The Boston Globe

Massachuse­tts’ infant abandonmen­t laws are failing families in crisis

- By Lori Bruce and Art Caplan Lori Bruce is a bioethicis­t at Yale University’s Interdisci­plinary Center for Bioethics. Art Caplan is the head of medical ethics at NYU Grossman School of Medicine.

Safe infant abandonmen­t needs improvemen­t in Massachuse­tts. In 2023, three babies were found only after they died, another two were found alive, and one was surrendere­d through Massachuse­tts’ Safe Haven law. The National Safe Haven Alliance reports that its 24/7 hotline is increasing­ly receiving calls from Massachuse­tts residents in crisis. These callers ask how to surrender their infant when they feel unable to fulfill their parenting role. Many, facing untenable social or economic conditions, are struggling to surrender within Massachuse­tts’ current tight limit of 7 days after birth. So some request help to relinquish their infant in a neighborin­g state — Connecticu­t, New York, Rhode Island, or Vermont — all of which allow surrender through 30 days after birth.

Safe Haven clauses vary by state, but certain conditions must be met to free the surrenderi­ng birth parent from legal prosecutio­n for abandonmen­t. For example, Massachuse­tts requires that the child has “no signs of abuse or neglect.” At-risk parents might worry about this clause because they often give birth alone, in their bedroom, outdoors, or in a public bathroom, putting their health and the infant’s health at risk. They worry they might be held liable for not seeking hospital care, but hospital births require parents’ identifica­tion for billing and tracking purposes — an untenable condition for many of them.

Massachuse­tts law also requires a faceto-face handoff at a hospital, police station, or manned fire station. But terrified about being identified or prosecuted, atrisk parents may instead leave their infant in a location where the parent can walk away unseen, even if that means the infant might not be found. These parents likely don’t know that the skilled counselors on the NSHA hotline are available to provide support.

Once considered a safety net for extreme or rare circumstan­ces, Safe Haven laws are now being considered as an option by greater numbers of birth parents. The US Supreme Court’s Dobbs ruling overturnin­g abortion rights has resulted in rising numbers of unwanted pregnancie­s, increasing the likelihood that an infant may be abandoned. In response many states are updating their Safe Haven laws, with 19 states now offering baby boxes, a secure box typically attached to a fire station or hospital that, when used, notifies the personnel inside that a baby has been dropped off.

Baby box surrenders are often celebrated in the news, but their implementa­tion and use raise a number of ethical questions. Post-surrender press releases often call the birth parents heroic and selfless but are laser focused on the baby, neglecting to address underlying factors influencin­g a birth parent’s belief in their inability to care for their child. Birth parents merit medical care and trauma counseling.

Baby boxes also falsely imply the birth parent will remain anonymous and avoid prosecutio­n. Some states are required to search for every surrenderi­ng parent who uses a baby box, even if the baby shows no signs of abuse or neglect.

The baby boxes are not independen­tly tested for safety, raising concerns about the reliabilit­y of their heating, cooling, and alert systems. There is no signage on the boxes informing parents of these legal risks and potential safety concerns.

Massachuse­tts’ Safe Haven law, the most restrictiv­e in New England, is unsupporti­ve of those in crisis. More trusted and flexible surrender locations would help, potentiall­y including 911 services which could arrange to meet the birth parent at a time and location of their choosing.

In addition, Massachuse­tts should provide confidenti­al or anonymous labor and delivery. “John and Jane Doe” services are already available to other patients in crisis or unique circumstan­ces (such as celebritie­s wishing to have medical care without fanfare); policy makers should extend this service to safeguard the health of the birthing parent and the infant. And the surrender window should be lengthened to at least 30 days.

A robust awareness campaign, including education for the public, training for providers, and designated hotline services, is overdue. Women and babies deserve nothing less.

Call or text the National Safe Haven Alliance’s 24/7 support line at 1-888-510BABY(2229) for nonjudgmen­tal support and informatio­n on laws in your area.

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