Kelsey Carpenter was alone in her San Diego apartment when she went into labor on 14 November 2020.
The mother of two had planned a home birth for her third child. But the baby came two weeks earlier than expected, so she delivered on her own, then passed out, records show. When she awoke, her newborn – whom she named Kiera – was not breathing. Despite her attempts at CPR, the baby did not survive.
The loss, however, was only the beginning of Carpenter’s nightmare.
Police soon after arrested Carpenter, 33. The San Diego district attorney is moving forward with charges of murder “with malice” and child endangerment and has cited her decision to have an “unattended delivery” as well as her alleged drug use. Prosecutors have continued to pursue the case despite the county medical examiner saying the manner of death was an “accident”; medical experts testifying that the state’s cause-of-death claims were not backed by scientific evidence; and the passage of a new California law explicitly prohibiting the criminalization of pregnancy loss.
If convicted, Carpenter could face a life sentence.
“I am still stunned and horrified that a person could have the biggest tragedy of their life and lose a child who was loved and was so wanted, and then be charged with such a horrible crime,” Carpenter told the Guardian in a recent message from jail. “I had cherished the idea of this baby and was totally committed to becoming the best mother I knew how to be. I mourn every day for Kiera.”
The case comes as women across the US have been increasingly subjected to surveillance, arrest and charges for abortions, stillbirths and other actions that police claimed “endangered” their fetuses, with routine healthcare decisions and pregnancy outcomes treated as crimes.
Since the US supreme court overturned Roe v Wade in June 2022, a Nebraska teenager and her mother were charged with unlawful abortion and “concealing the death of another person” after allegedly obtaining abortion pills; a South Carolina woman was arrested after delivering a stillborn fetus in a hospital; a pregnant woman found with marijuana was jailed for months in Alabama to “protect” her fetus; and three women were sued for wrongful death after a Texas man alleged they helped his ex-wife obtain an abortion. Carpenter’s prosecution in California, a state considered a leader on reproductive justice and women’s rights, was a reminder that this crackdown was not limited to conservative states, advocates said.
“It’s this American idea that we can police our way out of these social problems – that placing someone in jail or prison is a way to address mental health needs, substance use disorders or lack of access to healthcare,” said Dana Sussman, acting executive director of Pregnancy Justice, a legal advocacy group assisting Carpenter. “It has really devastating outcomes for everyone.”
A tragic ‘accident’
Carpenter has struggled with substance use disorder for much of her adult life, stemming from sexual abuse and trauma she endured as a child, she said: “I tried to hide the pain of those experiences in drugs.” She repeatedly sought treatment and went to rehab, but said that medical professionals who learned of her addiction in some cases responded with punitive measures that caused her life to further unravel.
Her first son was born in 2012 and her second in 2019. In both cases, the hospitals reported that the infants tested positive for drugs and called California Child Welfare Services (CWS), which immediately took custody – despite the fact that both were healthy births, there was no indication either child suffered adverse consequences due to drug exposure, and she was taking prescribed addiction medication, her lawyers say. She has maintained relationships with both kids, with her mother adopting her oldest and Carpenter regaining joint custody of the youngest.
When Carpenter became pregnant again with Kiera, she was determined that this time would be different: “I did not want to risk losing my third child to the system … I love my babies and hoped to provide a sibling to them. I had imagined my sons being her big brothers and protecting her and showing her love.” In 2020, she prepared for a home birth, getting literature on delivery at home, reaching out to a midwife, and buying medical supplies, baby care items, a changing table and a crib.
She was also in drug treatment again. Records show that in September, she visited a methadone clinic, which prescribes patients medications to manage addiction and withdrawal. The facility was aware she was pregnant and had her take buprenorphine, which leading medical associations and US health agencies recommended for pregnant patients with opioid use disorder.
After delivering her baby, she cut the umbilical cord and secured it with cloth and tape, and also tried unsuccessfully to breastfeed her newborn before losing consciousness amid significant blood loss, her lawyers said. After discovering her baby was lifeless, she attempted CPR and called 911.
She was hospitalized – and then arrested for child endangerment.
‘Like someone ripped my heart out’
Shande Carpenter, Kelsey’s mother, showed up to the Oceanside police station where her daughter was in shock and severe physical pain while being questioned by officers: “She was hysterically crying, collapsing in my arms, completely inconsolable, hyperventilating. She told me Kiera had passed away and the police were blaming her. It was gut-wrenching. I felt like someone was ripping my heart out.”
She was initially released, but in March 2021, Summer Stephan, the San Diego district attorney, charged Carpenter with murder, prompting local news stories headlined “Drug addict loses third child”. She faced significant online abuse, death threats and harassment, including someone spraying “baby killer” on her car, her mother said: “I was fearful for her safety, and all of this was happening while she was trying to mourn Kiera.”
Kelsey Carpenter said the stress was overwhelming, and she was consumed by grief: “Before I was arrested I slept with Kiera’s ashes next to me every night and told her all of the hopes I had had for us. She was so fully loved for the few minutes I had her. I miss her so much.”
The county coroner’s November 2020 autopsy deemed the loss an “accident”, and said the cause was “perinatal death associated with methamphetamine and buprenorphine exposure and unattended delivery”. But a Yale University expert who reviewed placental records for Carpenter’s lawyers said a rupture was the most likely cause, meaning blood loss prior to or during delivery, and that there was no evidence that drug exposure was responsible.
At a hearing in September 2022, a police detective acknowledged that it was not illegal to have an unattended home birth nor to use buprenorphine. And the medical examiner, when cross-examined by Carpenter’s attorney Brian White, acknowledged it was “not a homicide because there’s no intent to kill”, it would be “reasonable” to “certify this death as undetermined” and it was possible the baby might not have survived if the birth had been at a hospital.
In addition to the legality of home birth and uncertainty about the cause of death, Carpenter’s lawyers grew more confident in their case late last year when lawmakers adopted reproductive rights legislation that made clear this kind of prosecution simply isn’t allowed.
But the new law has not stopped the San Diego DA.
‘Who do these prosecutions serve?’
AB2223, which went into effect in January, states that a person cannot be charged for conduct during pregnancy that results in abortion, miscarriage, stillbirth or perinatal death. Its adoption came after a district attorney in California’s Central Valley spent years pursuing murder cases against Chelsea Becker and Adora Perez, two women who had stillbirths, alleging without scientific basis that drug use caused their losses.
Advocates, backed by the state’s attorney general, argued that California’s “murder of a human fetus” statute has long only applied to third parties – if, for instance, someone shoots a pregnant person, leading to a miscarriage. The new law makes this explicit and is supported by medical experts, who argue that criminalizing pregnancy outcomes is unethical, counter to scientific evidence and harmful for public health.
Research shows that policies that punish people for substance use during pregnancy can lead to worse outcomes, in part because people skip prenatal care and treatment out of fear, said Dr Sarah CM Roberts, University of California, San Francisco, professor of obstetrics, gynecology and reproductive sciences: “We’re prosecuting and blaming people for a decision to avoid care, when we as a society put the policies in place that made them scared to get care.”
Reproductive rights and health experts who submitted a brief in Carpenter’s case also noted that scientific studies have not demonstrated that a pregnant person’s use of methamphetamine causes infant death.
“It’s concerning that people who have anything but a perfect birth are vulnerable to this kind of state misinterpretation of the event as willful and the individual therefore culpable for the tragic outcome,” said Dr Mishka Terplan, an OB-GYN physician and addiction expert. “Who do these prosecutions serve? They certainly don’t serve Ms Carpenter. What is to be gained from this?”
Jennifer Chou, ACLU of Northern California staff attorney, said Carpenter’s case served to create further mistrust in the medical system: “Why are we prosecuting tragedies instead of preventing them? For Ms Carpenter, Ms Perez and Ms Becker, what would have been helpful is connections to resources that they needed to stay healthy, but instead we put them into the criminal system.”
Before Roe v Wade was overturned, Pregnancy Justice tracked 1,700 cases of pregnancy criminalization in the US, many involving substance use claims. While prosecutions of pregnant people suffering from addiction have not typically sparked widespread outrage, Sussman said she hoped people were now paying attention; those cases are the “blueprint” for the broader crackdown on bodily autonomy in a country that increasingly values “fetal personhood” and no longer has a constitutional right to abortion.
Separated from her kids
As Carpenter’s lawyers have moved to dismiss the case by citing AB2223, San Diego prosecutors have focused on her conduct after the birth, claiming she did not properly secure the umbilical cord, that she took 28 minutes to call 911 after waking up, and that if she had sought help faster, “the baby would have survived”.
Tanya Sierra, a DA spokesperson, said in an email that the DA “fully recognizes the reproductive rights enshrined by AB 2223”, but alleged that the new law was not relevant: “Carpenter is not being prosecuted for her decision to have a home birth or substance use. This is not a case involving abortion, stillbirth, or any other pregnancy outcome. This is a case about a newborn baby who died as a direct result of a parent’s acts and omissions after the baby’s live birth.”
Carpenter’s attorneys have countered that there was no clear evidence any of her actions after delivery caused the death and that the DA was still criminalizing her lawful home birth: “The law is clear: decisions a woman makes during pregnancy cannot be used to prosecute her for the outcome of the pregnancy,” said Daniel Arschack.
It’s unclear if Stephan, the DA, has prosecuted similar cases, which are rare in California. A former Republican, now a registered independent, Stephan has presented herself as a champion for women and children, and has made national headlines for her conspiracy case against leftist protesters demonstrating at a pro-Trump rally. Oceanside police did not respond to inquiries. The medical examiner declined to comment.
Carpenter was originally released on bail, but after a failure to appear in court, she was arrested again and brought to jail in January, her lawyers said, once again separating her from her children.
Shande said she wished the DA and the public understood who her daughter really was – a mother deeply devoted to her sons, who has a gentle spirit. “She’s a beautiful, loving, caring, sweet woman, who has been trying so hard for years to heal from the pain that drives her addiction, so she can conquer this disease.” One of the hardest parts of her incarceration is that her two sons can only see her during brief video visits; the oldest, age 11, cries, saying he misses cuddling and playing with his mom, and the youngest, age three, doesn’t understand why he has to talk to her on a screen.
Carpenter had been working to get her real estate license to better support her kids, but she is now unsure she’ll be able to pursue that career, she said, adding that the turmoil of her case had exacerbated her struggles with addiction.
“I wish that instead of taking my babies away when I was trying to beat my dependency problem, I could have been supported and been assured that having a baby in a hospital while being treated for dependency did not mean that my baby would be taken away,” she said. “I have been a good mother to my children and I would have been to Kiera if I’d had the chance.”
