The moment they enter the world, they will be what their parents are not: U.S. citizens.
Such is their birthright, granted by the 14th Amendment to an estimated 340,000 babies born annually to undocumented immigrants.
But in the marathon fight over immigration control, that 143-year-old constitutional guarantee has become the latest target and the delivery room the new front. The pejorative anchor babies already is in the lexicon.
"Once a child is born here, the parents make the argument that they should be allowed to stay as that child's guardian. They are using that child as an anchor [to] play on our heartstrings," said Pennsylvania Rep. Daryl Metcalfe, a Butler County Republican who has built a national reputation as a crusader against what he calls "illegal alien invaders."
Immigrant advocates dismiss his contention as myth, and point to a recent study that found that undocumented immigrants generally "come for work and to join family members." The Washington-based nonprofit Immigration Policy Center concluded that "they do not come specifically to give birth" and game the immigration system.
Such assertions have not tempered efforts by immigration-control proponents to effectively do away with "birthright citizenship" for illegal immigrants' children.
On the federal level, two Republican senators, David Vitter of Louisiana and Rand Paul of Kentucky, want to accomplish it by amending the Constitution to allow automatic citizenship only if a child has at least one parent who is a citizen, a legal permanent resident, or an active-duty soldier.
On the state level, Metcalfe, joined by lawmakers from 40 other states, is promoting model legislation under the rubric "National Security Begins at Home." Among the suggested bills: In lieu of automatic citizenship, states would issue distinctly marked birth certificates for the newborns of illegal immigrants to distinguish them from U.S. citizens.
Pointing out that immigration policy is a federal prerogative, immigrant advocates say such proposals are beyond state lawmakers' authority, not to mention unconstitutional.
Metcalfe's "model [birth certificate] statute claims not to confer any particular benefit or penalty on the basis of the different markings," said Alison Parker, U.S. program director for Human Rights Watch, an international advocacy group. But "differentiating citizens on the basis of their parents' immigration status would inevitably result in discriminatory treatment."
Supporters of birthright citizenship - including the American Civil Liberties Union, the Mexican American Legal Defense and Education Fund, the Migration Policy Institute, and the Constitutional Accountability Center - have hit back hard, issuing white papers on the 14th Amendment's intent, organizing pro-immigrant rallies, and running radio ads.
According to a 2010 Pew Hispanic Center analysis, slightly more than 4 percent of adults in the United States are undocumented immigrants. But because of their youth and high birthrates, they produce an estimated 8 percent of the approximately 4.3 million babies born annually.
What is the real anchoring power of "anchor babies"? Advocates contend the talk is overblown.
U.S.-born children cannot "protect their parents from deportation," the Immigration Policy Center's analysis said. "Every year the U.S. deports thousands of parents of U.S. citizens."
Those children can sponsor their parents for permanent residency, but not before age 21. In most cases, if the petition is granted, the parents would still have to leave the United States for at least 10 years - the penalty for having been here illegally in the first place.
The center's report concluded: "Undocumented immigrants do not come to the U.S. to give birth as part of a 31-year plan."
But birthright citizenship has its benefits.
In households with typically low incomes, the infants are immediately eligible for Medicaid and other government benefits, though their parents are not.
Metcalfe stresses the economic impact.
The estimated 140,000 illegal immigrants in Pennsylvania, he said, drain state coffers to the tune of $1.4 billion a year, much of it to cover uncompensated emergency-room services for people "who shouldn't be on our soil in the first place."
In 2006, Jack Ludmir, chief of obstetrics at Pennsylvania Hospital, founded a prenatal clinic for immigrant women, Latina Community Health Services.
He sees about 50 women a week, who pay on a sliding scale that averages $5, but nothing if they cannot afford it. He writes their names in an old-school notebook. Not all are Latina; he has had patients from Egypt and Pakistan.
Ludmir does not ask their immigration status. But based on their lack of Social Security numbers, he estimates that at least 14 percent of the women who deliver there are undocumented.
"I didn't bring these people here," he said. "They are here, in my backyard, and they are coming to my hospital."
Not every hospital has such a clinic, and fewer hospitals - citing high costs - are providing maternity services. Pennsylvania Hospital happens to be near the immigrant-dense neighborhoods of South Philadelphia, though Ludmir gets referrals from Puentes de Salud, a free clinic in Center City that he co-founded in 2004 with Steve Larson, an associate professor of emergency medicine at the Hospital of the University of Pennsylvania.
From childhood, Ludmir was imbued with a global, immigrant-friendly sensibility. He was born in America when his Romanian parents came here for his father's medical residency, and raised in Peru, where the family made its home.
But, he said, he does not provide hundreds of thousands of dollars of subsidized care purely from the goodness of his heart. It is more in Pennsylvania Hospital's interest to provide preventive care against gestational diabetes, high blood pressure, and other complications, he said, than to incur astronomical unreimbursed costs when a woman in a life-or-death crisis needs an emergency delivery.
Although illegal immigrants are not entitled to publicly funded health benefits, hospitals cannot turn away any woman in labor.
"I am not a politician," Ludmir said. "I am not here to argue that the borders should be tighter. That is not my fight.
"But the law is the law, and unless Metcalfe and others change it," he said, these children "are U.S. citizens."
One of his patients is 27-year-old Navora Popoca, who has children born on both sides of the border in what demographers call a "mixed-status" family.
Like Lizbeth Ramos and most other Mexican immigrants in the Philadelphia area, Popoca comes from a town near Puebla, where she gave birth to a son in 2001. That year, her husband, Roberto, a laborer on a corn farm in Mexico, made his way into the United States. Working in factories and as a landscaper, he could earn as much per hour here as in a whole day in Mexico.
In 2003, Navora crossed the Sonoran Desert into Arizona and eventually arrived in Philadelphia. About a year later, she gave birth to twin girls at Temple University Hospital.
On a recent day, Ludmir performed an ultrasound examination for what will be her fourth child, due in June.
Because of low family income, the U.S.-born twins are eligible for Medicaid, but not the rest of the family, including the Mexican-born son.
"With the girls, if they have any medical issues, they can just go to the doctor" and it will be paid, she said. "My boy can't."
Civil rights cornerstone
As the cornerstone of American civil rights, the 14th Amendment affirms that "all persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States," regardless of their parents' citizenship.
Ratified in 1868, it was designed to rectify the U.S. Supreme Court's 1857 Scott v. Sandford decision, which held that no one of African descent, including both slaves and free people, could ever become a U.S. citizen.
Immigrant advocates say the amendment's framers wanted to make sure the government could never again use race, ethnicity, and parentage to decide who among those born in America is worthy of citizenship.
Several Supreme Court cases have essentially upheld that interpretation, but without directly addressing the question of whether children of illegal immigrants are covered by the amendment.
Metcalfe and his supporters say the phrase subject to the jurisdiction thereof is open to reinterpretation. They say it does not apply to illegal immigrants because they owe their allegiance to a foreign power and not the United States.
At a January news conference led by Metcalfe, John Eastman, a professor of law at Chapman University in Orange, Calif., said illegal immigrants cannot be drafted into the U.S. military, for example, or tried for treason in America.
They may be "subject to our territorial laws," he said, "but not to the full and complete jurisdiction" of the United States. Therefore, he concluded, their children should not be granted citizenship.
Eastman will put forth his argument Saturday at a public debate on birthright citizenship at the National Constitution Center. Moderated by veteran reporter Jeff Greenfield, the panel will include Metcalfe, U.S. Court of Appeals Judge Marjorie O. Rendell, and other experts.
Both sides say the citizenship debate cuts to the heart of American values.
For Metcalfe, an Army veteran, his definition of patriotism dictates that he restrict eligibility for America's most precious gift.
"It's not just happenstance that [undocumented immigrants] are here for an illegal job, and now they're having a baby," he said. But whatever their motivation, "you still have someone with no allegiance to this country having a child here, which ultimately . . . undermines the foundation of our nation."
Lofty arguments are not on Lizbeth Ramos' mind as she awaits the arrival of her twins in June but frets about the possibility of premature delivery.
Asked if it matters whether her children have U.S. citizenship, she falls silent for a moment, then shrugs and smiles.
"I really don't care. I just want healthy babies."
The National Constitution Center debate at 5:30 p.m. Saturday is free to the public, but reservations are required. Call the ticket office at 215-409-6700.
Contact staff writer Michael Matza at 215-854-2541 or firstname.lastname@example.org.