Preventing Infant Abduction

July 2, 2023

An unfortunate but essential nursing role is protecting the infant from abduction (kidnapping). Precautions include teaching parents how to recognize the picture identification badge worn by birth facility personnel; providing parents with written and oral information, including a picture of staff identification badges, and cautioning parents to never give their infant to anyone who does not have proper identification.

Staff members who are working temporarily on the unit are assigned special identification badges that are carefully monitored so that they cannot be removed from the premises without alerting the staff. In some agencies, an electronic sensor is attached to each infant with a bracelet or tag. The sensor activates an alarm if it goes near an exit or if it is cut or removed from the infant. With some systems, all exits lock automatically if an alarm is activated.

Entrances to the maternity unit should be in areas where staff can watch people enter and leave. Unit doors may be locked at all times. Entrance requires knocking, pressing a call signal, or using a card key or a code on the lock. Visitors to maternity units may be required to check in with security guards or other staff members and wear special visitor identification tags. Remote exits are locked and often equipped with video cameras and alarms. Staff must respond quickly whenever a door alarm sounds.

Newborns are usually abducted by women who are familiar with the birth facility and its routines. They are of childbearing age, are often overweight, and may live near the birth facility. They usually visit several

Cultural Considerations: Postpartum Period

Many cultures emphasize certain postpartum rituals for mother and baby. In some cultures, including Chinese, Mexican, Korean, and Southeast Asian, these rituals may include bathing, activity, and dietary restrictions designed to restore the hot-cold (yin-yang) balance of the body:
- The mother may observe a long period of seclusion and rest with avoidance of physical activity. Household responsibilities and infant care are provided by other female family members. The period of seclusion may last from 2 weeks to 40 days.
- These cultures avoid cold and maintain increased body warmth; avoid bathing, hair washing, exercise, and exposure to wind for 7 to 30 days after childbirth; and add extra heat (cover with blankets).
- The woman may avoid cold and raw foods and water. She may eat only warm foods and drink hot beverages to replace blood loss and to restore the balance of hot and cold in her body. Traditional foods of culture are encouraged.
- The woman may wear an abdominal binder. She may prefer not to give her baby colostrum.
In other cultures, breastfeeding practices are not established until after milk comes in because of belief that colostrum is “bad” for the baby.
A low-income mother may need to contend with stressors that distract her from developing a relationship with her baby. Inability to pay for infant supplies or child care, chaotic home situations, and worry over eligibility for social and health care services deplete the women’s mental and physical energy.
An Arabic woman may eat special meals designed to restore her energy.
- She is expected to stay at home for 40 days after delivery to avoid illness from exposure to the outside air.
A Haitian woman may request to take the placenta home to bury or burn.

times to learn the routines so that they can impersonate birth facility staff to gain access to a newborn. They often know the layout of the facility and the locations of exits well. The woman may have had a previous pregnancy loss or be unable to get pregnant. She may want an infant to solidify her relationship with her husband or boyfriend. Although the woman plans the kidnapping scheme, she waits for an appropriate opportunity to take any infant (Box 27-12).

Discharge: before 24 Hours and after 48 Hours

Early postpartum discharge, shortened hospital stays, and 1-day maternity stays are all terms for the length of hospital stays of a mother and her baby after a low-risk birth. The trend of shortened hospital stays is based largely on efforts to reduce health care costs, coupled with consumer demands to have less medical intervention and more family-focused experiences.

Box 27-12 Precautions to Prevent Infant Abductions

All personnel must wear appropriate identification that is easily visible at all times. No one without appropriate identification should handle or transport infants.
Enlist parents’ help in preventing kidnapping. Teach them to allow only hospital staff with proper identification to take their infant from them.
Teach parents and staff to transport infants only in their cribs and never by carrying them. Question anyone walking in the hallway carrying an infant.
Investigate anyone with a newborn near an exit or in an unusual part of the facility.
Be suspicious of anyone who does not seem to be visiting a specific mother or who asks detailed questions about nursery or discharge routine.
Be suspicious of unknown people carrying large bags or packages that could contain an infant.
Respond immediately when an alarm sounds signaling that a remote exit has been opened or an infant has been taken to an unauthorized area.
Never leave infants unattended at any time. Teach parents that their infant must be observed at all times. If no family members are present, the mother can take her infant into the bathroom with her or send the infant back to the nursery if she wishes to nap.
Take infants to mothers one at a time. Never leave an infant in the hallway unsupervised.
When an infant is left in a mother’s room, place the crib away from the doorway.
If entrances to the maternity unit or nurseries are equipped with locks that open to codes or card keys, protect them from others.
When a parent or a family member comes to the nursery to take an infant, always match the infant and adult identification bracelet numbers. Never give an infant to anyone without the correct identification bracelet or other proper identification.
Alert hospital security immediately of any suspicious activity.
Suggest that parents not place announcements in the paper or signs in their yard that might alert an abductor that a new baby is in the home.

Laws Relating to Discharge

Health care providers have expressed concern with shortened stays because some medical problems do not show up in the first 24 hours after birth. New mothers do not have sufficient time to learn how to care for their newborns and identify problems such as jaundice and dehydration related to breastfeeding difficulties.

The concern for the potential increase in adverse maternal-infant outcomes from hospital early discharge practices led the American College of Obstetricians and Gynecologists, the American Academy of Pediatrics, and other professional health care organizations to promote the enactment of federal and state maternity length-of-stay bills to ensure adequate care

for both the mother and the newborn. The Newborns’ and Mothers’ Health Protection Act of 1996 provides minimum federal standards for health plan coverage for mothers and their newborns. The act requires all health plans to allow the new mother and the newborn to remain in the hospital for a minimum of 48 hours after a normal vaginal birth and 96 hours after a cesarean birth unless the attending provider, in consultation with the mother, decides on early discharge.

Maternal Follow-Up Care

After delivery, the woman is instructed to make a follow-up appointment with her health care provider in 6 weeks. Some birthing units require this appointment be made before discharge. If the nurse schedules the appointment, the patient needs prompt notification of the date and time of the appointment. Women with complications may be seen sooner.

Well-Baby Follow-Up Care

Healthy infants are seen by the physician at 2 weeks of age. Babies who are discharged before 48 hours of age are traditionally seen by the health care provider within 3 to 5 days after discharge. The purpose of this appointment is to review nutritional status, elimination, and the presence of jaundice. The schedule of appointments for a well baby is every 2 to 3 months until age 18 months. Milestone visits are planned for ages 2 and 3 years and then every 2 years. These visits focus on preventive care such as health education, nutritional assessments, review of growth and development, and routine immunizations (see Chapter 29).