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As How to Have an American Baby explains, Chinese-based companies rent out maternity hotels in the U.S., where expecting Chinese mothers are looked after as they carry their pregnancies to term. Because the babies are born on American soil, they're granted U.S. citizenship.

Sunny Los Angeles seems like an ideal place to deal with the discomforts that come with pregnancy. Many of the women in maternity hotels seem to agree. They can people-watch on the nearby beaches, eat nutritious food prepared for them by hotel staff and shop for baby gear of all shapes and sizes to welcome their American baby.

How to Have an American Baby, directed by Leslie Tai, investigates the complex shadow economy of birth tourism. The concept can be difficult to wrap your head around. Essentially, Chinese tourists live in America during their final trimester of pregnancy in apartments or houses rented out by companies based in China. The companies employ people who reside in the U.S. to take care of the mothers and advise them through the course of their pregnancy. The mothers then have their baby stateside, and the child gets American citizenship.

The film is a series of parallel vignettes that follow different people related to the maternity hotel industry. It can be a little jarring and disorienting at first because of the editors’ choice to fade to black after the end of the vignettes, but it helps separate the storylines for the viewer. 

From the staff that run the hotels, to the nannies that stay with the expectant mothers while they’re in labor, to the mothers and fathers seeking a better life for their child, Tai weaves in and out of separate stories to construct a larger narrative that explains why the hotels exist in the first place.

Tai shot and interviewed all of the subjects over the course of a few years, which creates a palpably deep intimacy.  The documentary is entirely in Chinese with English subtitles, which furthers the closeness between the director and her subjects. Things aren’t explicitly stated for the viewer but revealed in confessionals or natural dialogue between characters. This further creates an immersive experience for the viewer and heightens the emotional experience of watching the film. 

One of the film’s darkest moments is the parallel editing of two mothers having drastically different birth experiences. We watch as one successfully delivers a healthy baby, but the dialogue in the room is interspersed with nurses’ calls about another baby with a falling heart rate in the next room. We learn later that the baby has died of a brain hemorrhage. 

“To me this film really embodies this concept of all of life’s joys and sorrows — the foundational and fundamental choices that women make to provide the best future that they can for their children, and all of the pain and beauty therein — all told through Leslie’s delicate and nuanced filmmaking,” producer Jillian Schultz says in the post-film Q&A.

You may not agree with the choices the characters make, but How to Have an American Baby will make you emotional with its devastating span of human experiences.

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