I N FANT ABDUCTION

lowering the rwk

In July 1998, a wonian disguised as a nurse nhducted 11 newborn

baby from a hospital in Florida. Earlier in that yenr, two nbduc-

tiom occurred in thc Midwest. A couple ~ibJiictc.J n ntwhorii

from her sleeping mother’s room i n ;I Knnsns C i t y hospitnl, nnci ;i

few weeks later, an infant was stolen from ii Chicngo niiiternity

unit. In both o f these latter instances, the hospital spokesperson

expressed frustration to the TV news cameras over the difficulty in preventing

infant abductions. One stated, “This is a hospital, not a prison.”

The crime of infant abduction has a significant impact 011 the family and hos-

pital staff. For nurses who work on neonatal units and in hirthing centers who

are concerned that “this could easily happen,” the potentinl for ahductions does

exist in many locations. In collaboration with security, law enforcement ngen-

cies, and administration, nurses can assess and address the potentiill for infant

abductions where they work. VICTORIA CARROLL, RN, MSN

December 1999/January 2000 A W H O N N L i f e l i n e s 25

Reducing Infant Infant Abduction Infant abduction is the taking of a child younger than 1 year old by a non-family member for other than "tradi- tional" kidnaping motives. Most often, infant abductions don't appear to be motivated by a desire for money, sex, revenge, or custody (Ankrom & Lent, 1995). According to the National Center for Missing and Exploited Children (NCMEC), 160 infants were abducted between 1983 to 1996, and 10 are still missing. Ninety-three of these abductions occurred in health care facilities:

56 percent from the mother's room 15 percent from the nursery 17 percent from a pediatric room 12 percent from other hospital locations During that time, 39 states reported infant abductions:

25 in California 22 in Texas 10 in Florida 9 in New York

Kidnappers have targeted the homes of infants 5 1 times from 1983 to 1996. In an FBI study of 145 abductions, a high risk of violence was associated with nonhospital abductions, leading to the deaths of seven mothers and one father (Ankrom & Lent, 1995).

Prevention The first step in reducing the potential for infant abduc- tion is to select a safety and prevention team that meets regularly. The responsibilities of the team should include:

Periodic assessment Training and prevention Crisis response

The team should include members from security, nursing, human resources, and public relations. They may require information from consultants in hospital security, legal experts, media representatives, and law enforcement personnel during the assessment and plan- ning phases, and a t times of crisis.

Assessment Any security assessment must consider recent Joint Commission for the Accreditation of Healthcare Organizations (JCAHO) standards. These standards mandate specific security measures for newborn nurs- eries and birthing centers, and cover three general areas (Aldridge, 1995):

Personnel orientation and continuing education Identification of patients and staff Access control

Among the necessary proactive strategies listed is a recommendation that all health care personnel wear conspicuous color photo ID badges plus a second form of unique identification. Another important policy is that babies are never carried and are always pushed in a bassinet. A security camera system to monitor activity in the halls of the maternity and pediatric units is neces- sary. Video tapes should be retained for a minimum o f 7 days. Physical security safeguards that control access to

Victoria Carroll, R N , M S N , is a clinical instructor at the University of Northern Colorado in Ft. Collins, Co., and a nursing consultant in health care workplace violence.

26 A W H O N N L i f e l i n e s

U

Abductions Infant abduct ions from hospitals have been reduced 55 percent since 1991, according t o the National Center for Missing & Exploited Children (NCMEC). Officials at t h e NCMEC credit this reduction t o a program, "Safeguard Their Tomorrows," a prevention training program developed by NCMEC in conjunction with AWHONN and Mead J o h n s o n Nutritionals.

Officials a t NCMEC s t r e s s t he importance of the par- ents ' role in reducing abduction risks. Parents can fol- low guidelines in "Safeguard Their Tomorrows" called "What Parents Need t o Know." The guidelines describe security measu res parents should take before entering t h e hospital, during t h e hospital stay, and a t home .

Because of t h e popularity of hospital maternity su i tes and the trend toward keeping newborns in t h e s a m e room a s their mothers , paren ts have gotten used t o considering the hospital a s their h o m e away from home . "A parent is t h e co-caregiver of their newborn and needs t o r emember that they a re on duty all t h e t ime, even in t h e hospital, when they themselves m a y b e a patient," said J o h n Rabun, vice president and chief operating officer of NCMEC. "Thousands of peo - ple c o m e into a hospital every day. A parent mus t learn how t o de te rmine which of those a re health care per- sonnel and which aren't."

Safeguards Their Tomorrows is a n educational pro- g ram developed to heighten awareness a m o n g hospi- tal personnel abou t preventing infant abduction from hospitals, a s well a s h o w t o respond in such crisis si tu- ations. For more information abou t this program or to obtain the guidelines, s u r f to: www.enfami/.com or www. missingkids.com.

the nursing unit are necessary, as is a policy that states that no home address should be divulged to the public in birth announcements that would put the infant and family at risk after discharge.

Tra in i ng Staff should be familiar with the abductor profile and why they abduct infants. In a study of 62 infant abduc- tors, 58 were female. The largest group was 30 to 39 years of age (43 percent). The most common body type o f female abductors was a large build (58.6 percent), with a median weight of 160 pounds at the time of the event. In terms of race, 36 were white, 18 were black, and eight were Hispanic (Burgess et al., 1995). Most abductors were of the same race o r ethnicity as the infant (Ankrom & Lent, 1995). The typical abductor does not have a violent criminal history, but may have a history of criminal acts, such as passing bad checks. Some of the personal characteristics of abductors include lying, deception, lack o f interpersonal empathy, a need to be special, and feelings of envy (Burgess et al., 1995). They're often married or involved in a relationship, and usually live near the abduction site. Women who steal a baby may have unresolved childbearing issues such as the loss o f a child through miscarriage, custody, o r adop-

Volume 3, Issue 6

tion. Many of the abductors stole a baby in an attempt to hold together a failing relationship.

institutions before the abduction. They may be familiar with the hospital through previous employment or vol- unteer work. They may ask detailed questions about hospital procedures and floor plans. When abducting an infant, they may pose as a nurse, a social worker, other hospital staff, o r as a babysitter. The act of abducting ranges from no physical force to lethal force. Violence is more likely to occur if the abductor is challenged in the process of carrying out the act (Burgess et al., 1995).

Staff should also learn techniques to prevent infant abductions such as the use o f infant and parent identifi- cation. Training on how to challenge suspicious people tactfully is vital (Aldridge, 1995). Parents must be included as integral members o f the abduction preven- tion team by orienting them to the unit’s policies and written guidelines designed to protect their infant.

However, a unique approach that is simple and cost- effective could be added: the use of a password between nurses and parents before any exchange of infants occurs. Mutually decided on by parents and the nurse, a password is a security measure an abductor cannot cir- cumvent. The list of passwords for each baby to whom the nurse is assigned would stay on her person and be inaccessible to unauthorized persons. Because home nursing visits are now common as a result of early dis- charge, the use of a password is also recommended in these instances.

Abductors frequently visit maternity units a t multiple

Crisis Response A plan must be developed that outlines the complete response to an infant abduction. A time frame is set in which the local police and the FBI must be notified. An immediate and simultaneous search of the entire health care facility must be activated. Alerting the media as soon as possible is a key element in the recovery effort. However, a plan that mandates that all information released to the media about the abduction be cleared by administration and law enforcement authorities is important.

Impact of Abduct ions The impact of an abduction on parents and staff mem- bers is immediate. Trauma from the experience often creates severe and long-term psychological manifesta- tions. Extreme fear and anxiety are frequently experi- enced by parents until the infant is recovered. Regardless of the length of time the infant is missing, there will be a re-bonding period. Parents tend to become exceptionally protective of their child or chil- dren and report recurring nightmares about the abduc- tion. Nurses frequently experience significant guilt, thinking they could have prevented the abduction in some way. Both groups tend to exhibit symptoms of posttraumatic stress response, such as trouble concen- trating, poor sleep patterns, and an exaggerated startle response (Burgess & Laming, 1995).

l e g a I Imp I ications Hospitals face liability concerns when an abduction occurs, because they have a duty to take reasonable

actions to prevent foreseeable harm to those f o r whom they provide care. Parents also can sue for a hospital’s failure to officially identify an infant between birth and abduction, causing delays when the child is recovered and before the child can be returned to the parents (Aldridge, 1995).

Promoting a Vision Nurses can encourage health care professionals and oth- ers to pool their strengths in seeking solutions aimed at preventing infant abductions:

Nurture ideas from within Expect commitment from management and participa- tion from all employees Strive for a customized security action plan Publish the evaluations of implemented interventions to encourage and help others striving to improve the safety of their workplace and decrease the incidence and impact of infant abduction +

REFERENCES Aldridge, G. (1 99.5, May). Protecting hospitals against infant

Ankrom, 1.. G., Lcc Lent, C. J. (1995, September). Cradle rob- abductors. Security Management, 61-64.

bers: A study of the infant abductor. FBI Law Enforcement Bulletin.

Burgess, A. W., Burgess, A. G., Dowdell, E. B., Hartrnan, C. R., Nahirny, C., Lcc Rabun, J. B.(1995). Infant abductors. ]ournal o f Psychosocial Nursing, 33(9), 30-37.

Infant Abductions. Arlington, VA: National Center for Missing and Exploited Children.

Abductions. ( 1 995). Arlington, VA: National Center for Missing and Exploited Children.

Burgess, A. W., & Lanning, K. V. (1995). A n Analysis of

Guidelines on Prevention o f and Response to Infant

ImDortant Infant I

Safety Questions H Are you concerned about a lack of security on

H Do you know the profile of the infant abductor?

H Would you be able to tactfully confront a

H What would your role be in the event of a criti-

H Have you attended in-services on the prevention

your unit?

suspicious person on your unit?

cal incident where you work?

of infant abduction in the last year?

For More Information A complete self-assessment guide for health care facilities is available in the ”Guidelines on Prevention of and Response to Infant Abductions” from the NCMEC. This guide designates specific interventions as necessary or recommended. To receive a copy of this guide, call (800) 843-5678.

December 1999/January 2000 A W H O N N L i f e l i n e s 27