ORANGEBURG, S.C. \u2014 Amari Marsh had just finished her junior year at South Carolina State University in May 2023 when she received a text message from a law enforcement officer.<\/p>\n
\u201cSorry it has taken this long for paperwork to come back,\u201d the officer wrote. \u201cBut I finally have the final report, and wanted to see if you and your boyfriend could meet me Wednesday afternoon for a follow up?\u201d<\/p>\n
Marsh understood that the report was related to a pregnancy loss she\u2019d experienced that March, she said. During her second trimester, Marsh said, she unexpectedly gave birth in the middle of the night while on a toilet in her off-campus apartment. She remembered screaming and panicking and said the bathroom was covered in blood.<\/p>\n
\u201cI couldn\u2019t breathe,\u201d said Marsh, now 23.<\/p>\n
The next day, when Marsh woke up in the hospital, she said, a law enforcement officer asked her questions. Then, a few weeks later, she said, she received a call saying she could collect her daughter\u2019s ashes.<\/p>\n
At that point, she said, she didn\u2019t know she was being criminally investigated. Yet three months after her loss, Marsh was charged with murder\/homicide by child abuse, law enforcement records show. She spent 22 days at the Orangeburg-Calhoun Regional Detention Center, where she was initially held without bond, facing 20 years to life in prison.<\/p>\n
This August, 13 months after she was released from jail to house arrest with an ankle monitor, Marsh was cleared by a grand jury. Her case will not proceed to trial.<\/p>\n
Her story raises questions about the state of reproductive rights in this country, disparities in health care, and pregnancy criminalization, especially for Black women like Marsh. More than two years after the U.S. Supreme Court issued its Dobbs v. Jackson Women\u2019s Health Organization<\/em> decision, which allowed states to outlaw abortion, the climate around these topics remains highly charged.<\/p>\n Marsh\u2019s case also highlights what\u2019s at stake in November. Sixty-one percent of voters want Congress to pass a federal law restoring a nationwide right to abortion, according to a recent poll<\/a> by KFF, the health policy research, polling, and news organization that includes KFF Health News. These issues could shape who wins the White House and controls Congress, and will come to a head for voters in the 10 states<\/a> where ballot initiatives about abortion will be decided.<\/p>\n This case shows how pregnancy loss is being criminalized around the country, said U.S. Rep. James Clyburn<\/a>, a Democrat and graduate of South Carolina State University whose congressional district includes Orangeburg.<\/p>\n \u201cThis is not a slogan when we talk about this being an \u2018election about the restoration of our freedoms,\u2019\u201d Clyburn said.<\/p>\n \u2018I Was Scared\u2019<\/strong><\/p>\n When Marsh took an at-home pregnancy test in November 2022, the positive result scared her. \u201cI didn\u2019t know what to do. I didn\u2019t want to let my parents down,\u201d she said. \u201cI was in a state of shock.\u201d<\/p>\n She didn\u2019t seek prenatal care, she said, because she kept having her period. She thought the pregnancy test might have been wrong.<\/p>\n An incident report<\/a> filed by the Orangeburg County Sheriff\u2019s Office on the day she lost the pregnancy stated that in January 2023 Marsh made an appointment at a Planned Parenthood clinic in Columbia to \u201ctake the Plan-C pill which would possibly cause an abortion to occur.\u201d The report doesn\u2019t specify whether she took \u2014 or even obtained \u2014 the drug.<\/p>\n During an interview at her parents\u2019 house, Marsh denied going to Planned Parenthood or taking medicine to induce abortion.<\/p>\n \u201cI\u2019ve never been in trouble. I\u2019ve never been pulled over. I\u2019ve never been arrested,\u201d Marsh said. \u201cI never even got written up in school.\u201d<\/p>\n She played clarinet as section leader in the marching band and once performed at Carnegie Hall. In college, she was majoring in biology and planned to become a doctor.<\/p>\n South Carolina state Rep. Seth Rose<\/a>, a Democrat in Columbia and one of Marsh\u2019s attorneys, called it a \u201creally tragic\u201d case. \u201cIt\u2019s our position that she lost a child through natural causes,\u201d he said.<\/p>\n On Feb. 28, 2023, Marsh said, she experienced abdominal pain that was \u201cway worse\u201d than regular menstrual cramps. She went to the emergency room, investigation records show, but left after several hours without being treated. Back at home, she said, the pain grew worse. She returned to the hospital, this time by ambulance.<\/p>\n Hospital staffers crowded around her, she said, and none of them explained what was happening to her. Bright lights shone in her face. \u201cI was scared,\u201d she said.<\/p>\n According to the sheriff\u2019s department report, hospital staffers told Marsh that she was pregnant and that a fetal heartbeat could be detected. Freaked out and confused, she chose to leave the hospital a second time, she said, and her pain had subsided.<\/p>\n In the middle of the night, she said, the pain started again. She woke up, she recalled, feeling an intense urge to use the bathroom. \u201cAnd when I did, the child came,\u201d she said. \u201cI screamed because I was scared, because I didn\u2019t know what was going on.\u201d<\/p>\n Her boyfriend at the time called 911. The emergency dispatcher \u201ckept telling me to take the baby out\u201d of the toilet, she recalled. \u201cI couldn\u2019t because I couldn\u2019t even keep myself together.\u201d<\/p>\n First medical responders detected signs of life and tried to perform lifesaving measures as they headed to Regional Medical Center in Orangeburg, the incident report said. But at the hospital, Marsh learned that her infant, a girl, had not survived.<\/p>\n \u201cI kept asking to see the baby,\u201d she said. \u201cThey wouldn\u2019t let me.\u201d<\/p>\n The following day, a sheriff\u2019s deputy told Marsh in her hospital room that the incident was under investigation but said that Marsh \u201cwas currently not in any trouble,\u201d according to the report. Marsh responded that \u201cshe did not feel as though she did anything wrong.\u201d<\/p>\n More than 10 weeks later, nothing about the text messages she received from an officer in mid-May implied that the follow-up meeting about the final report was urgent.<\/p>\n \u201cOh it doesn\u2019t have to be Wednesday, it can be next week or another week,\u201d the officer wrote in an exchange that Marsh shared with KFF Health News. \u201cI just have to meet with y\u2019all in person before I can close the case out. I am so sorry\u201d<\/p>\n \u201cNo problem I understand,\u201d Marsh wrote back.<\/p>\n She didn\u2019t tell her parents or consider hiring a lawyer. \u201cI didn\u2019t think I needed one,\u201d she said.<\/p>\n Marsh arranged to meet the officer on June 2, 2023. During that meeting, she was arrested. Her boyfriend was not charged.<\/p>\n Her father, Herman Marsh, the band director at a local public school in Orangeburg, thought it was a bad joke until reality set in. \u201cI told my wife, I said, \u2018We need to get an attorney now.\u2019\u201d<\/p>\n \t\t\t\t\t<\/p>\n \t\t\t\t\t<\/p>\n Pregnancy Criminalization<\/strong><\/p>\n When Marsh lost her pregnancy on March 1, 2023, women in South Carolina could still obtain an abortion until 20 weeks beyond fertilization<\/a>, or the gestational age of 22 weeks.<\/p>\n Later that spring, South Carolina\u2019s Republican-controlled legislature passed a ban<\/a> that prohibits providers from performing abortions after fetal cardiac activity can be detected, with some exceptions made for cases of rape, incest, or when the mother\u2019s life is in jeopardy. That law does not allow criminal penalties for women who seek or obtain abortions.<\/p>\n Solicitor David Pascoe, a Democrat elected to South Carolina\u2019s 1st Judicial Circuit whose office handled Marsh\u2019s prosecution, said the issues of abortion and reproductive rights weren\u2019t relevant to this case.<\/p>\n \u201cIt had nothing to do with that,\u201d he told KFF Health News.<\/p>\n The arrest warrant alleges that not moving the infant from the toilet at the urging of the dispatcher was ultimately \u201ca proximate cause of her daughter\u2019s death.\u201d The warrant also cites as the cause of death \u201crespiratory complications\u201d due to a premature delivery stemming from a maternal chlamydia infection. Marsh said she was unaware of the infection until after the pregnancy loss.<\/p>\n Pascoe said the question raised by investigators was whether Marsh failed to render aid to the infant before emergency responders arrived at the apartment, he said. Ultimately, the grand jury decided there wasn\u2019t probable cause to proceed with a criminal trial, he said. \u201cI respect the grand jury\u2019s opinion.\u201d<\/p>\n Marsh\u2019s case is a \u201cprime example of how pregnancy loss can become a criminal investigation very quickly,\u201d said Dana Sussman, senior vice president of Pregnancy Justice<\/a>, a nonprofit that tracks such cases. While similar cases predate the Supreme Court\u2019s Dobbs<\/em> decision, she said, they seem to be increasing.<\/p>\n \u201cThe Dobbs<\/em> decision unleashed and empowered prosecutors to look at pregnant people as a suspect class and at pregnancy loss as a suspicious event,\u201d she said.<\/p>\n Local and national anti-abortion groups seized on Marsh\u2019s story when her name and mug shot were published online by The Times and Democrat<\/a> of Orangeburg. Holly Gatling, executive director of South Carolina Citizens for Life<\/a>, wrote a blog post<\/a> about Marsh titled, in part, \u201cOrangeburg Newborn Dies in Toilet\u201d that was published by National Right to Life. Gatling and National Right to Life did not respond to interview requests.<\/p>\n Marsh said she made the mistake of googling herself when she was released from jail.<\/p>\n \u201cIt was heartbreaking to see all those things,\u201d she said. \u201cI cried so many times.\u201d<\/p>\n Some physicians are also afraid of being painted as criminals. The nonprofit Physicians for Human Rights published a report<\/a> on Sept. 17 about Florida\u2019s six-week abortion ban that included input from two dozen doctors, many of whom expressed fear about the criminal penalties imposed by the law.<\/p>\n \u201cThe health care systems are afraid,\u201d said Michele Heisler<\/a>, medical director for the nonprofit. \u201cThere\u2019s all these gray areas. So everyone is just trying to be extra careful. Unfortunately, as a result, patients are suffering.\u201d<\/p>\n Chelsea Daniels, a family medicine doctor who works for Planned Parenthood in Miami and performs abortions, said that in early September she saw a patient who had a miscarriage during the first trimester of her pregnancy. The patient had been to four hospitals and brought in the ultrasound scans performed at each facility.<\/p>\n \u201cNo one would touch her,\u201d Daniels said. \u201cEach ultrasound scan she brought in represents, on the other side, a really terrified doctor who is doing their best to interpret the really murky legal language around abortion care and miscarriage management, which are the same things, essentially.\u201d<\/p>\n Florida is one of the 10 states with a ballot measure related to abortion in November, although it is the only Southern state with one. Others are Montana, Missouri, and Maryland.<\/p>\n \u2018I Found My Strength\u2019<\/strong><\/p>\n Zipporah Sumpter, one of Marsh\u2019s lawyers, said the law enforcement system treated her client as a criminal instead of a grieving mother. \u201cThis is not a criminal matter,\u201d Sumpter said.<\/p>\n It was not just the fraught climate around pregnancy that caused Marsh to suffer; \u201crace definitely played a factor,\u201d said Sumpter, who does not believe Marsh received compassionate care when she went to the hospital the first or second time.<\/p>\n The management of Regional Medical Center, where Marsh was treated, changed shortly after her hospitalization. The hospital is now managed by the Medical University of South Carolina, and its spokesperson declined to comment on Marsh\u2019s case.<\/strong><\/p>\n Historically, birth outcomes for Black women in Orangeburg County, where Marsh lost her pregnancy, have ranked among the worst in South Carolina. From 2020 through 2022, the average mortality rate for Black infants born in Orangeburg County was more than three times as high as the average rate for white infants statewide.<\/p>\n Today, Marsh is still trying to process all that happened. She moved back in with her parents and is seeing a therapist. She is taking classes at a local community college and hopes to reenroll at South Carolina State University to earn a four-year degree. She still wants to become a doctor. She keeps her daughter\u2019s ashes on a bookshelf in her bedroom.<\/p>\n \u201cThrough all of this, I found my strength. I found my voice. I want to help other young women that are in my position now and will be in the future,\u201d she said. \u201cI always had faith that God was going to be on my side, but I didn\u2019t know how it was going to go with the justice system we have today.\u201d<\/p>\n KFF Health News Florida correspondent Daniel Chang contributed to this article.<\/em><\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n