It crystallized in 2024, when nearly 100 academics, child welfare advocates and legislators sent a letter to the U.S. Department of Health and Human Services. They asked the agency to regulate baby boxes.

The Food and Drug Administration does not consider the boxes to be medical devices — a label that regulates everything from electronic toothbrushes to bandages.

That’s concerning to Lori Bruce, a bioethicist from Yale University who signed the letter. The boxes, she said, have heating and cooling elements and alarms that could fail.

“It is unsettling that the federal government declined to regulate devices that have so many implications for the safety and wellbeing of infants,” Bruce said. “A bassinet is a medical device. A baby box is a bassinet with alarms, electricity and HVAC.”

In an email, Kelsey said her product has internal safety protocols, testing requirements and mandatory daily checks from first responders. “They are not medical devices,” she wrote. “They are safety devices designed to facilitate legal custody transfer.”

Still, the controversy continues, with more than 400 boxes installed across the country.

In Maryland, medical groups pushed back on legislation approving the boxes, citing safety concerns. In Nebraska, a lawmaker successfully opposed baby boxes, which were ultimately written out of legislation. The devices, Sen. Carol Blood said, could “unknowingly provide concealment for crimes such as rape, incest or human trafficking.”

She also pointed out financial gain for nonprofits such as Kelsey’s: “We’re opening the doors for these grifters to come to Nebraska.”

And in Indiana, the fight over boxes was just as contentious a decade ago. But ultimately, state health officials lost.

Kelsey’s attorney at the time was James Bopp Jr., a prominent conservative lawyer who has led efforts to restrict abortion.

“Freedom is the norm, not government regulation,” Bopp Jr. said in 2016. “We do not think there is any state or federal law that regulates baby boxes, so there are no federal bureaucrats to deal with.”

‘No endorsement’ from Indiana Department of Health

In 2015, legislators asked a commission of state leaders to develop recommendations for safety protocols and standards for baby boxes.

Dr. Jerome Adams, a member and the commissioner of the Indiana Department of Health at the time, didn’t approve of the boxes. Neither did the commission’s Task Force on Infant Mortality and Child Health, a group made up of doctors and child welfare officials.

“There is simply no evidence to suggest the use of a baby box is a safe and prudent way to surrender a child,” Adams said in a joint 2016 statement with the Indiana Department of Child Services.

Instead, both agencies encouraged parents to surrender babies in-person. That’s a stance echoed by traditional Safe Haven groups, who say direct handoffs help mothers get immediate medical care and mental health support.

Emails obtained by Mirror Indy show Kelsey fighting back.

The state health department’s “accusations and mischaracterizations” about the safety of baby boxes, Kelsey wrote in a June 2016 email to agency leadership, are “unwarranted, ignorant (in the purest meaning of the word) and just plain wrong.”

Another section, directed at Adams: “YOU ARE NOT INTERESTED IN COMING TOGETHER AND WORKING WITH SAFE HAVEN BABY BOXES FOR THE BETTERMENT OF WOMEN AND CHILDREN IN THIS STATE.”

Ultimately, Kelsey installed the boxes — without the support of the Indiana Department of Health and Department of Child Services. And in 2017, legislators supported her mission by expanding the state’s Safe Haven Law to include baby boxes.

When Adams opposed the devices in 2016, Kelsey said, baby boxes were still new: “That does not mean they were inherently unsafe. Since then Indiana law has changed and boxes have operated without injury or death.”

Adams, reached by Mirror Indy via email, said he still has safety concerns all these years later. Those include possible delays in medical care for the surrendered baby and no “standardized oversight” of the boxes.

“As for why Indiana now has so many baby boxes, that didn’t then and doesn’t now reflect a state health department endorsement,” said Adams, who later became the U.S. Surgeon General under President Trump in 2017. “Laws changed and local entities were allowed to install them. The health department didn’t have the authority to stop that, even if not leading or recommending it as an evidence-based approach.”

See Dr. Jerome Adams’ full 2026 statement to Mirror Indy

The Indiana Department of Health, which has new leadership under Dr. Lindsay Weaver, did not answer questions about previous safety concerns. “We can’t speculate about past conversations regarding safe haven boxes,” a spokesperson wrote in a December 2025 email.

Adams, for his part, championed solutions outside of the boxes: improving awareness of the Safe Haven Law, expanding health care access and support for moms in crisis.

“Those approaches are backed by data,” he wrote, and “address why people feel like they have no options in the first place.”

‘Just an escape hatch’

In Indianapolis, one hospital has a baby box.

Franciscan Health installed the device in 2024. Melanie Boosey, the hospital’s manager of labor and delivery, started raising donations in the wake of Indiana’s near-total abortion ban. Even if the box isn’t used often, she said, it’s there as a last resort.

“I know the argument that it shouldn’t be a policy to just build baby boxes everywhere,” Boosey said. “But when working within the construct of my state law and a Catholic institution, I felt like this was something we could do.”

Other doctors said the boxes distract from the very issues that create crisis pregnancies: poverty, child care access and limited prenatal care.

“Putting an infant in a box and pretending it’s a win is a bit problematic,” said Dr. Elizabeth Ferries-Rowe, an OB-GYN at Eskenazi Health. “It’s just an escape hatch from the problems the state created.”

Alternate programs exist in Indianapolis. The BIRTH Fund gives up to $20K to pregnant women living in the city’s worst zip codes for infant mortality — no strings attached. Research shows financial pressure is a key reason people give up their children.

“We’re working toward long-term solutions that would make a baby box obsolete,” said Benjamin Tapper, the city’s chief diversity and equity officer who helped set up the fund in Indianapolis.

In an email, Kelsey said she supports policies that help with economic stability, housing and health care access — and that her nonprofit’s hotline connects parents to these resources.

“However, these programs do not address acute crisis moments, which are the circumstances in which unsafe abandonment occurs,” she wrote. “A baby box is not a substitute for economic policy — it is an emergency intervention.”

That sentiment rings true for the Barkman family, who adopted a baby in 2020 after he was placed in the box at Decatur Township Fire Station 74. The northside couple, who struggled with infertility, had long prayed for a child.

“Surrendering your child is one of the most selfless acts and biggest showing of love,” Kimberly Barkman told Mirror Indy. “We’re so grateful to Samuel’s mom for doing that.”

Sometimes, the little boy visits fire stations with his parents. “I was in there?” his mom remembers him asking once, pointing at the box.

In the moment, she nodded. Barkman knows she’ll be fielding questions for years to come. But she’s glad he’s alive and asking.

“We don’t want infants abandoned,” Barkman said. “We don’t want Brookside Park to happen again.”

Babyland

On Sept. 1, 2025, remains were found in the Indianapolis eastside park. Some Safe Haven advocates claimed it was the state’s first fatal infant abandonment in more than a decade.

Kelsey talked about the mother on TikTok. “If she would have just utilized the Safe Haven law, none of this would be happening,” Kelsey said. “A perfectly healthy little girl, just discarded like trash.”

Mirror Indy asked the Marion County Coroner if the death occurred in-utero or after birth, but did not receive an answer. The coroner’s office said the cause and manner of death are undetermined.

When Safe Haven fails, someone else enters the fold: Linda Znachko, the founder of He Knows Your Name, a local ministry honoring the lives of abandoned and unclaimed babies.

She was by Kelsey’s side at the Indiana Statehouse for the November Safe Haven anniversary event. The two met in 2015 at a funeral for an abandoned baby. “That’s a problem,” Kelsey had said, pointing at the little casket going into the ground. “I have the solution.”

A decade later, Znachko is still pleading for parents to use the boxes.

“Baby Haven was found 15 minutes away from two baby boxes,” she told the crowd, repeating the name she gave the remains found at Brookside Park. “Let this be the day Indiana says no more.”

Half a month later, Znachko’s Mercedes-Benz weaved through Washington Park East Cemetery, stopping at a section still covered in snow. A blue sign read, “Babyland.”

Here, the debates over politics and policies go silent.

Znachko got out of her car and placed flowers on more than 50 graves. A small number were for infants abandoned in public throughout the years; others were left unclaimed at funeral homes or hospitals.

She personally buried many of them and often chooses their names in death. Most come from the Bible.

“These moms are tragically desperate, gripped by fear and unfortunately alone,” Znachko said. A woman with family and support, she continued, would not abandon a child: “That is not the heart of a mother.”

Sometimes, she tires of the questions and narratives about these tragedies.

“It’s really important to shift our focus from the homeless mom story or the addicted mom story or the dumpster story,” Znachko said. “These babies are laid to rest, and I believe they’re hanging out in heaven together.”

The newest plaque said “Baby Haven.” Roses from the October funeral were brown and dying. But one carnation, red against the snow, was still fresh.

Mirror Indy, a nonprofit newsroom, is funded through grants and donations from individuals, foundations and organizations.

Mirror Indy reporter Mary Claire Molloy covers health. Reach her at 317-721-7648 or email maryclaire.molloy@mirrorindy.org. Follow her on X @mcmolloy7.