The Safe Haven Baby Box at a firehouse in Carmel, Ind., looked like a library book drop. It had been available for three years to anyone who wanted to surrender a baby anonymously.
However, no one had ever used it before the beginning of April. When the alarm went off, Victor Andres, a firefighter, opened the box and, to his disbelief, found a newborn boy wrapped in towels.
The discovery made the local TV news, which praised the mother’s courage and called it “a time to celebrate.” Later that month, Mr. Andres took another newborn, a girl, from the box. In May, a third baby appeared. Over the summer, three more infants were left at baby box locations across the state.
The baby boxes are part of the safe haven movement, which has long been closely linked to anti-abortion activism. Safe Harbor offers desperate mothers a way to anonymously surrender their newborns for adoption and, advocates say, avoid hurting, abandoning or even killing them. The refuges can be boxes that allow parents to avoid talking to anyone or even being seen when they surrender their babies. More traditionally, the refuges are places like hospitals and fire stations where staff are trained to accept a face-to-face referral from a parent in crisis.
All 50 states have safe haven laws designed to protect surrogate mothers from criminal charges. The first, known as the “Baby Moses” law, was passed in Texas in 1999 after a number of women abandoned infants in garbage cans or dumpsters. But what began as a way to prevent the most extreme cases of child abuse has become a wider phenomenon, supported especially among the religious right, which strongly promotes adoption as an alternative to abortion.
Over the past five years, more than 12 states have passed laws allowing baby boxes or expanding safe harbor options in other ways. And safe harbor surrenders, reproductive health and child welfare experts say, are likely to become more common after the Supreme Court’s decision to overturn Roe v. Wade.
During oral arguments in the case, Dobbs v. Jackson Women’s Health Organization, Judge Amy Coney Barrett suggested that safe harbor laws offered an alternative to abortion by allowing women to avoid “the burdens of parenthood.” In the court’s ruling, Justice Samuel A. Alito Jr. cited free harbor laws as a “modern development” that, in the majority’s view, obviated the need for abortion rights.
But for many adoption and women’s health experts, safe havens are hardly a panacea.
For them, a safe surrender is a sign that a woman fell through the cracks of existing systems. They may have hidden their pregnancies and given birth without prenatal care, or they may suffer from domestic violence, substance abuse, homelessness or mental illness.
The adoptions themselves can also be problematic, with women potentially unaware that they are terminating parental rights, and children are left with little information about their origins.
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If a parent uses a safe harbor, “there has been a crisis and the system has already failed in some way,” said Ryan Hanlon, president of the National Council for Adoption.
Boost the movement
Safe harbor surrenders are still rare. The National Safe Haven Alliance estimates that 115 legal surrenders occurred in 2021. In recent years, there have been over 100,000 domestic adoptions annually and more than 600,000 abortions. Studies show that that the vast majority of women who refuse abortion are uninterested in adoption and continue to raise their children.
But the safe haven movement has become much more prominent, in part because of a boost from a charismatic activist with roots in anti-abortion activism, Monica Kelsey, founder of Safe Haven Baby Boxes.
With Ms. Kelsey and allied lobbying across the country, states like Indiana, Iowa and Virginia have tried to make safe harbor surrenders easier, faster and more anonymous — by allowing older babies to be dropped off, or allowing parents to leave the scene without speaking to another adult or share any medical history.
Some who work with children in Safe Harbor are particularly concerned about the baby boxes. There are now more than 100 across the country.
“Is this infant being surrendered without coercion?” asked Micah Orliss, director of the Safe Surrender Clinic at Children’s Hospital Los Angeles. “Is this a parent who is in a bad place and could benefit from some time and discussion in a warm handover experience to make their decision?”
Mrs. Kelsey is a former doctor and firefighter and an adoptee who says she was abandoned at birth by her teenage mother, who had been raped.
She first came across a “safe” baby — a concept that dates back to medieval Europe — on a 2013 trip to a church in Cape Town, South Africa, where she was on an abstinence speaking tour.
She returned home to Indiana to found a nonprofit organization, Safe Haven Baby Boxes, and installed her first baby box in 2016.
To use one of Mrs. Kelsey’s boxes, a parent pulls open a metal drawer to reveal a temperature-controlled hospital sink. Once baby is inside and the drawer is closed, it locks automatically; the parent cannot open it again. An alarm is triggered and the facility’s employees can gain access to the pool. The box also sends a 911 call. Twenty-one babies have been left in the boxes since 2017 and the average time a child is inside the box is less than two minutes, Ms Kelsey said.
She has raised money to put up dozens of billboards advertising the safe harbor option. The ads feature a photo of a handsome firefighter cradling a newborn and the Safe Haven Baby Box emergency phone number.
Mrs. Kelsey said she was in contact with lawmakers across the country who wanted to bring the boxes to their regions, and predicted that within five years her boxes would be in all 50 states.
“We can all agree that a baby should be placed in my box and not in a container to die,” she said.
Due to the anonymity, there is limited information about the parents who use safe harbor. But Dr. Orliss, of the Los Angeles clinic, performs psychological and developmental evaluations on about 15 such babies annually, often following them through their toddler years. His research found that more than half of the children have health or developmental problems, often as a result of inadequate prenatal care. In California, unlike in Indiana, safe harbor surrenders must be face-to-face, and parents are given an optional medical history questionnaire, which often reveals serious problems such as drug use.
Still, many children do well. Tessa Higgs, 37, a marketing executive in southern Indiana, adopted her 3-year-old daughter, Nola, after the girl was dropped off at a safe haven just hours after her birth. Mrs. Higgs said the biological mother had called the Safe Haven Baby Box hotline after seeing one of the group’s billboards.
“From day one she has been so healthy and happy and thriving and exceeding all developmental milestones,” said Ms. Higgs about Nola. “She is perfect in our eyes.”
Legal gray areas
For some women seeking help, the first point of contact is the Safe Haven Baby Box emergency phone line.
This hotline, and another maintained by the Safe Haven National Alliance, tell callers where and how to legally surrender children, along with information about the traditional adoption process.
Safe Harbor groups say they inform callers that anonymous surrenders are a last resort and provide information on how to keep their babies, including ways to get diapers, rent money and temporary child care.
“When a woman is given options, she will choose what is best for her,” said Ms. Kelsey. “And if that means that in her moment of crisis she chooses a baby box, we should all support her in her decision.”
But Ms. Kelsey’s hotline doesn’t talk about the legal time limits to be reunited with the baby unless callers ask for it, she said.
In Indiana, which has the majority of baby boxes, state law does not specify a timeline for termination of birth parents’ rights after safe harbor surrender, or for adoption. But according to Don VanDerMoere, the Owen County, Ind., prosecutor who has experience with infant law in the state, biological families are free to come forward until a court terminates parental rights, which can happen 45 to 60 days after an anonymous surrender.
Because these waivers are anonymous, they typically lead to closed adoptions. Birth parents are unable to choose the parents, and adoptees are left with little or no information about their family of origin or medical history.
Mr. Hanlon, of the National Council for Adoption, pointed to research shows that, in the long term, birth parents feel more satisfied with giving up their children if biological and adoptive families maintain a relationship.
And in the case of safe harbor, if a mother changes her mind, she must prove to the state that she is fit.
According to Ms. Kelsey, since her operation began, two women who said they had put their infants in boxes have tried to regain custody of their children. Such cases can take months or even years to resolve.
Birth mothers are also not immune to legal jeopardy and may not be able to navigate the technicalities of each state’s free harbor law, said Lori Bruce, a medical ethicist at Yale.
While many states protect surrogate mothers from criminal prosecution if their babies are healthy and unharmed, mothers in severe crisis — dealing with addiction or abuse in the home — may not be protected if their newborns are affected in some way.
The idea that a traumatized postpartum mother is able to “properly Google the laws is slim,” Bruce said.
With Roe’s death, “we know we’re going to see more abandoned babies,” she added. “My concern is that this means more prosecutors will be able to prosecute women for abandoning their children in an unsafe manner – or for not following the letter of the law.”
On Friday, Indiana’s governor signed a law banning most abortions, with few exceptions.
And the safe haven movement continues apace.
Mrs. Higgs, the adoptive mother, has kept in touch with Monica Kelsey of Safe Haven Baby Boxes. “The day I found out about Roe vs. Wade, I texted Monica and said, ‘Are you ready to get even busier?'”