Story by Anna Neil
Graphic by Denise Kyeremeh
Content warning: This article contains mention of sexual assault and infanticide.
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Attacked, raped and discarded on the roadside. This was the reality of a 17-year-old girl in 1972. Six weeks later, she learned she was pregnant.
After being hidden for the remainder of her pregnancy, this young parent gave birth to a daughter, abandoning her in an Ohio hospital two hours after her arrival.
Her daughter’s name is Monica Kelsey.
Fifty years later, Kelsey is the CEO and founder of Safe Haven Baby Boxes, a nonprofit dedicated to preventing “the illegal abandonment of newborns.”
A nationwide crisis
Between 1989 and 1999, the rate of infanticide was 222.2 per 100,000 person-years, as reported by the Centers for Disease Control and Prevention. In 1999, Texas passed the country’s first “Baby Moses law.”
Nationwide, the surrender of a newborn is now protected under “safe haven” laws. Prior to the passage of these laws, journalists, health care professionals and community advocates started conversations on prevention, according to one advocate Heather Burner.
Burner is the executive director of the National Safe Haven Alliance, a nonprofit equipping providers and parents “with safe alternatives that prevent infant abandonment.” She is also the director of the Arizona Safe Baby Haven Foundation.
“And that’s where it really truly originated, is seeing a higher number of babies, at that time, put in dangerous locations and being found dead even,” Burner said. “That kind of triggered folks to advocate and look at, ‘How can we establish this safe haven law?’”
Following the nationwide enactment of safe haven laws by 2008, infanticide dropped 66.7% between 2008 and 2017, according to the CDC.
And while this is a significant decrease, the risk of homicide for newborns is 5.4 times greater than that of other ages.
States vary in how many days birth parents have to surrender an infant. The shortest duration of time allotted is three days, in states such as California and Alabama. The longest span of time is in North Dakota, where birth parents have one year to surrender.
Following the relinquishment of the infant, the birth parent has a set number of days, varying per state, to reclaim their child before the termination of parental rights. Each state also varies on where or to whom infants can be surrendered.
Options for parents
On her flight home from Cape Town, South Africa, in 2001, Kelsey scribbled a rough image on a Delta Air Lines napkin. Upon landing in her home state of Indiana, she traveled to visit a builder in Fort Wayne.
“I want you to build me a baby box,” she said.
“What?”
“A baby box. I mean, I’m gonna save babies in boxes at fire stations and hospitals.”
Kelsey was on a speaker tour when she stumbled across a church in Cape Town. Outside of the church was an infant safety device. To her, it looked like a mailbox, but locals told her it was a place for people to anonymously bring infants if they could not raise them.
Kelsey decided to bring this concept home with her. While safe surrender was an option in all states by 2008, she looked to meet a specific need for surrendering parents: anonymity.
“We still have adoptions going on in Indiana, we still have parenting plans going on in Indiana, we still have parents walking into fire stations and hospitals and surrendering their child by a hand-off in Indiana,” she said.
“But the parents that want a last resort option, that don’t want to face someone, they don’t want to talk to you; this is an option for them here.”
Since their start in 2016, Safe Haven Baby Boxes has launched 141 Baby Boxes across nine states. Beyond the infant safety devices this nonprofit provides, the Arizona Safe Baby Haven Foundation operates drop off drawers for infants.
Left: Example of a Safe Haven Baby Box Drop Off. Right: CEO and Founder Monica Kelsey speaking in front of a Baby Box. Photo courtesy of Safe Haven Baby Boxes.
On the National Safe Haven Alliance’s 24/7 Crisis Hotline, operators talk through the four options parents can choose for their infant, according to Burner.
“We typically have folks that are calling us in a life or death crisis situation,” she said. “They usually don’t call us when they’re five months pregnant, trying to make a plan. It’s usually the baby’s already here, or the baby’s about to come, and they have no planning.”
If the caller is open to being connected with OB-GYN services, the operator connects them to local providers, Burner said. Then, they talk through parenting, temporary placement, adoption and safe haven.
“We’re able to walk them through this process so that folks don’t feel so confused, that they’re getting much more, like I said, comprehensive, wraparound care and getting that support,” Burner said.
Safe Surrender in North Carolina
Per the 2001 North Carolina law, surrendering adults can anonymously leave their infant with a “responsible adult” within seven days of birth. But this and other details of the state’s Safe Surrender Law have since changed.
In February 2023, the North Carolina Senate passed changes to the law. In April, the state House followed suit. The main revision is that infants must now be surrendered to a health care provider, law enforcement officer, social services worker or certified emergency medical service worker.
Additionally, the revisions address surrendering parent privacy rights and require a law education component for high school students.
In response, Nia Johnson and Lori Bruce wrote an op-ed for the Charlotte Observer, specifically highlighting the change that no longer allows any responsible adult to receive a surrendered infant.
“We know that many people don’t feel safe walking into a hospital, even just for standard medical care,” said Bruce, a bioethicist and the associate director at the Yale Interdisciplinary Center for Bioethics. “We know that even the act of walking through hospital doors, for many people, can be in itself a traumatic event.”
Bruce recommended community involvement via legislators meeting with at-risk populations and women’s groups to better understand where those adults may feel both physically and emotionally safe.
“How could we put some safer measures into place not only for the infant, but for the birth parent who may be suffering all kinds of emotional and psychiatric and physical ramifications from having often birthed by themselves, outside of a hospital system,” she asked.
Bruce said that, while North Carolina has more locations for surrender than other states, these are not community informed locations. Additionally, she said women in rural North Carolina “feel that their health needs have been forgotten.”
According to the 2022 March of Dimes Report Card for North Carolina, 20 counties were given a score of 80-100 on their Maternal Vulnerability Index. The higher the index score, the greater the chance of “poor pregnancy outcomes and pregnancy related deaths.”
“I really look to the local communities to define that for me, because I don’t know what it’s like to be in that position,” Bruce said. “And I want communities to tell me so that I can help make sure that there are places that feel safe for them.”
According to Kelsey, Baby Boxes are needed in not only at-risk communities. She said Carmel, Indiana — named the second wealthiest Midwest city in 2016 — got a Baby Box which sat empty for the first 1,174 days. Then, an infant was placed there. Afterwards, this location received two additional infants.
Her Charlotte Observer piece is only one of the op-eds Bruce is in the process of writing about the country’s safe haven laws. For each, she pairs with a local, in this case Johnson, to raise community awareness about these laws.
“That’s what it’s really going to take to help people to understand, first off what their options are, and secondly, how they might wish to engage with their legislators, if they’re able, to understand how these laws are actually enacted and the policies that may be quite problematic for the infants as well as the birth parents,” Bruce said.
What happens next?
In North Carolina, the singular Safe Haven Baby Box is located in Ashe County. As the nonprofit does not reach out to states, Kelsey said the Ashe County Sheriff’s Office contacted her organization to install a Baby Box.
After this initial contact, Safe Haven Baby Boxes walks through a 10-step process with the potential partner.
But what happens after an infant is placed in a Baby Box? In this climate-controlled environment, an alarm sounds, alerting the hospital, fire station or other location staff of an infant.
The infant is then taken to the hospital via ambulance for immediate medical care. Afterwards, they are turned over to an adoption agency or child protective services, Kelsey said.
“All of our babies that have come through our program have been adopted with the exception of one, and that one was reunited with his birth mom,” she said.
Kelsey said 90% of the program’s surrenders come through fire stations.
“I’m a retired medic and firefighter now, but the one thing that we see the most is death. And it’s so amazing to see life,” she said. “And so, you know, I’ve never pulled a baby from a dumpster, but I know fire fighters that have and it sticks with you. You never lose that vision.”
When Kelsey was 37 years old, she met her biological mother. This meeting gave Kelsey the empathy to do the work that she does.
“The day that I met her, you can see that it was almost like a light in her darkness that had been uncovered,” she said. “And so I’m blessed to have been able to get to know her and to love her, you know, while she was still on this earth. And she’s since passed, but it truly brings hope knowing that the daughter that she saved is now saving others.”
