Having a baby in New York as an Australian

A New York baby is a US citizen on day one. Making them an Aussie, and paying for the birth, takes a bit more work.

The short version

Medicare won't pay for a birth in New York, because there's no reciprocal health agreement with the US [7]. Your US health plan does the heavy lifting, so check its deductible and out-of-pocket maximum early.
Private-sector workers in New York get 20 hours of paid prenatal leave a year from their first day on the job [3].
New York Paid Family Leave gives up to 12 weeks at 67% of your average weekly wage, capped at US$1,228.53 a week in 2026 [1]. Immigration status isn't a factor [2].
NYC posts you a free birth certificate about four weeks after the birth [4]. A child born in the US is a US citizen, a position the Supreme Court confirmed in June 2026 for children of temporary visa holders [6].
For Australian citizenship by descent, lodge form 118 in ImmiAccount. The fee is A$380 [5].

Before the bump shows: check your cover

At home, a public hospital birth under Medicare costs you little or nothing. In New York, the bill goes to your insurer, and what you pay depends entirely on your plan. Smartraveller warns that US medical costs are much higher than Australia's and that the Australian Government won't cover them [7].

Pull out your plan summary and find four numbers:

The deductible, which you'll almost certainly hit.
The out-of-pocket maximum, which is your realistic worst case for the year.
Whether maternity, delivery and newborn care are covered in network at your preferred hospital.
How to add the baby. Most plans give you a limited window after the birth, often 30 days, to add a newborn. Miss it and you may wait until the next open enrolment.

A birth and the newborn's care can land in different plan years, or even trigger a second deductible for the baby. If you're choosing a plan during open enrolment and planning a pregnancy, the plan with the lower out-of-pocket maximum often works out cheaper, even with higher premiums. Our guide to health insurance in New York explains the terms.

Prenatal care: OB, midwife and where to deliver

In Australia, most low-risk pregnancies are run by midwives in the public system, with a GP or obstetrician stepping in as needed. In New York, the default is an obstetrician-gynaecologist (OB-GYN) in private practice who delivers at a hospital they're affiliated with. Your choice of OB largely decides your hospital.

Option	What it looks like in New York	Worth knowing
OB-GYN practice	The most common route. You may see several doctors in a group practice	Ask who is likely to be on call for the birth
Certified nurse-midwife	Hospital-based midwifery practices and birth centres exist across the city	Closer to the Australian midwife model for low-risk pregnancies
Maternal-fetal medicine specialist	For higher-risk pregnancies, alongside your OB	Usually needs a referral, check your plan
Doula	A non-medical support person you hire privately	Rarely covered by employer plans, so budget for it

Questions to ask before you commit:

Is the practice and the hospital in my network, and is the anaesthetist group too?
What's the practice's approach to induction and caesarean?
Which hospital do you deliver at, and can I tour the maternity floor?
How does after-hours care work in the first weeks?

New mums usually go home from hospital within a couple of days, sooner than many Australians expect. Line up a paediatrician before the birth. The hospital will ask who it is.

Paid prenatal leave

New York was the first state to give paid leave just for prenatal care. Since 1 January 2025, private-sector employees get 20 hours of paid prenatal leave in each 52-week period [3]. It covers part-time workers too, there's no waiting period, and it's separate from sick leave, so your employer can't make you use sick days first [3]. Only the pregnant employee can use it, not their partner [3].

New York Paid Family Leave

New York Paid Family Leave (PFL) is paid through a small payroll deduction and lets either parent take time to bond with a new child. In 2026 [1]:

Feature	2026 rule
Length	Up to 12 weeks, all at once or in full days
Pay	67% of your average weekly wage
Weekly cap	US$1,228.53
Employee contribution	0.432% of gross wages, capped at US$411.91 a year
Window	Bonding leave must be finished within 12 months of the birth

You're eligible after 26 consecutive weeks with your employer if you work 20 or more hours a week, or after 175 days if you work fewer [2]. Citizenship and immigration status are not a factor, so E-3 and H-1B holders are covered just like anyone else [2]. If you change jobs while pregnant, the clock restarts with the new employer [2].

Two things that confuse Australians:

PFL is not the whole of maternity leave. The birth parent's physical recovery is usually covered by separate short-term disability benefits, then PFL for bonding. Ask HR how your company stacks these, and whether it tops up pay above the PFL cap.
There's no federal paid parental leave. Unlike Australia's Parental Leave Pay, there is no national government payment. What you get depends on New York law and your employer's policy.

Australia's Parental Leave Pay is generally linked to living and working in Australia, so don't plan on it while you're in New York.

Registering the birth and getting the documents

New York City handles birth registration through the hospital. Here's how it runs [4]:

Fill in the Mother/Parent Worksheet at the hospital. It must be completed in English. Check the baby's full name and your mailing address carefully [4].
Ask for a Social Security number. The same worksheet helps your baby get a Social Security card, which you'll need for insurance and tax [4].
Unmarried parents both sign an Acknowledgment of Parentage to establish the legal father [4].
Wait for the post. Parents receive a free birth certificate about four weeks after the birth [4].
Order a long-form certificate. The short form is for domestic use. The long form includes extra details such as time of birth and is generally used internationally. Extra certificates cost US$15 each [4].
Get an apostille if needed. Order the long form with a Letter of Exemplification, have it authenticated by the County Clerk at 60 Centre Street for US$3, then get the apostille from the New York Department of State [4].
Apply for the US passport. Your baby will need it for any trip out of the country.

Corrections made by the hospital are free within 12 months, and adding a given name is free within 60 days [4].

Making your baby an Australian

A child born in New York is a US citizen. In Trump v. Barbara, decided on 30 June 2026, the Supreme Court held that children born in the US to temporarily present parents, such as visa holders, are citizens at birth [6]. That also means your child will have US tax filing obligations for life if they keep that citizenship, something worth knowing early.

Australian citizenship isn't automatic. It's available by descent if at least one parent was an Australian citizen when the baby was born [5]:

Lodge form 118 online through ImmiAccount. The fee is A$380, or A$160 for each extra sibling applying at the same time [5].
Fees are indexed on 1 July each year, so check before you pay [5].
If the Australian parent was themselves a citizen by descent, they generally need to have spent two years in total in Australia. Our guide to citizenship by descent for babies born overseas covers this and the document list.

Once citizenship is approved, apply for the Australian passport through the Australian Consulate-General in New York, which takes appointments online. Australia allows dual citizenship, and the US doesn't make your child choose. In practice your child will travel on the US passport in and out of the US, and the Australian one in and out of Australia.

When you visit home, enrol the baby in Medicare only if you're moving back. Medicare is for people living in Australia, not for holiday check-ups.

A rough timeline

When	What to do
Before trying	Check your health plan and PFL eligibility date
First trimester	Choose OB or midwife and hospital, use prenatal leave hours [3]
30 days before leave	Give your employer notice for PFL where you can
Birth	Hospital worksheet, SSN request [4]
Within about 30 days	Add baby to your health plan
About four weeks	Birth certificate arrives [4]
Next	US passport, then form 118, then Australian passport [5]

Expecting and want to swap paediatrician names or ask who's done form 118 recently? Join Cooee USA, our Facebook group for Australians in the USA. Plenty of members have had their babies in New York.

Having a baby in New York: insurance, Paid Family Leave and two passports