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From the NY Times – By SHARON LaFRANIERE

Published: February 22, 2012

HONG KONG — For years, Hong Kongers have nursed complaints about the growing parade of visitors to their city from mainlandChina. The mainlanders spit, litter, jaywalk and cut in line, the locals grouse; they talk too loudly, eat on the subway and otherwise flout Hong Kong’s more refined standards of public behavior.

Those are quibbles, though, compared with the uproar over the latest mainland invasion: pregnant women flocking here to give birth.

The appeal of Hong Kong, a former British colony that is now a semiautonomous Chinese region, is understandable. Medical care here is far superior to what is found in most of China. Chinese children born here automatically receive the right to permanent residency in Hong Kong, entitling them to 12 years of free education and other benefits that are not available to mainlanders, including visa-free travel to many foreign countries. Some parents also sidestep China’s family-planning rules, which limit most couples to one child, by having their second child born offshore.

Hong Kong residents, though, are outraged that local pregnant women are being shut out of maternity wards because mainlanders have snapped up the beds. Despite official quotas on maternity care for nonresidents, nearly 4 in 10 births in Hong Kong last year were to mainland parents. Residents are demanding a crackdown, and a hard look at the residency rights law.

The controversy epitomizes Hong Kong’s tetchy relationship with the rest of China 15 years after the end of British colonial rule in 1997.

On the one hand, Hong Kong has courted mainland visitors for economic reasons, and has benefited enormously. About 28 million mainlanders came last year, up by two-thirds since 2008, and many of them to shop: sales of electronics, jewelry and other luxury goods in Hong Kong have soared. As recently as a few years ago, city officials saw mainland mothers-to-be as a revenue stream as well, and urged hospitals to accommodate them.

But the seven million residents of Hong Kong increasingly fear that mainlanders are challenging them for services, for property and to some extent for their cultural identity. Many suspect that wealthier mainlanders see Hong Kong as an escape option, for their children if not themselves, should confidence in China’s future fade.

Mainland buyers accounted for nearly one-fifth of the value of Hong Kong residential apartments sold last year, and are one reason that prices are soaring. The number of schoolchildren commuting to Hong Kong schools from Shenzhen, a sprawling mainland urban area just north of the border, has tripled in five years.

“The issue is the capacity of the society to accept so many travelers,” said Ivan Choy, a senior instructor in public administration at the Chinese University of Hong Kong. “The issue of the maternity beds has pushed it past the tipping point.”

Insults are flying. A shouting match erupted last month after one mainland mother allowed her child to eat noodles in a Hong Kong subway car. When a Peking University professor who saw a video of the incident called Hong Kongers “dogs” on an Internet talk show, furious Hong Kong residents demonstrated outside the Chinese government’s liaison office. A liaison official later condemned the professor’s remarks, which by official Chinese standards was an extraordinary apology.

Angry Hong Kongers have taken to calling mainland visitors “locusts.” After some residents bought a full-page newspaper advertisement showing a giant locust looming over Victoria Harbor and declaring that “Hong Kongers have had enough,” mainlanders responded with a mock advertisement urging China to cut off water and power supplies to the city.

Some scholars argue that the friction is essentially a family squabble among compatriots who are actually growing closer. Hong Kong residents “are becoming more, not less, ‘Chinese,’ ” said Michael DeGolyer, director of the Hong Kong Transition Project, a research group that tracks political trends.

Few Hong Kongers pledge loyalty to China’s Communist Party, Mr. DeGolyer said. A solid majority want to preserve Hong Kong’s pluralistic, international character. Still, he said, most now support a requirement that schoolchildren sing China’s national anthem and raise the Chinese flag daily.

“From a variety of indicators, we see that attachment to China has strengthened,” Mr. DeGolyer said.

But others sense a widening divide. Since 2007, more Hong Kong residents have identified themselves primarily as Hong Kong citizens than primarily as Chinese citizens, according to surveys by the University of Hong Kong’s Public Opinion Program, except in 2008, when China was host to the Olympic games.

Hospitals are a major battleground, partly because Hong Kong’s are so much better. Maternal mortality is 15 times higher on the mainland than in Hong Kong. Infant mortality is 13 times higher.

One morning this month, the maternity floor of Precious Blood Hospital, a private institution in an older Hong Kong neighborhood, bustled with pregnant mainland women, their relatives and the agents they had hired to arrange care and obtain visas. One agent juggled three cellphones and a notebook on her lap, desperately trying to secure a bed for a mainlander who was due to give birth in September.

“If I can afford the medical costs of my wife giving birth in Hong Kong, why not?” asked a 38-year-old building designer from Shenzhen who would give only his surname, Yue. He said he paid about 80,000 Hong Kong dollars (more than $10,000) so that his first child, a boy, would be born in the city.

Resentment from Hong Kongers did not faze him. “If mainland tourists didn’t come here,” he said quietly, “the economy would collapse.”

Hong Kong residency for his son was not a deciding factor, he said, because he suspects the city will be progressively integrated with the mainland. “Maybe in 20 years, it will not mean anything,” he said.

Another father-to-be seemed mostly to want a residency card for his baby. He and his newly pregnant wife traveled nearly 1,000 miles from Wuxi to inspect Precious Blood. “One of my friends is going to England to give birth,” he said. “If you give birth on the plane and the plane is in U.K. airspace, you have U.K. citizenship.”

Maggie Wong, 31, an office clerk and lifelong Hong Kong resident who had twins eight months ago, said she felt pushed aside by mainland couples. Three and a half months into her pregnancy, Ms. Wong said, she tried to schedule delivery at the public hospital near her home, “but they said there were so many mainland mothers that the beds were all full.” So she went to a private hospital, though it meant spending her husband’s life savings and borrowing from his parents.

“I am a citizen of Hong Kong. I pay Hong Kong taxes,” she said. “I kept thinking, ‘What is this? How can this be?’ Of course it creates bad feelings.”

Hong Kong has lowered quotas for mainlander births again this year, and has tightened its border checks in hopes of preventing last-minute cross-border runs to hospitals. Of the 35,736 mainland women who gave birth in Hong Kong last year, 1,656 simply showed up in emergency rooms.

Tensions may grow. It is the year of the dragon, considered one of the luckiest. If tradition holds, the birth rate will spike. Private Hong Kong hospitals are said to be booked into October.

“I want a dragon baby!” Lui Dikming, a freelance artist, yelled during a demonstration outside a government building this month. “But even if you book when you are five weeks pregnant, there is no room.”

Joyce Lau contributed reporting from Hong Kong. Hilda Wang contributed research from Hong Kong, and Mia Li and Edy Yin from Beijing.

This article has been revised to reflect the following correction:

Correction: February 22, 2012

An earlier version of this article incorrectly said that mainland Chinese buyers accounted for nearly one-quarter of the value of Hong Kong residential apartments sold last year. They accounted for nearly one-fifth.