Michmutters

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.

No one had ever used it, though, until early April. When its alarm went off, Victor Andres, a firefighter, opened the box and found, to his disbelief of him, a newborn boy wrapped in towels.

The discovery made the local TV news, which praised the courage of the mother, calling it “a time for celebration.” Later that month, Mr. Andres pulled another newborn, a girl, from the box. In May, a third baby appeared. By summer, three more infants were left at baby box locations throughout the state.

The baby boxes are part of the safe haven movement, which has long been closely tied to anti-abortion activism. Safe havens offer desperate mothers a way to surrender their newborns anonymously for adoption, and, advocates say, avoid hurting, abandoning or even killing them. The havens can be boxes, which allow parents to avoid speaking to anyone or even being seen when surrendering their babies. More traditionally, the havens are locations such as hospitals and fire stations, where staff members are trained to accept a face-to-face handoff from a parent in crisis.

All 50 states have safe haven laws meant to protect surrendering 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 trash cans or dumpsters. But what began as a way to prevent the most extreme cases of child abuse has become a broader phenomenon, supported especially among the religious right, which heavily 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 haven options in other ways. And safe haven surrenders, experts in reproductive health and child welfare 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, Justice Amy Coney Barrett suggested that safe haven laws offered an alternative to abortion by allowing women to avoid “the burdens of parenting.” In the court’s decision, Justice Samuel A. Alito Jr. cited safe haven laws as a “modern development” that, in the majority’s view, obviated the need for abortion rights.

But for many experts in adoption and women’s health, safe havens are hardly a panacea.

To them, a safe haven surrender is a sign that a woman fell through the cracks of existing systems. They may have concealed their pregnancies and given birth without prenatal care, or they may suffer from domestic violence, drug addiction, homelessness or mental illness.

The adoptions themselves could also be problematic, with women potentially unaware that they are terminating parental rights, and children left with little information about their origins.

If a parent is using a safe haven, “there’s been a crisis and the system has already failed in some way,” said Ryan Hanlon, president of the National Council for Adoption.

Boosting the Movement

Safe haven surrenders are still rare. The National Safe Haven Alliance estimates that 115 legal surrenders took place in 2021. In recent years, there have been over 100,000 domestic adoptions annually, and more than 600,000 abortions. Studies show that the vast majority of women denied an abortion are uninterested in adoption and go on 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 allies lobbying across the country, states like Indiana, Iowa and Virginia have sought to make safe haven surrenders easier, faster and more anonymous — allowing older babies to be dropped off, or allowing relinquishing parents to leave the scene without speaking to another adult or sharing any medical history.

Some who work with safe haven children are concerned about the baby boxes, in particular. 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 spot and could benefit from some time and discussion in a warm handoff experience to make their decision?”

Ms. Kelsey is a former medic and firefighter, and an adoptee who says she was abandoned at birth by her teenage mother, who had been raped.

She first encountered a baby “safe” — a concept dating back to medieval Europe — on a 2013 trip to a church in Cape Town, South Africa, where she was on a pro-abstinence speaking tour.

She returned home to Indiana to found a nonprofit, Safe Haven Baby Boxes, and installed her first baby box in 2016.

To use one of Ms. Kelsey’s boxes, a parent pulls open a metal drawer to reveal a temperature-controlled hospital bassinet. Once the baby is inside and the drawer is closed, it locks automatically; the parent cannot reopen it. An alarm is triggered and the facility’s staff members can access the bassinet. The box also sends out a 911 call. Twenty-one babies have been left in the boxes since 2017, and the average amount of 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 haven option. The advertisements feature a photo of a handsome firefighter cradling a newborn, and the Safe Haven Baby Box emergency hotline number.

Ms. Kelsey said she was in contact with legislators 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 a baby should be placed in my box and not in a dumpster to die,” she said.

Because of the anonymity, there is limited information about the parents who use safe havens. But Dr. Orliss, of the Los Angeles safe haven clinic, performs psychological and developmental evaluations on some 15 such babies annually, often following them through their toddler years. His research on him found that more than half the children have health or developmental issues, often stemming from inadequate prenatal care. In California, unlike in Indiana, safe haven surrenders must be done face-to-face, and parents are given an optional questionnaire on medical history, which often reveals serious problems such as drug use.

Still, many children do well. Tessa Higgs, 37, a marketing manager 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 de ella. Ms. 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,” Ms. Higgs said of Nola. “She’s perfect in our eyes.”

Legal Gray Areas

For some women seeking help, the first point of contact is the Safe Haven Baby Box emergency hotline.

That hotline, and another maintained by the Safe Haven National Alliance, tell callers where and how they can legally surrender children, along with information about the traditional adoption process.

Safe haven groups say they inform callers that anonymous surrenders are a last resort, and give out 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’s best for her,” Ms. Kelsey said. “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 does not talk about the legal time constraints for reuniting 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 terminating birth parents’ rights after safe haven surrenders, or for adoption. But according to Don VanDerMoere, the prosecutor in Owen County, Ind., who has experience with infant abandonment laws in the state, biological families are free to come forward until a court terminates parental rights, which can occur 45 to 60 days after an anonymous surrender.

Because these relinquishments are anonymous, they typically lead to closed adoptions. Birth parents are unable to select the parents, and adoptees are left with little to no information about their family of origin or medical history.

Mr. Hanlon, of the National Council for Adoption, pointed to research showing that over the long term, birth parents feel more satisfied about giving up their children if biological and adoptive families maintain a relationship.

And in safe haven cases, 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 placed their infants in boxes had tried to reclaim custody of their children. Such cases can take months or even years to resolve.

Birth mothers are also not immune from legal jeopardy, and may not be able to navigate the technicalities of each state’s safe haven law, said Lori Bruce, a medical ethicist at Yale.

While many states protect surrendering mothers from criminal prosecution if babies are healthy and unharmed, mothers in severe crisis — dealing with addiction or domestic abuse, for example — may not be protected if their newborns are in some way affected.

The idea of ​​a traumatized, postpartum mother being able to “correctly Google the laws is slim,” Ms. Bruce said.

With the demise of Roe, “we know we are going to see more abandoned babies,” she added. “My concern is that means more prosecutors are going to be able to prosecute women for having unsafely abandoned their children — or not following the letter of the law.”

On Friday, the Indiana governor signed legislation banning most abortions, with slim exceptions.

And the safe haven movement continues to appear.

Ms. Higgs, the adoptive mother, has stayed in touch with Monica Kelsey of Safe Haven Baby Boxes. “The day that I found out about Roe vs. Wade, I texted Monica and was like, ‘Are you ready to get even busier?’”

On Friday, the governor of Indiana signed into law a near-total abortion ban, making the state the first to approve sweeping new restrictions since the Supreme Court overturned Roe v. Wade in June.

On Saturday morning, one of Indiana’s biggest employers, the pharmaceutical company Eli Lilly, issued a strong objection to the new restrictions. “Given this new law,” it said in a statement, “we will be forced to plan for more employment growth outside our home state.”

The company, which employs more than 10,000 people in Indiana, began by saying that “abortion is a divisive and deeply personal issue with no clear consensus among the citizens of Indiana.” It noted that Eli Lilly has expanded its employee health plan coverage to include travel for reproductive services. But, it added, “that may not be enough for some current and potential employees.”

It was among the first major employers in the state to weigh in on the new law.

Shortly after, Jon Mills, a spokesman for Cummins, an engine company that employs about 10,000 people in the state, said: “The right to make decisions regarding reproductive health ensures that women have the same opportunity as others to participate fully in our work force. and that our work force is diverse. There are provisions in the bill that conflict with this, impact our people and impede our ability to attract and retain top talent.” I have added that Cummins’s health care benefits cover elective reproductive health procedures, including medical travel benefits.

Mr. Mills also said that, “prior to, and during the legislative process, we shared our concerns about this legislation with legislative leadership.”

Roche, the Swiss pharmaceutical company that has its North American headquarters in Indianapolis, did not have an immediate comment. Other companies with headquarters or large offices in Indiana did not immediately respond to requests for comment.

After the Supreme Court’s decision, few companies weighed in directly on the ruling. Far more did they say they would expand their employer health care coverage to cover travel and other expenses for employees who may need to seek reproductive health care out of state.

Some companies with a large presence in Indiana have previously stated that they will cover travel for employees. In June, Kroger said that it would cover up to $4,000 in travel expenses for employees on its health care plan. The software company Salesforce, which has about 2,300 employees in Indianapolis, has also said that it would move employees who want to leave states where abortion is banned. Neither immediately responded to a request for comment.

In his statement, Eli Lilly described the Indiana law as “one of the most restrictive anti-abortion laws in the United States.” It went on: “As a global company headquartered in Indianapolis for more than 145 years, we work hard to retain and attract thousands of people who are important drivers of our state’s economy. Given this new law, we will be forced to plan for more employment growth outside our home state.”

WASHINGTON — President Biden finally tested negative for the coronavirus on Saturday, a week after his rebound case emerged, but the White House physician said the president would remain in isolation “in an abundance of caution” until a second negative test.

Mr. Biden has been staying away from the Oval Office since he tested positive again on July 30, though he has tried to maintain a public presence through appearances by video from the White House residence. The recurrence of the virus has kept him off the road for political events and delayed summer vacation plans as well.

The president has experienced few symptoms during his rebound case, according to Dr. Kevin C. O’Connor, the White House physician, and he appeared in relatively good health in his video events over the last few days. “The president continues to feel very well,” Dr. O’Connor said in a memo released to reporters on Saturday.

Through the president’s initial bout with Covid-19 and during his rebound case, Dr. O’Connor has never appeared before reporters to answer questions, unlike previous White House doctors under other presidents. The White House has never offered a clear explanation about why. Dr. O’Connor’s daily memos have provided no theories about where and how the president was infected. White House officials have said that those deemed to have been in close contact with Mr. Biden all tested negative.

The president was treated with Paxlovid early in his bout with Covid, and while the drug has been credited with great success in suppressing the virus and preventing severe cases and hospitalizations, a number of patients who have taken it have nonetheless tested positive again a few days after the last dose of the five-day regimen.

Initial clinical studies found that only about 1 percent to 2 percent of those treated with Paxlovid, which is made by Pfizer, experienced symptoms again. Subsequent studies of patients have found higher rates, though still in the single digits.

But some doctors and patients have speculated that the rebound rate could be even higher because of anecdotal experiences and because of the characteristics of the highly contagious Omicron subvariants in circulation this summer. Among those who have had a rebound case after taking Paxlovid was Dr. Anthony S. Fauci, the president’s chief medical adviser and a leading figure in the response to the pandemic.

Mr. Biden has been described by aides as eager to get out of isolation and back on the road as the midterm congressional campaign begins to heat up. As a result of his infection, he has had to cancel a number of planned trips and has limited his contact with aides, advisers and others at a time when he has scored some important victories that he would like to promote.

“I wish I were with you in person, quite frankly,” he told Vice President Kamala Harris and several cabinet members over a video feed during an event on Wednesday describing his plans to take action to protect abortion rights. “But I’m getting there.”