delivered in Hong Kong’s emergency rooms – an unnecessary medical risk since such wards are not equipped or staffed properly for deliveries.

Some Hong Kong government officials have raised the possibility of an outright ban on mainland Chinese women giving birth in the city, but critics have argued enforcement is problematic. 

Others have suggested ending the practice of granting automatic permanent residency status to babies born to non-local parents.  To do so, according to legal experts as well as Hong Kong’s Chief Executive Donald Tsang, would mean having to reinterpret the Basic Law – the territory’s mini-constitution. 

Any such action would require consultations with Beijing, which could prove to be a political minefield for Hong Kong, which prides itself on its Western-style democratic values.

China to ban names that signal 'orphan' status

'Locusts' & 'running dogs'
Adding fuel to the fire is a recent series of tense confrontations between local and mainland residents.

Last month, Hong Kong citizens were outraged over a report that a Dolce & Gabbana boutique had banned local shoppers from taking photographs of its shop, but allowed mainland Chinese tourists and other visitors to snap away.  A Facebook campaign days later galvanized more than a thousand people to protest outside the shop, forcing it to shut early.

Barely a week later, a heated dispute broke out on the Hong Kong subway when a mainland Chinese child was asked to stop eating on the train – a practice banned in the territory.  The argument between locals and mainlanders was captured by a cell phone camera, and the video went viral on the Internet.

Tensions were further inflamed by comments from a Peking University professor, who when shown the video of the subway dispute, called the territory’s residents “running dogs of the British imperialists.”

This month, a group of concerned Hong Kong citizens bought a full-page ad in a popular mainstream Chinese-language Hong Kong daily newspaper that called mainland visitors “locusts.”  The term refers to the large numbers overrunning the territory to consume all its resources.

A “locust” song even made the rounds on the Internet, with spiteful lyrics poking fun at mainland Chinese, and inspiring at least one group of young Hong Kong men to roam around singing the song at visiting mainland Chinese.

An identity crisis
“I think the real reason that Hong Kong people are upset is because they feel helpless politically,” said Wen Yunchao, a mainland blogger and activist now living in the territory.  “The rules they believe in are being broken by all these mainland visitors, and yet they still have to rely on China economically.”

Dr. Elaine Chan at the Center of Civil Society and Governance at Hong Kong University agrees the tension is “a manifestation of something deeper.”

“Hong Kong people do not have a very positive view of mainlanders,” she said.  “Not just because they are buying properties and not just because they are buying all the luxury goods.  But also because of how they carry themselves.”

Both Wen and Chan argue there’s an underlying sensitivity to and awareness of the fact that Hong Kong is bound up with China –culturally, historically, politically, and economically – and yet there remains a gap in fundamental values between the two: in terms of the rule of law or basic civility.  That tension makes some people in the territory uncomfortable.

For now, Beijing has remained silent at least on the cross-border births issue, although authorities in neighboring Guangdong province have promised to find a solution.

But another hot-button topic may soon eclipse that of birth tourism.  The main topic of conversation last week was a government proposal to open up the border to mainland Chinese drivers and their vehicles.  Concern over road safety issues is so great in Hong Kong that an online petition has already gathered 7,000 signatures.

With additional reporting by Bo Gu.

BEIJING – Wenzy Duan dreams about becoming a delegate to the United Nations.

“I know this [ambition] is pretty high,” said the 17-year old Beijing native.  “But I think I can give it a shot.” 

To prepare, Duan wants to study international relations at an American college – someplace like the University of Washington. “I hear [it] is good at social science," she said.

The University of Washington is one of approximately 10 U.S. universities Duan plans to apply to in the coming year with the help of an education consultant she hired last summer.

“I know that the scores is not the only thing that the university will consider whether you can get in or not,” said the high school senior.

Duan is not alone.  Today, China sends more of its students to America than any other country. During the 2010-11 academic year, 157,588 Chinese students were studying in the U.S. – an increase of 23 percent from the previous year, according to the Institute of International Education. 

The growing market of Chinese students wanting to go to the U.S. has created various cottage industries in China and the U.S. –  among them are education consultants who help students navigate the maze of college applications and "brokers" representing American universities who seek student candidates paying full tuition. But it's also fueled anxiety among American students and their parents about increased competition from abroad.

---

Education consultants: the main cottage industry
“When [Chinese students] decide to come to the U.S. and study in the U.S. school, they have no idea,” said Steven Ma, president of ThinkTank Learning, the consulting group with which Duan is working.  "What do colleges in the U.S. look for anyway?  What do they want?  What type of students they want?  And that’s where we come in.”

ThinkTank Learning, based in Santa Clara, Calif., offers tutoring and college counseling.  Most of the students contracting its services have been Asian-American, but Ma said increasingly his firm began fielding calls from mainland Chinese families wanting their advice. 

Eventually ThinkTank Learning opened a branch in Shenzhen in 2009 and then in Beijing a year later.  It charges anywhere from $17,000 to almost $40,000 for tailored consultation packages lasting six to 12 months, dispensing advice on choosing the right schools, writing essays, or preparing for interviews.  

“They’ll just tell you when you need to get something done by what deadline and how do you prepare your application to the school’s standards,” said Julia Yin, Duan’s mother, a petroleum engineer who hails from Hunan province.  “Basically, everything is DIY [do it yourself.]"

Go West, Young Man (and Woman)
China sent its first student to an American college in 1850: A native of Guangdong Province named Yung Wing earned his degree from Yale University, paving the way for thousands more over the following century.

The flow of students from China to America dried up in the 1950s when the establishment of the People’s Republic of China gave way to tumult and isolation, and did not re-start until 1974 1978.

From then until just a few years ago, "It was almost all graduate students, most of them funded by the host universities through research assistantships or teaching assistantships," said Peggy Blumenthal, senior counselor to the president at the Institute of International Education (IIE).

Now, Chinese undergraduates drive the growth, particularly in the past two years.  At the start of the 2006-07 academic year, 9,955 Chinese undergrads were enrolled in U.S. schools. The following year, that figure jumped to 16,450.  By the 2010-11 academic year, 56,976 undergraduates made up a third of all Chinese students living in the U.S.

“What you’re seeing is the growth of the middle class of China who can really afford to send their kids to the U.S.,” said Blumenthal.  “The Chinese undergrads are all coming virtually self-funded.”

The fact that so many students pay their own way has not gone unnoticed.

"Foreign students spend about $21 billion a year in the U.S. in tuition and living expenses for them and their families,” said Charles Bennett, Minister-Counselor for Consular Affairs at the U.S. embassy in Beijing – where Ambassador Gary Locke has made among his top priorities the expansion of visa processing capacity in China.

“That’s a very large sum of money for U.S. academic institutions,” continued Bennett, especially as so many face shrinking endowments or reduced state funding.

The Chinese comprise at least 21 percent of all international students newly enrolled in American schools, which means that they and their families contribute roughly $4 billion to the American economy, according to the U.S. Department of Commerce.

Edging out American students in America?
Recent reports, however, have suggested mainland Chinese students and their ability to pay full tuition are costing American students placement in American colleges. A bankrupt state school system in California – one of the most popular destinations for Chinese students – has meant that its well-regarded schools are seeing record enrollments from out-of-state and international students. 

For the 2010-11 academic year, California welcomed the most international students – 96,535. And for the tenth year in a row the University of Southern California was the leading host U.S. institution for overseas students, enrolling 8,615, according to the IIE.

But the IIE argues adding mainland Chinese students is helpful for diversity.  “Most Americans will not study abroad. On the other hand, their careers will be global,” observed Blumenthal.  “They need to learn how to interact with professionals from other countries, and many of them will be from China.  There are very few industries or business not affected by China.”

Moreover, at the graduate level, Chinese students aren’t competing against American students for a seat in the classroom, according to Blumenthal.  “There still aren’t enough Americans in the pipeline wanting to get graduate training in the fields of science, technology, engineering, and math,” she said.

But detractors note other challenges have surfaced as a result of so many Chinese students going to U.S. schools.  Among them is whether some applicants from the mainland are cheating their way into admissions by falsifying their academic records or achievements. 

One consulting company in Beijing that works U.S. universities, Zinch China, says 90 percent of Chinese undergraduates submit false recommendation letters for their U.S. college applications and that 70 percent enlist someone else to write their essays.

The dishonesty works the other way, too.  A growing number of “education brokers,” who work on behalf of U.S. institutions to solicit Chinese students, have led to misrepresentations and predatory fees, according to a revealing report from Bloomberg News. Some agents promise admission to top-flight schools, charge exorbitant fees, in some instances including a portion of scholarship funds, and students can end up at schools that are a far cry from the "dream schools" they hope to attend.  

Can China produce innovative thinkers?
The desire among Chinese students to seek an American college degree has grown stronger over the years owing to a number of factors.

Above everything else, there is the fierce competition for gaining admissions to a preeminent Chinese university. The selection process is decided solely by the gaokao, an annual national college entrance examination that lasts nine grueling hours over two to three days.

This past year, more than 9 million students across China took the gaokao.  And believe it or not, that number has been declining since 2008 as more students opt out of the gaokao and sign up for exams like the TOEFL (Test of English as a Foreign Language) and the SAT (Scholastic Aptitude Test), both of which are generally prerequisites for applying to any U.S. college or university.

A lively debate is growing about whether China’s education system can produce innovative thinkers who can enable the country to lead – not just catch up with or follow in the footsteps of industrialized economies like the U.S. or Britain. Such concerns triggered a widespread discussion online when Steve Jobs died earlier this year.

“The students here are not as robotic as Americans think,” said Gene Hwang, a 27-year-old Taiwanese-American, who has been working in China for ThinkTank Learning for almost two years.  “But they are held back by some of the systems in schools, which emphasize rote memorization….  We work with them on [developing] critical thinking.”

Broadening those horizons
“When I get into America, I can get [a liberal] education [that] could open my mind,” said Zhang Yuqi, a soft-spoken but intense 17-year-old high school senior.

He’s been working with a ThinkTank Learning consultant for three months, reviewing which schools to apply to and working on his essays.  A possible math major, he has his eye on Carnegie-Mellon and Emory where he hopes to find a climate that differs from his elite Beijing high school, which he says has too many “planned activities.”

Duan wants to study in the U.S., because “they accept all different kinds of different ideas.  You can dream about anything,” she said.  “In America, I can experience more…maybe all kinds of things I will never experience in China.”

For high school junior Dolly Luo, it's simply about getting the best education.  “The U.S. has the most well-developed college education," said the 16-year-old Beijing native who loves Harry Potter and dreams about attending an Ivy League college.

Her parents have similar faith in the U.S. college experience.

“She will have more opportunities, and it will broaden her horizons,” said William Luo.  In fact, Dolly’s father had harbored his own U.S. scholarly ambitions, but he didn’t have the financial resources to enable him to pursue his graduate studies in America.

“I hope when Dolly goes abroad and she learns American values or Western values that she can absorb the Western education – the good parts: the culture, the education,” continued Luo.  “In China, we would need that.”