DAPHNE, ALA.—The dozens of people gathered at the fire station one June afternoon quieted when the battalion chief dressed in a heavy blue uniform approached the podium. He was there to bless the fire station’s new baby box, a temperature-controlled bassinet installed in the side of the building where parents could safely and anonymously surrender infants that they felt they could not care for. He led the crowd, sweltering in the 90°F heat, in praying over the box: the 18th in Alabama and 344th in the nation.
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“Heavenly Father, we come before you to dedicate this safe haven,” he began. “We know that each and every child placed not only in this cradle, but similar cradles across the country, are children you formed in the womb, and we know that you have a special plan for all of them.”
Afterward, people gathered to take pictures in front of the box, where signs note that a silent alert will activate if a baby is placed in it. A few people discussed the baby boxes that would soon open in the nearby towns of Spanish Fort and Foley, which, like this one, were funded by private donations.
In the wake of the 2022 Dobbs v. Jackson Women’s Health Organization Supreme Court decision that gave states the ability to essentially outlaw abortion, communities and nonprofits are installing these baby boxes, which cost more than $16,000 each, in hopes of reducing dangerous infant-abandonment rates and giving more options to women who must carry pregnancies to term. They say the alternative is that mothers will break the law and abandon their infants somewhere unsafe. So far, 22 infants have been abandoned in 2025, according to the National Safe Haven Alliance; 11 were found alive, and 11 were deceased.
In the past two decades, nearly two dozen mostly red states have amended their safe-haven laws, which allow people to anonymously give up their infants for adoption through face-to-face surrenders at hospitals and fire stations, to also permit people to surrender babies in these boxes. The trend has picked up in the past few years.
Mississippi, for instance, passed a law in 2023 that changed its safe-haven law to allow infants to be dropped off in a “baby safety device,” and Alabama followed shortly after, allowing the installation of baby boxes at hospitals and fire stations. Now, baby boxes have been approved in more than 18 states, largely ones with near total bans on abortion, including Oklahoma, Kentucky, Tennessee, Virginia, Arkansas, Iowa, Kansas, Montana, Texas, West Virginia, Wisconsin, Idaho, Louisiana, New Hampshire, Florida, South Dakota, and North Dakota. They’re supported by antiabortion groups, which say they provide another safe way for mothers in crisis to surrender their babies.
For politicians, the legislation is a low-cost way to seemingly solve a bipartisan issue. “I saw this as a threefold bill: saving a baby’s life, keeping a young lady from making the worst decision of her life and being charged with manslaughter, and giving more of those who want to be parents the opportunity for a baby,” Representative Donna Givens, the Republican freshman legislator who sponsored the bill in Alabama, told me at the ceremony.
Some places are even spending public funds for these boxes. In 2022, Indiana set aside $1 million to install and promote safe-haven boxes, and San Antonio budgeted $500,000 in 2024. In a May bill, Missouri earmarked $250,000 to help install at least 25 more baby boxes. Lawmakers in states including Tennessee and Arkansas have introduced legislation that would ensure that every county in the state has a baby box. “It’s just growing like wildfire,” Givens says.
But as baby boxes spread, other people are questioning whether this is the best way to support women in crisis. Dozens of doctors, politicians, adoption advocates, ethicists, and lawyers wrote a letter in November 2024 to the U.S. Secretary of Health and Human Services arguing that the boxes “are fraught with unintended harms and negative consequences.” The letter argues that the boxes are unregulated and uninspected by the government, which means they could potentially endanger infants; that the lack of face-to-face interaction in a baby-box surrender deprives mothers of any counseling or medical help after the difficult task of birthing the baby alone and then giving it away; that the anonymous nature of the boxes means that children won’t have any way to know their family or medical history; and that the boxes may also help conceal crimes like rape, incest, or human trafficking.
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Lori Bruce, a professor of bioethics at Yale University and one of the letter’s main signatories, says the proliferation of baby boxes and the fanfare surrounding them—most are featured in local news when they open—might lead women to feel as if abandoning their infants is the only choice with support or investment behind it.
“The signs on these boxes don’t provide options; they don’t say you can go to a hospital, where there may be funds to help you keep your baby,” Bruce says. In many ways, the boxes overlook the trauma of surrendering a child, she says, even though “the absolute vast majority of parents who feel that they have to relinquish their child experience unrelenting grief and trauma that never goes away.”
Some critics also argue that the money being spent on boxes would be better spent on giving women the financial and emotional support they need to raise their children. Gretchen Sisson, a sociologist at the University of California, San Francisco, and the author of the 2024 book Relinquished: The Politics of Adoption and the Privilege of American Motherhood, interviewed dozens of mothers who gave up their newborns for adoption between 2000 and 2020. Most said they would have kept their babies had they had things like a car seat, for example, or an extra $1,000 to spend on the child’s care. Most regretted giving their babies up for adoption and went through a long period of depression after the relinquishment.
There’s little evidence that these boxes actually reduce infant-abandonment rates, especially since all U.S. states already allow women to anonymously surrender their newborns at hospitals and fire stations. In Germany, where the first baby boxes appeared around 2000, studies showed they led to no reduction in infant death or abandonment.
Yet since the vast majority of women can’t get abortions anymore in places like Alabama, which passed a near total abortion ban in June 2022, many local politicians are settling on baby boxes as a solution.
“To be a pro-life state, you have to give options,” Matt Simpson, an Alabama state Republican representative who voted for the 2023 state bill that allowed baby boxes, told me at the ceremony. “You have to give that next step. It can’t just be, ‘Well, we’re antiabortion.’”
The history of newborn relinquishment
Figuring out what to do with a newborn a mom doesn’t feel equipped to raise is a centuries-old problem. Some medieval churches in Europe had devices called foundling wheels that would allow people to anonymously leave an infant inside a hatch that would rotate into the building and alert someone waiting on the other side. But in the U.S., abandoning an infant under any circumstances was largely illegal until the late 1990s.
Then, after a few incidents in which infants were found abandoned and dead, Texas passed the country’s first safe-haven law, also known as the Baby Moses law, in 1999. It allowed parents to anonymously surrender an unharmed newborn to staff at designated locations. The rest of the country soon followed.
Though the details of safe-haven laws vary by state, most say that during a short window of time—often up to 30 to 45 days after a baby is born—a parent can anonymously relinquish an infant without fear of prosecution if certain requirements are upheld. (The baby must be alive and healthy, for instance.) The laws establish safe-haven locations and stipulate that the baby be turned over to the state, though in some states, private adoption agencies are allowed to take custody of the child. Most states allow parents to try to reclaim their child if they change their mind within 30 days or so.
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Safe-haven laws were pushed by the antiabortion movement, which held that for some women without access to social and economic resources, relinquishing that newborn is the most noble thing she can do, says Laury Oaks, a professor at the University of California, Santa Barbara, and the author of Giving Up Baby: Safe Haven Laws, Motherhood, and Reproductive Justice. It’s not a coincidence that these laws were passed right after the end of traditional welfare, which was eliminated in 1996, in an era when women had less support and had to work in order to receive benefits, she says.
Oaks argues that safe-haven laws signal a problem with how a society operates and are not a solution to unplanned pregnancies. They create a dichotomy, she says, in which poor women may feel that they have to do the “right thing”: give up their child. Otherwise they risk being a “bad” mother. “My interests are in turning it around and saying, ‘What safety nets are we missing from our society?’” she says. “I don’t want to be in a society where it is condoned for a person to give birth alone, then be responsible for getting the newborn to a certain place in order not to be prosecuted.”
Still, people appear to be using safe-haven laws. In 2024, 156 babies in the U.S. were relinquished under safe-haven laws, according to the National Safe Haven Alliance. By contrast, 39 babies were illegally or unsafely abandoned—a 70% decrease from 2004, when more safe-haven laws started going into effect. Infant homicides decreased by 67% in the decade or so after safe-haven laws were introduced, according to the U.S. Centers for Disease Control and Prevention.
Safe-haven laws surfaced in the Dobbs Supreme Court case, when Justice Amy Coney Barrett asked why these laws would not be a solution for people to relieve themselves of the “burdens of parenting.” In the final Dobbs decision, the majority Justices argued that today, women have “little reason to fear” that their babies will not find a suitable home, in part because of safe-haven laws.
The company that’s cornered the baby-box market
In the U.S., almost every baby box is sold by a single Indiana nonprofit: Safe Haven Baby Boxes. The device is essentially a big temperature-controlled drawer installed on the side of a building with a lot of information printed on the outside, including the phone number for a crisis line run by Safe Haven Baby Boxes that helps guide people through the process of surrendering a child. When a person opens the drawer and places a baby in the bassinet inside, three separate alarms sound to alert first responders, and an orange bag falls out with information about what rights a parent has, and what a mother’s body experiences after birth.
Safe Haven Baby Boxes are the brainchild of Monica Kelsey, a former medic who founded the company after seeing a baby box on a trip to South Africa in 2015. Kelsey, who was adopted as an infant, sketched out the design for her boxes on an airplane napkin.
Kelsey’s idea hit a nerve. In June 2020, there were just 29 baby boxes throughout the country, and now there are more than 10 times as many. Baby boxes are spreading in large part because of Kelsey, who has an active presence on TikTok. She was abandoned at birth at an Ohio hospital in 1973 (and later learned, when she tracked down her birth mother, that she had been conceived after her mother was raped). She says that she wants to stand up for other children who were relinquished at birth. “This is my legacy,” she said in one TikTok video as she blessed a baby box. “I will forever walk with these moms as they choose something safe for their child, and I will forever walk with these kids and show them their worth.”
Caitlin Kelly, a Mississippi nurse, says she lobbied for baby-box legislation to be passed in Mississippi after a friend showed her Kelsey’s videos on TikTok. “I said, ‘Well, why don’t we have that here?’” says Kelly, who has four children, including two who are adopted, and who is a representative for the company.
There are certainly families ready to adopt the babies surrendered in these boxes. In 2024, eight babies were surrendered to Alabama, for instance, four of whom were hospital surrenders and four of whom were left in baby boxes. The state found families for all of them.
Adoptions can occur quickly. The National Safe Haven Alliance recommends that parents be allowed to reclaim their parental rights within at least 30 days after relinquishment. But that’s not allowed in some states, including Alabama. “There’s no take-backs, no changing your mind,” says Amanda Mancuso, deputy director of children and family services for the Alabama department of human resources.
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In Alabama, adoptive parents can get permanent custody of the child within six weeks, says Mancuso. That’s a rapid timeline in a country where most adoptions can take a year or longer.
Still, for many, baby boxes are not a reminder of a tragedy for a woman who carried a baby, gave birth alone, and then abandoned that child. Instead, they’re seen with joy.
“It’s a fun thing for our foster and adoptive workers,” Mancuso says. Families who want to adopt usually want babies, and through these surrenders, care workers can make a family’s dream come true. “We have a lot of families who are interested in these children,” she says, “and we want to serve those families and serve those children.”
The downside to baby boxes
Compared with other safe-haven options, the value of baby boxes is an open question. Micah Orliss, a psychologist and founder of the Safe Surrender Clinic at Children’s Hospital Los Angeles, argues that leaving a baby in a box does not add any benefit to the current safe-haven system in many states, in which a mother engages in a “warm handoff,” surrendering her baby to a medical professional or EMT.
California, for instance, has dramatically lowered infant-abandonment rates through public-awareness campaigns, he says; the state does not have baby boxes. “The baby-box approach needlessly raises the risk of a child being unattended or overlooked if the system fails in some way,” Orliss said in testimony opposing a 2025 Connecticut law that would have authorized such devices. (The bill did not pass.) “It also prevents any scrutiny in the circumstances of surrender, in which the mother may be coerced into relinquishing their baby.”
Nationally, baby boxes are not used nearly as frequently as face-to-face surrenders. Kelsey’s group has facilitated 234 face-to-face surrenders through its hotline, which counsels women who might want to surrender their babies, but just about 62 babies have been left in boxes since Kelsey started the organization, according to Kelly, the nurse and company representative.
Even many safe-haven groups oppose baby boxes, arguing that the boxes don’t deal with the root issues that would force a woman to abandon her baby. The National Safe Haven Alliance, for instance, says it tries to keep families together and provide as many resources to a woman as possible while she’s pregnant and after she gives birth. “There’s a place for anonymous surrender, but is that what we want to push?” says Leah Kipley, assistant director of the National Safe Haven Alliance. “That’s what’s been around since the Middle Ages.”
Sometimes new parents just need someone to listen, says Nick Silverio, founder of the Florida nonprofit A Safe Haven for Newborns, which helps women who are considering surrendering their infants (and which opposes baby boxes). Last year, Silverio received a call through his organization’s 24/7 hotline from a weeping mother who had gone to a fire station to surrender her baby and found the station empty. He calmed her down by talking about her baby, he says, and eventually sent her diapers and wipes and helped her come to the decision to keep it.
Even moms who surrender their babies can have second thoughts, he says. Over the course of two decades, his organization has helped six moms who surrendered their babies and came back for them in a short period of time after learning a family member would help, he says.
By bypassing the face-to-face meeting, boxes make it much harder for a trained professional to check in on the mother and make sure she had time to think through her decision and doesn’t want the baby back. “Placing a baby in a box eliminates all contact with the surrendering parents and probably reduces the health care professional’s ability to determine if the baby is sick, injured, abused, neglected, trafficked, or if the mother needs help,” Silverio says.
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There can also be consequences down the line, say adoptee-rights groups, who argue the complete anonymity of baby boxes makes it nearly impossible for adoptees to gain any information about their birth parents and extended families. “It’s unethical, it denies civil rights to adopted people, it denies the right of the non-relinquishing parent,” says Marley Greiner, the co-founder of Bastard Nation, an adoptee-rights group, who writes the blog Stop Baby Boxes Now!
Baby boxes in other countries often facilitate the face-to-face interaction missing in the U.S. model. In Germany, for instance, the organization that sponsors baby boxes puts an ad in the paper when a baby gets dropped off offering to help the mother. About half of the time, the mother goes back to the facility to pick up the child, according to one 2018 analysis of the German program.
Yet Safe Haven Baby Boxes says that it offers an option women need—that it was “never intended to be a replacement for face-to-face relinquishments or any other safe-surrender options.” The organization says that “relinquishment in a baby box is only intended to expand the options for a mother in crisis.” The group also runs a 24/7 crisis line that it says offers mothers “every possible supporting service and option including a parenting plan, adoption plan, referrals to pregnancy resource centers, face to face surrenders, and, as a last resort, assistance with a safe surrender in a Safe Haven Baby Box.”
The organization says that there are still mothers who want anonymity because they feel judged, have arrest warrants, or are involved with child services for their other children. “The anonymous option takes away the fear and judgment and stigma that might come along with a face-to-face safe-haven surrender,” says Kelly.
An alternative approach
Other countries offer an alternative to baby boxes that many advocates say is better for both mother and child. It’s called confidential birth, and it allows a woman to remain anonymous while receiving prenatal care, giving birth in a hospital, and learning her options, including temporarily placing her baby elsewhere or surrendering it to a third-party organization that will take care of it while she recovers. This helps protect the mother’s mental and physical health while letting her decide what is best for her and her child, advocates say.
After lawmakers in Germany determined that anonymous surrenders deprived children of the chance to learn anything about their parentage, Germany passed a confidential-birth law in 2014. (A German ethics council had also found that baby boxes are a “one-sided” response that does not ensure medical care for the mother or child.) Under the law, a pregnant woman can pursue a confidential birth by calling a 24/7 hotline and getting referred to a nearby counselor. She shares her real name with the counselor and gets access to prenatal and pregnancy care. The counselor does not share her name with anybody else, but her child can, upon turning 16, access the mother’s personal details and contact her. The law also provides a pathway for a woman to regain custody of her child.
Confidential birth is also available in Japan, which has strict abortion regulations and high stigma around single parenting. Studies have shown that almost 40% of women in Japan using confidential birth ultimately decided to keep their children, Bruce says. And in Austria, during the first 10 years of a law that allowed anonymous birth, 90% of women using the country’s safe-haven law gave birth in a hospital.
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In the U.S., one of the big obstacles to confidential birth is that birth services must be billed to someone, whether private insurance or Medicaid. That might mean that bills, or other correspondence about the birth, could be sent to a woman’s home, where an abusive partner, for instance, might find them.
But advocates call confidential birth a key way to reprioritize mothers in birth discussions. “We don’t want to acknowledge the mother, or think about the birth mom in crisis,” says Grace Howard, a professor at San José State University and the author of The Pregnancy Police: Conceiving Crime, Arresting Personhood, which follows state attempts to criminalize and surveil pregnant women. “If we acknowledge the mother, then we look at the people adopting these brand-new infants, and it’s not romantic anymore. It’s a tragedy.”
One irony of baby-box laws is that they purportedly guarantee freedom for mothers at the same time that many states are taking control over women’s reproductive health in other ways. Alabama, for instance, has made it hard for women without insurance to get access to birth control; its attorney general has vowed to prosecute people who help women cross state lines to get an abortion; its ban on abortion has made it difficult for women to get treated when they’re having a miscarriage.
For all the attempts to control what women are doing during pregnancy, less attention is paid to how they do after birth. The state’s focus shifts, lightning fast, to the baby, and resources for the mothers fade away.
At the baby-box blessing in Daphne, Ala., none of the speakers mentioned the struggles of mothers during and after pregnancy, or the trauma that can follow them after relinquishing a child. Their tone was upbeat, and their focus was on the happy life a child could have—would have, they were sure—should they ever end up in this device.
“We hope this is never used, but if it is, it gives a choice to someone in need,” Daphne’s Mayor Robin LeJeune told me inside the fire station. “If that choice is life, you can’t go wrong.”