A thief in the night: Guidelines to preventing infant abductions from the hospital

On Father’s Day, a young mother sits in her room in a secure and well-managed private hospital in North Carolina, feeding her newborn infant. A woman in a nurse’s uniform comes into the room and tells the mother that she is taking the infant for tests and to have him weighed. The mother hands her infant over and, within minutes, the infant is out of the hospital, abducted by the woman impersonating a nurse. Happily, thanks to a speedy response by law enforcement and effective media coverage, the child is recovered two days later, unharmed. When questioned, the abductor, convicted for kidnapping, says simply: "I wanted an infant for myself."

While not a crime of epidemic proportions, abduction by non-family members of infants (birth through six months) from hospitals has clearly become a subject of concern for parents, maternal/childcare nurses, hospital security and risk management administrators, law enforcement, and the National Center for Missing and Exploited Children (NCMEC). With the goal of preventing crimes against children, NCMEC–in cooperation with the Federal Bureau of Investigation (FBI) Academy, the International Association for Healthcare Security and Safety (IAHSS), and the University of Pennsylvania School of Nursing–has studied infant abductions from hospitals, homes, and other sites and considers them preventable in large part by "hardening the target." 

Based on a study of cases (begun in 1988) from 1983 through 1992, the best estimate for the nationwide incidence of infant abductions, by non-family members, is between 12 and 18 yearly. Because a number of cases may not be reported to the NCMEC or other organizations, however, this estimate may be conservative. (As a point of comparison, there are approximately 4.2 million births yearly in the United States at approximately 3,500 birthing facilities). Seventy-seven (77) of the cases studied were abductions from hospital premises, and thirty-three (33) were infant abductions from the home, following many of the same patterns as the hospital abductions. Nine (9) additional infants were abducted from other places such as malls, offices, parking lots, etc. Of the facilities in which infants have been abducted, 11 percent of the abductions occurred in facilities with no more than 200 beds, 39 percent of the abductions occurred in facilities with between 201 and 400 beds, 24 percent of the abductions occurred in facilities with between 401 and 600 beds, and 26 percent of the abductions occurred in facilities with more than 600 beds. Of all the infants abducted from the hospital, more than 95 percent were located and safely returned, usually within a few days to two weeks. Anecdotal evidence would suggest that there may be numerous attempts at most birthing facilities each year.

The typical hospital abduction case involves an "unknown" abductor impersonating a nurse, hospital employee, volunteer, or relative in order to gain access to an infant. The obstetrics unit is an open and inviting one. It can be filled with medical and nursing staff, visitors, students, volunteers,and participants in parenting and newborn care classes. The number of new and changing faces on the unit is high, thus making the unit an area where a "stranger" is unlikely to be noticed. Because there is generally easier access to a patient’s room than to the newborn nursery and a newborn infant spends increasingly more time with his/her mother rather than in the traditional nursery setting, most abductors "con" the infant directly from the mother’s arms.

The Offender

The offender is almost always a to be involved in planning or execution of the abduction, but may be an unwitting partner to the crime. The significant other is often gullible in wanting to believe that his wife/girlfriend/companion indeed gave birth to or adopted the infant now in her possession and may vehemently defend against law enforcement's attempts to retrieve the child. The vast majority of these women take on the "role" of a nurse and represent themselves  as such to the victim mother and anyone else in the room with the mother. Once the abductor assumes this role, she asks to take the baby for tests, to be weighed, photographed, etc. Obviously, arriving at the decision to ask the mother if she can take the infant for a "test" or photograph" takes forethought on the part of the abductor. Most often the abductor has no prior criminal record; however, the pretense of being someone else has been seen in those abductors who have a past history of passing bad checks or forgery. These women demonstrate a capability to provide good care to the baby once the abduction occurs. The infants who have been recovered seem to have suffered no ill effects and were found in good physical health. The offenders, in fact, consider the babies to be "their own." There is no indication that these are "copycat" crimes, and most offenders can be found within the same general community where the abduction occurred.

These crimes are not always committed by the stereotype of the "stranger." In most of these cases, the offenders made themselves known and achieved some degree of familiarity with hospital personnel, procedures, and the victim parents. The abductor, a person with a compulsive personality, usually visits the nursery unit for several days before the abduction, repeatedly asking detailed questions about healthcare facility procedures, and the layout of the maternity unit. In the case cited above, the offender had taken the infant from a room with which she was highly familiar: Her adult daughter had given birth there just four months earlier. Moreover, these women usually impersonate nurses or other healthcare personnel, wearing uniforms or other hospital staff attire. They have also impersonated lab technicians, social workers, photographers, and other professionals who may normally work in a hospital. They often visit or survile more than one hospital in the community to assess security measures and explore infant populations.

The abductor may not target a specific infant for abduction. When an opportunity arises, she may immediately snatch an available victim, often be visible in the hallway for as little as four seconds and escape via a fire exit stairwell. Since the abductor is compelled to show off her new infant to others, use of the media to publicize the abduction is critical in encouraging citizens to report situations they find peculiar. Most often infants are recovered as a direct result of the leads generated by media coverage of the abduction. The abductor should not be portrayed in the media as a "hardened criminal"–this may frighten the abductor into fleeing the immediate area, abandoning, or seriously harming the infant.

Case in point, Susie was married, in an abusive/battering relationship with her spouse, participated in two support groups for battered women, and had three children who were removed from her care by Child Protective Services. Susie began "announcing" to people in January that she was pregnant and started to visit a local children’s hospital where she informed the staff that her "baby" was going to be "born" with a "heart problem." She frequently showed staff members a sonogram of "her baby" despite the fact that she was not pregnant.

In November the women in her support groups asked about the impending "birth" of her child and, since she did not appear to be pregnant, accused her of faking the pregnancy. Apparently feeling pressured to "give birth to her baby" Susie went to the children’s hospital, arrived on a floor where a Code Blue was in progress, disconnected an infant from a cardiac monitor, put the infant under her sweater, and walked out of the hospital.

Susie’s sister-in-law, learning of the abduction through the media and suspecting that Susie’s "baby" was the child who was abducted from the hospital, called the police. Upon investigating, the police found the child, an altered birth certificate for the child, and a roll of film which contained pictures of a "pregnant looking" Susie. Although Susie did not harm the infant, she had placed raisins in the baby’s naval to make it "look" as if the child were a newborn.

What Parents Need to Know

Hospital personnel should remind parents, in a warm and comforting way, of the measures they should take to provide maximum child protection. The guidelines listed below provide good, sound parenting techniques that can also help prevent abductions of infants from the hospital:

  1. At some point before the birth of your baby, learn about security procedures at the facility where you plan to give birth to your baby and request a copy of the facility’s written guidelines on procedures for "special care" and security procedures in the maternity ward. Make sure you know all of the facility’s procedures that are in place to safeguard your infant while staying in that facility.
  2. While it is normal for new parents to be anxious, being deliberately watchful over the newborn infant is of paramount importance.
  3. Never leave your infant out of your direct line-of-sight — even when you go to the bathroom or take a nap. If you leave the room or plan to go to sleep, alert the nurses to take the infant back to the nursery or have a family member watch the baby.
  4. After admission to the facility ask about hospital protocols concerning the routine nursery procedures, feeding and visitation hours, and security measures.
  5. Do not give your infant to anyone without properly verified hospital identification. Find out what additional or special identification is being worn to further identify those hospital personnel who have authority to handle the infant.
  6. Become familiar with the hospital staff who work in the maternity unit. During short stays in the hospital, be sure you know the nurse assigned to you and your infant.
  7. Question unfamiliar persons entering your room or inquiring about your infant — even if they are in hospital attire or seem to have a reason for being there. Alert the nurses station immediately.
  8. Determine where your infant will be taken for tests, and how long the tests will take. Find out who has authorized the tests. If you are uncomfortable with anyone who requests to take your baby or unable to clarify what testing is being done or why your baby is being taken from your room, it is appropriate to go with your baby to observe the procedure.
  9. For your records to take home, have at least one color photograph of your infant (full, front-face view) taken and compile a complete written description of your infant, including hair and eye color, length, weight, date of birth and specific physical attributes.
  10. Consider the risk you may be taking when permitting your infants birth announcement to be published in the newspaper. Birth announcements should never include the family’s home address and should be limited to the parents’ surname(s).
  11. At some point after the birth of your baby, but before discharge from the facility, request a set of written guidelines on the procedures of any follow-up care extended by the facility that will be scheduled to take place in your home. Do not allow anyone into your home without properly verified hospital identification. Find out what additional or special identification is being worn to further identify those staff members who have authority to enter your home.
  12. The use of outdoor decorations to announce the infant’s arrival, such as mylar balloons, large floral wreaths, wooden storks, and other lawn ornaments may not be safe any longer.
  13. Only allow persons into your home who are well known by someone in your household. It is ill-advised to allow anyone into your home who is just a mere acquaintance, especially if met briefly since you became pregnant or gave birth to your baby. There have been several cases where an abductor has made initial contact with a mother and baby in the hospital setting and then subsequently abducted the infant at the family home. In addition, there have been cases in which initial contact with a mother an baby was made in other settings such as shopping malls. A high degree of diligence should be exercised by family members when home with the baby.

This material is reprinted from "For Healthcare Professionals: Guidelines on Preventing Infant Abductions" ©1993 by the National Center for Missing and Exploited Children (NCMEC), Arlington, Virginia, USA, and reprinted with permission. All rights reserved.