Court Opinion

ID: 9412058
Source: CourtListenerOpinion
Date Created: 2023-07-28 19:04:29.133743+00
Date Added: 2024-06-11T16:41:25.507764
License: Public Domain

Filed 7/28/23
                        CERTIFIED FOR PUBLICATION

                COURT OF APPEAL, FOURTH APPELLATE DISTRICT

                                   DIVISION ONE

                            STATE OF CALIFORNIA

 KELSEY CARPENTER,                        D081640

         Petitioner,

         v.                               (San Diego County
                                          Super. Ct. No. SCN422556)
 THE SUPERIOR COURT OF SAN
 DIEGO COUNTY,

         Respondent;

 THE PEOPLE,

         Real Party in Interest.

       ORIGINAL PROCEEDING in mandate challenging an order of the
Superior Court of San Diego County, Michael D. Washington, Judge. Petition
denied.
       Brian J. White; Law Office of Amber Fayerberg and Amber Fayerberg
for Petitioner.
       No appearance for Respondent.
       Summer Stephan, District Attorney, Linh Lam, Valerie Ryan, and
Jennifer Kaplan, Deputy District Attorneys, for Real Party in Interest.
         Effective January 1, 2023, the Legislature enacted a new law providing
immunity from criminal or civil liability for a person’s acts or omissions with
respect to their pregnancy or pregnancy outcome, including “perinatal death
due to causes that occurred in utero.” (Health & Saf. Code, § 123467, subd.

(a).)1 As part of the same bill, the Legislature declared that an individual’s
fundamental right of privacy regarding personal reproductive decisions
includes “the right to make and effectuate decisions about all matters
relating to pregnancy, including prenatal care [and] childbirth[.]” (§ 123462.)
This case requires us to explore the dividing line between immune conduct
relating to a person’s pregnancy or reproductive decisions and non-immune
post-birth conduct allegedly causing the death of an infant who was born
alive.
         The relevant facts are undeniably tragic. Kelsey Carpenter gave birth
to a baby girl at home, alone, after deciding that she would not risk having
her child removed from her custody as had happened with her two older
children when they tested positive for drugs after being delivered at the
hospital. She again used drugs during her pregnancy. After Carpenter’s
daughter was born, the baby struggled to breathe, and Carpenter attempted
to provide her with CPR. Carpenter also cut the baby’s umbilical cord but did
not clamp it, and the umbilical stump continued to bleed. Carpenter bathed,
diapered, clothed, and attempted to breastfeed the baby before seemingly
passing out. When she woke up, her newborn daughter was dead.
         Before the new immunity provision went into effect, the People charged
Carpenter with implied malice murder and felony child endangerment,
contending that Carpenter intentionally chose an unattended at-home
delivery, despite being warned of the dangers, in an effort to evade child

1        Undesignated statutory references are to the Health and Safety Code.
                                        2
welfare services and at the risk of her daughter’s life. According to the
People, Carpenter’s acts and omissions, including her failure to seek medical
assistance after realizing her baby was in distress, caused the baby to bleed
to death. The People presented evidence in support of the charges against
Carpenter at a preliminary hearing, at the end of which the magistrate found
the evidence sufficient to hold Carpenter to answer on the charges.
Carpenter then moved to dismiss the information.
      By petition for writ of mandate, Carpenter now challenges the superior
court’s order denying her motion to set aside the information for lack of
probable cause under Penal Code section 995. She contends that she is
immune from prosecution based on the new law, which went into effect after
the preliminary hearing, but before the superior court ruled on her section
995 motion. Carpenter argues that the People’s prosecution of her is
unlawful because it is based on her actions and omissions with respect to her
pregnancy outcome and violates her right to choose to have an unattended
home birth.
      We agree that Carpenter cannot be prosecuted for her decision to have
an unattended home birth or any effect that her alleged drug use or lack of
prenatal care during pregnancy may have had on her baby. We conclude,
however, that the law does not preclude the People’s prosecution of Carpenter
for her acts and omissions after her daughter was born alive. Given the
minimal showing the prosecution is required to make at a preliminary
hearing, and after conducting an independent review of the record, we also
conclude that there was sufficient cause—albeit by the thinnest of margins—
to bind over Carpenter on the implied malice murder and felony child
endangerment charges. We therefore deny the petition.

                                       3
              FACTUAL AND PROCEDURAL BACKGROUND
      In November 2020, Carpenter went into labor at her apartment
approximately two weeks before her due date. She gave birth at home to a
baby girl named Kiera who died within hours. In March 2021, the People
charged Carpenter with one count of murder (Pen. Code, § 187, subd. (a)) and
one count of felony child endangerment resulting in death (Pen. Code, § 273a,
subd. (a)). In September 2022, a preliminary hearing was held before a
magistrate judge. The People presented evidence consisting of testimony
from law enforcement officers, Carpenter’s statements, text messages sent to
and from Carpenter, and testimony from the medical examiner who
performed Kiera’s autopsy.
A. Events Leading Up to the Birth
      1. Carpenter’s Conversations and Text Messages with Her Mother
      Detective Ryan Malone, who was one of the officers assigned to
investigate Kiera’s death, testified at the preliminary hearing that he
interviewed Carpenter’s mother, Shande, to get more information about
Carpenter. Shande stated that her daughter suffered from anxiety,
depression, and oppositional defiant disorder, occasionally drank alcohol, and
used to be on methadone. She was aware that Carpenter was pregnant but
had not spoken to her much in the two months leading up to Kiera’s birth due
to an argument they had. The last time Shande spoke on the phone to
Carpenter, about a week before she gave birth, Carpenter mentioned to her
mother that she was “red-flagged” by Child Welfare Services (CWS). Shande
told Detective Malone that Carpenter had two other children who were
removed from her custody by CWS after testing positive for drugs at the time
of birth. Carpenter had visitations with her sons, but they were not under
her direct care. One of Carpenter’s sons was under Shande’s care.

                                       4
      Carpenter told Shande that when it came to her most recent

pregnancy, she wanted to have her babies2 at home with the help of a
midwife. Shande told Detective Malone that Carpenter was excited to have
the babies and wanted to keep them.
      During the hearing, Detective Malone read several text messages
between Carpenter and Shande into the record. The pair exchanged texts the
day before Carpenter went into labor, with Carpenter expressing frustration
with her mother for not allowing her to see her son. Shande asked Carpenter
when she was due and then said, “It’s not safe to have twins at home, Kelsey,
especially bc they will be born addicted to methadone which you’re on for
most of the pregnancy and whatever you’re on now, not to mention alcohol, et
cetera. WAY TOO DANGEROUS FOR THEM AND YOU.” Carpenter did
not respond until the following day at 10:42 p.m. when she told her mother
she was in labor. She also left her mother a voicemail around the same time,
telling her she was in labor, but Shande was sleeping and did not respond.
      2. Carpenter’s Other Text Messages
      Before and during labor, Carpenter also sent a number of text
messages to various other people discussing her labor and decision not to go
to a hospital to give birth. These texts provide a general timeline of the
events leading up to Kiera’s birth.
      The morning of November 14, 2020, Carpenter texted a contact listed in
her phone as “Ryan CLINIC” that she was having contractions, stating that
they were “coming every few minutes so [I’m ]gonna chug this wine and take
klonopins and push my children . . . . I AM NOT LOSING MY KIDS AND
THATS WHAT WILL HAPPEN IF I GO TO THE HOSPITAL. . . .” At
3:45 p.m., she texted Ryan again, saying she was in active labor. Ryan asked

2     Carpenter mistakenly believed she was pregnant with twins.
                                       5
whether Carpenter was in the hospital, and she responded: “Fuck no!!!!!!!
I’m DOING IT HERE IM NOT LOSING MY[]FUCKING KIDS!!”
      Carpenter seemed to blame Ryan for not helping her delay her early
labor, texting him at 4:05 p.m.: “What don’t u get!!!!!!! Had u given me
something THIS MORNING I WOULD HAVE LASTED THE DAY [¶] . . . [¶]
You think I don’t know you had s[hi]t that could have subsided my labor and
you DID NOTHING [¶] . . . [¶] Bye im having my babies tonight probably in
the middle of the night im 3 middle fingers . . . .” Shortly after 6:00 p.m., she
texted Ryan again: “Your bitch ass could have stopped it with fetalnyl [sic] I
will hate you for the rest of my life got[]it ? Because I wasn’t dilated
yesterday and now by tomorrow afternoon ill have either dead or alive babies
im NOT LOSI[NG] THEM.TO YOUR SALT SHIT AND WINE COCKTAIL
[¶] . . . [¶] And get the fuck away from.me!!!!!!!! If you tell ANYONE IM
HAVING THEM AT HOME BY MYSELF YOU CAN JUMP OFF THE
BRIDGE WITH JEFF FOR ALL I CARE!!!!”
      At 6:22 p.m., Carpenter texted someone named Shawn M. that she had
been in labor since 4:00 a.m. that morning and would not be going to the
hospital. She said she was “hurting really badly” and told him not to tell
anyone that she was giving birth at her apartment “where the kids were safe
from the system.”
      At 6:37 p.m., Carpenter texted her friend Eddie E.: “Im in labor. [¶]
No hospitals are happening f[o]r me tonig[h]t. I had my bloody show i had
my mucus membrane break and I have contractions less than 5 minutes
apart[.] [¶] . . . [¶] I need some clean towels and sheets its a big one on the
list[]. [¶] For home births[.] [¶] Please do you have anything I am
contacting a midwife I met but I need your help[.] [¶] Im scared !!!!!!!!!!!!!!!
I have stuff in my system from yesterday, and I AM NOT LOSING MY

                                         6
KIDS[.]” Eddie responded: “I have no wheels right now or money[.] . . . Let
me see what I can do[.]”
      At 6:53 p.m., Carpenter texted another contact in her phone, Ken K.,
asking if his wife was a midwife and seeking help with the birth. She told
Ken she had been studying for months and asked him if he could provide
clean towels and sheets. When Detective Malone later spoke with Ken, he
confirmed that Carpenter had texted him asking if his wife could help her
with her labor and delivery. Ken told Carpenter he could not assist her but
that he would keep their conversation confidential, as she asked him not to
tell anyone what she was doing.
      At 7:33 p.m., Carpenter texted Eddie again: “You have no medical
experience just forget it what I need fro[m] you is towels and sheets can your
brother bring them over[?] [¶] I’m about to get in my bath and ride out some
of these contractions and I need new sheets put on my bed for the birthing
itself to take them out clean them up and I have to prepare for cpr I have a
ton to do[.] [¶] It will be another 10 hours but 5 of that is pushing and
making sure they are ok[.] I can’t get through a contraction without having
to stop talking so they are severe enough to where my next stage is water
breaking or someone has to d[o] it for []me . . . you don’t trust any midwife or
nurses u.k[n]ow??? [¶] I need the set up ready i have the health everything
for their breathing my CPR cert all ready but its getting harder to walk
around I need help[.]” Eddie replied that he would ask his brother.
      At 8:48 p.m., Ryan texted Carpenter again: “I would appreciate it if
you would come back down to reality and realize that you can’t have your
kids at home safely you haven’t even been to a prenatal care . . . you don’t
even know when your kids are supposed to be born you need help dude . . . .”
At 10:42 p.m. Carpenter texted Ryan: “Im.in labor [i]n.my bathtub with

                                        7
twins and its the most excruciating pain in the entire world[.]” Ryan
responded: “Dude is anyone there[?] [¶] I’m being dead serious you have to
be careful with this I know you’re fear [sic] but this is no joke what if
something goes wrong[?]” Carpenter replied: “I NEED AN OPIA[TE]. THIS
IS THE MOST PAIN IVE EVER EVER BEEN IN IN MY LIFE . . . [¶]
Please!!!!!! Otherwise i have to go the hospital their heart beats are ok but im
contracting every 30 seconds [¶] . . . [¶] My mom won’t answer !!!!! And the
hospital now [sic] I’ve drank Ive smoked cigarettes I’ve done whatever to try
to stop this process [¶] . . . make it easier PLEASE GET FENTANYL THEY
WONT TEST FOR IT[.]”
      At 11:14 p.m., Carpenter texted Ryan again: “Eddie’s brother[] just
walked out an[d ]left . . . [m]e in the bathtub my contrac[ti]ons are every 15
secs[.] [¶] Im crying I fe[e]l I need to push[.] [¶] I need somet[hing] for the
pain[.] [¶] Omg im freaking[.]”
      Ryan did not respond until 1:09 a.m., when he texted: “Dude I’m going
to call an ambulance[.] [¶] Please help me help you I don’t know what else to
do[.] [¶] I’m going to give it 10 minutes then I’m going to have to call. I don’t
know what else to do and you could get seriously hurt or the babies[.] [¶]
Everything will get worked out I know you’re scared and don’t want to loose
[sic] them but if you don’t get to the hospital [it] could end really bad[.]”
      3. Statements from Carpenter’s Contacts
      Eddie told Detective Malone that Carpenter planned to give birth at
home to avoid the hospital because of her history with CWS with her previous
children. Eddie encouraged her to go to the hospital multiple times.
      Detective Malone also testified that he spoke with Eddie’s brother,
Iran A., who told the detective that he received texts from Carpenter at
around 8:19 p.m. the night of November 14 asking him to bring rubber gloves

                                         8
and masks to her apartment, which he did. Iran had not met Carpenter in
person at that point, but he had previously agreed to give her a ride to the
hospital when she went into labor. Iran arrived at Carpenter’s apartment at
around 10 p.m. At Carpenter’s request, he checked her cervix, retrieved “a
bottle of wine and some pills” for her, and drew her a bath. According to
Iran, Carpenter then insisted that Iran leave her apartment because he did
not seem comfortable with the situation. When Detective Malone asked Iran
why he did not call 911, Iran stated that Carpenter “commanded him” not to.
B. Events After the Birth
      The parties agree that Carpenter gave birth to Kiera sometime after
11:14 p.m. on November 14 and before 6:29 a.m. on November 15.
      1. Carpenter’s Texts
      At 6:29 a.m. on November 15, Carpenter used her phone for the first
time since the prior night, texting Ryan: “My daughter died[.]” [¶] “I woke
up next to a dead baby[.] [¶] I’ve been giving her mouth to mouth its not
working[.] [¶] Im going to kill.myself today. [¶] Bye[.]”
      2. Carpenter’s Statements to First Responders
      Carpenter called 911 at 6:59 a.m. on November 15. She was crying and
told the dispatcher that she had just given birth and the baby was not
breathing. She said that she had tried to give the baby CPR but it was not
working. The dispatcher asked Carpenter whether she had planned on
having a home birth, and she said “no.”
      Paramedics arrived on the scene at 7:05 a.m. Paramedic Captain
Rocky Rehberg was the first person to enter Carpenter’s apartment after her
call to 911. Detective Malone testified that Captain Rehberg said his “first
thought was that the baby was dead -- was blue around the lips, had no
pulse, was limp, and he thought that was odd because, according to their

                                       9
knowledge, the baby -- the mom had just given birth prior to the arrival and
the baby seemed like he had been dead -- she had been dead longer than
that.” Captain Rehberg told Detective Malone that he remembered noticing
that the umbilical cord had not been clamped and he thought that the baby
had died from blood loss.
      Officer Ann O’Neill spoke with Carpenter at her apartment, and
Carpenter said she had given birth about two hours before the officers
arrived. She told Officer O’Neill that after she gave birth, “the baby was not
breathing, [and] possibly had a nasal passage blockage.” Carpenter said she
had not been able to call 911 sooner because her cell phone was dead. Officer
O’Neill testified that the officers and paramedics urged Carpenter to go to the
hospital, but she initially refused because she said she had an issue at the
hospital with the birth of her prior child, “which is why she wanted to have
the baby at home.”
      3. Observations of Law Enforcement and Medical Staff at the Hospital
      Oceanside Police Officer Tyrone Dunn testified that he was on duty the
morning of November 15 when he received a “possible CPR call” and was
directed to Tri-City Medical Center, where Kiera had been transported by
ambulance. Upon entering the Emergency Department, Officer Dunn ran
into Captain Rehberg, who stated that the baby had no pulse when he
arrived at the scene. Officer Dunn then entered the room where one of the
emergency room (ER) physicians, Dr. Ma, was talking and giving directions
to nurses attending to Kiera. Dr. Ma asked why the baby had low blood
pressure, and when he inspected her diaper, he found a pool of blood in the
diaper, leading him to suspect the baby was bleeding.
      Medical staff then directed Officer Dunn to bags of clothing and a
placenta that the paramedics had taken to the hospital with them. Officer

                                      10
Dunn described seeing a piece of Scotch tape on Kiera’s umbilical cord stump
as she was laying on the table in the ER and medical staff were attempting to
save her life. Dr. Ma removed the piece of tape from the baby’s body. The
photograph of the piece of tape with blood on it shown at the preliminary
hearing also depicted a bloody piece of gauze, but Officer Dunn did not recall
seeing any gauze by the umbilical cord when he was in the room.
      4. Carpenter’s Post-Arrest Statements to Law Enforcement Officers
      After she was arrested, Carpenter agreed to speak to law enforcement
officers about what happened during and after Kiera’s birth. Carpenter told
Detective Malone and his partner that while in labor, she felt like she needed
to have a bowel movement, so she went to the bathroom. While she was over
the toilet, she pushed multiple times and eventually gave birth to a crying
baby girl. Carpenter said she cut the umbilical cord using medical scissors,
put some cloth over the end of the umbilical cord, and tried to nurse the baby.
At that point, the baby seemed like she was having trouble breathing and
began turning blue, so Carpenter started giving the baby CPR, but it was not
working.
      Carpenter told the officers she initially could not call 911 because her
phone was dead, and she could not find her phone charger. She eventually
found her phone charger, charged her phone, and called 911. When asked
why she could not go to a neighbor’s apartment to ask for help, she said she
was in pain and could barely walk.
      Carpenter also told the officers that she was working with a midwife
named Shannon S. and that she never planned on having the baby at home
but instead had always planned on having the baby at the hospital. She
stated that she wanted to work with the midwife to ask her about
“HypnoBirthing” because being at the hospital was very stressful. Carpenter

                                      11
said she made an agreement with Tri-City Medical Center that she would
give birth there. She stated that she had not been trying to avoid CWS.
      5. Carpenter’s Statements to Others
      Detective Malone testified that contrary to what Carpenter had said,
Shannon told officers that although she was a registered nurse in Georgia,
Carpenter never talked to her about acting as a midwife or providing any
medical assistance for her birth. Shannon met Carpenter at their shared
doctor’s office several months before Carpenter gave birth. She exchanged
phone numbers with Carpenter with the intent of being friends with her after
she had her baby. Shannon had no knowledge of Carpenter’s plan to give
birth at home. Shannon told Detective Malone she had received a text from
Carpenter about being in labor, but she had recently lost her phone and did
not see the text until the following day.
      When Shannon saw Carpenter at their shared doctor’s office a couple of
days after Carpenter was released from jail, Carpenter relayed what had
happened during her labor and delivery. According to Shannon, Carpenter
said she gave birth in the bathroom, where she started bleeding profusely,
and then the baby came quickly. Carpenter told Shannon she had secured
the baby’s umbilical cord but did not say how. She also told Shannon that
after Kiera was born, she had trouble breathing. Shannon told Carpenter
that was probably because the baby needed deep suction, which the hospital
could have performed. Carpenter further told Shannon that after she woke
up, Kiera was dead on her chest, and her body was blue. This led Shannon to
believe that Carpenter must have passed out at some point after giving birth.
Finally, Shannon told Detective Malone that Carpenter told her that she had
previously read online about “the percentages of the bad things happening

                                       12
during home births . . . but she never thought it would really happen to her in
real life.”
       6. Items Found at Carpenter’s Apartment
       At the hearing, Detective Malone described what was found after
officers executed a search warrant and searched Carpenter’s apartment. The
officers found the medical scissors and plastic sheeting Carpenter had
mentioned during her interview, as well as a bloodstained binder from Tri-
City Medical Center with information on how to take care of a newborn,
including paperwork titled “Neonatal Release Care Guide.” Also at the
apartment was a book titled “Parenting, Substance Misuse, and Child
Welfare,” which had some pages that had been tabbed or highlighted, some
insurance paperwork for LB Medical Group LLC for midwife services, and a
printout from a website titled “Emergency Labor. What To Do If You Have
To Give Birth Alone,” which was a “step-by-step” guide. Detective Malone
testified that the printout stated that “step 2 is to call 911” and he “recall[ed]
somewhere around step 5 or 6 it tells you what to do with the umbilical cord.
And it says to not cut the umbilical cord because of the blood and other life-
saving things that are in there to help keep the baby alive while you wait for
EMS to arrive.” Other items found at the apartment included a contraction
timer, crib, a changing table, baby toys, gauze dressing pads, a fetal Doppler
monitor, an opened packet of antibiotic ointment, a plastic or rubber bulb
suction, a baby bottle, and other baby care items.
       Detective Malone also testified that officers found drug paraphernalia
in Carpenter’s apartment, including a plastic ice cream scoop with
crystallized methamphetamine in it and a crushed aluminum can containing
black tar heroin residue. Carpenter told officers that the drug paraphernalia
belonged to someone named Ryan K. who had recently been at her

                                        13
apartment. She said that she had been receiving daily treatment for
methadone, but that was the extent of her drug use.
C. Autopsy and Cause of Death
      Medical examiner Dr. Anna Park determined the cause of death to be
“perinatal death associated with methamphetamine and buprenorphine
exposure and unattended delivery.” Dr. Park concluded in her medical report
and at the hearing that the manner of death was “accidental,” but she agreed
that other medical examiners could reasonably have concluded the cause of
death to be “undetermined.” When questioned at the hearing what she
meant by “unattended delivery,” Dr. Park stated that the phrase was “meant
to describe the fact that improper procedure was performed in order -- at the
time of delivery, which included not clamping the umbilical cord upon cutting
the cord. In addition, no sterile procedure was used to cut the cord, and there
was no medical personnel to -- present to monitor the fetus upon delivery.
Typically, you have fetal monitoring during the time of delivery too. And, in
essence, also to describe the hemorrhaging at the umbilical stump which was
apparent at the time of the autopsy.” She also testified to seeing dried blood
around the umbilical stump and the baby’s abdomen, that Kiera had been
“wrapped in a hospital blanket” that was “soaked” in blood, and that her
diaper “was also covered in blood,” although the amount of blood was
“unquantifiable.”
D. Magistrate’s Findings
      At the end of the hearing, the magistrate judge issued her findings,
stating that she found sufficient evidence under the probable cause standard
to bind Carpenter over on the implied malice murder charge: “In terms of the
implied malice murder, the subjective awareness, and the conscious disregard

                                      14
for human life, I do find that there is sufficient evidence for a preliminary
hearing. I do find that there is sufficient evidence of that.”
      The magistrate focused on Carpenter’s actions before Kiera’s birth as
she explained her findings: “She had -- what’s interesting is that she’s taken
a lot of steps to prepare for having this baby at home. And her goal is not to
have CWS involved because she’s aware of what’s going to happen if she does
have this at the hospital because of what had happened to her other two
children. So her desire to not get CWS involved really overcame her duty to
make sure that this baby was delivered safely. [¶] Not that she didn’t make
efforts to have a safe delivery in a sense: The article that she had at her
house, her inquiry as to a nurse, her inquiry of a midwife, which indicates to
this Court that she was aware that she shouldn’t be having this baby by
herself at home without any kind of medical training, and that it was not safe
to do so. So I do find that there is subjective awareness there.”
      The magistrate continued: “But even if she had this baby
unexpectedly, wasn’t expecting to go into labor early, she had multiple
opportunities to go to the hospital, and she had multiple people telling her by
text message that she needed to go to the hospital and get help and not
deliver this baby alone. But, again, she chose not to do that because of her
desire not to have CWS involved. And so when I listen to that evidence and
consider that evidence, I do find that there is enough for a preliminary
hearing bind-over, that there is implied malice.”
      Moving on to the element of causation and her conclusion, the
magistrate stated: “As to the expert testimony that I believe that you will
ultimately get out, Mr. White, from your experts -- and I had the doctor here
testify. And her analysis and cause of death was different than, I believe,
what your expert is going to testify to. She did agree to some points, but

                                       15
ultimately, her cause of death did not change even with the report that you
had asked her about. And so for all of those reasons, and based on the
evidence that this Court heard, I do believe that there’s probable cause to
believe that the following offenses in Counts 1, 2, and the allegation attached
to Count 2 have been committed and the defendant is guilty thereof. So I do
bind this case over to the Superior Court on both charges and the allegation
in Count 2.”
      At the end of the hearing, the complaint was deemed to be an
information, Carpenter was arraigned, and she entered a plea of not guilty to
both counts.
E. Penal Code Section 995 Motion to Dismiss
      In January 2023, Carpenter filed a motion to dismiss the information
pursuant to Penal Code section 995 (section 995 motion). Carpenter argued
that the newly enacted Assembly Bill No. 2223, which added and amended
certain sections of the Health and Safety Code, immunizes her from
prosecution, and that the People failed to present sufficient cause to bind the
case over for trial.
      The trial court heard argument and denied the motion, finding that the
magistrate could properly infer that the evidence of Carpenter’s post-birth
conduct was sufficient to bind her over on the implied malice murder charge.
The trial court stated: “The court can and [the magistrate] can infer from the
conduct of the defendant in doing those things and not calling 9-1-1, she
failed to act in her daughter’s best interest. She failed to get her daughter
the medical help that she should have known that her daughter needed
because she should have understood that she didn’t have the medical training
necessary to deliver her own child.”

                                       16
F. Writ Proceeding
      After Carpenter filed the present petition for a writ of prohibition, we
issued an order directing the superior court to show cause why the relief
sought in the petition should not be granted and stayed the criminal
proceedings against Carpenter in trial court. The People filed a return, and
Carpenter filed a reply.
                                 DISCUSSION
                                        I
      “When we review a section 995 motion, we ‘disregard[] the ruling of the
superior court and directly review[] the determination of the magistrate.’ ”
(People v. San Nicolas (2004) 34 Cal.4th 614, 654 (San Nicolas).) The
magistrate’s job at the preliminary hearing is “to determine whether there is
‘sufficient cause’ to believe defendant guilty of the charged offense.” (People
v. Abelino (2021) 62 Cal.App.5th 563, 573 (Abelino); see also Pen. Code,
§ 872.) “Sufficient cause” in this context means “ ‘reasonable and probable
cause,’ ”—in other words, facts that would lead a person “of ordinary caution
or prudence to believe and conscientiously entertain a strong suspicion of the
guilt of the accused.” (People v. Uhlemann (1973) 9 Cal.3d 662, 667.) It is a
level of proof below preponderance of the evidence. (People v. Superior Court
of San Diego County (2021) 73 Cal.App.5th 485, 496 (Valenzuela).)
      When a defendant files a section 995 motion, the court must set aside
the information if the defendant has been committed without reasonable or
probable cause. (Pen. Code, § 995, subd. (a)(2)(B).) To establish probable
cause sufficient to withstand the motion, “ ‘the People must make some
showing as to the existence of each element of the charged offense.’ ” (People
v. Scully (2021) 11 Cal.5th 542, 582.) Evidence sufficient to justify a
prosecution need not be sufficient to support a conviction. (Ibid.) Indeed, it

                                       17
is well settled that, when it comes to the required showing for probable cause,
the bar is “ ‘exceedingly low.’ ” (Abelino, supra, 62 Cal.App.5th at p. 573.)
      In reviewing the section 995 motion, we “conduct an independent
review of the evidence, but will not substitute our judgment for that of the
magistrate as to the credibility or weight of the evidence.” (San Nicolas,
supra, 34 Cal.4th at p. 654.) Absent express findings, however, we “cannot
assume [the magistrate] has resolved factual disputes or passed upon the
credibility of witnesses.” (People v. Slaughter (1984) 35 Cal.3d 629, 638
(Slaughter).)
      Carpenter argues that the trial court improperly substituted itself as
factfinder in reviewing the magistrate’s ruling, and she urges this court not
to “reweigh the facts.” But the magistrate here did not resolve any factual
disputes or assess the credibility of the witnesses. Rather, the magistrate
merely accepted the prosecution’s evidence and determined it was sufficient
to support the charges against Carpenter, stating: “In terms of the implied
malice murder, the subjective awareness, and the conscious disregard for
human life, I do find that there is sufficient evidence for a preliminary
hearing. . . . [B]ased on the evidence that this Court heard, I do believe that
there’s probable cause to believe that the following offenses in Counts 1, 2,
and the allegation attached to Count 2 have been committed and the
defendant is guilty thereof.” We find that this is a legal conclusion. (See
Slaughter, supra, 35 Cal.3d at p. 638; Zemek v. Superior Court (2020) 44
Cal.App.5th 535, 546 (Zemek) [where “the prosecution witnesses’ testimony
‘was not inherently improbable, [they were] not significantly impeached, and
the [magistrate] made no findings as to [their] demeanor,’ [the court] must
conclude that the magistrate’s remarks are legal conclusions”].)

                                       18
      Because the magistrate made a legal conclusion rather than factual
findings, we review the record independently to determine whether the
evidence presented at the preliminary hearing constituted sufficient cause to
sustain the charges in the information. (Zemek, supra, 44 Cal.App.5th at
p. 546; Valenzuela, supra, 73 Cal.App.5th at p. 499.) And where, as here, a
challenge to the sufficiency of the evidence is based on the interpretation of a
statute, our interpretation of the statute is de novo as well. (People v.
Gallardo (2015) 239 Cal.App.4th 1333, 1340.) We will not set aside the
information “ ‘if there is some rational ground for assuming the possibility
that an offense has been committed and the accused is guilty of it.’ ” (San
Nicolas, supra, 34 Cal.4th at p. 654.)
                                         II
      We first analyze Carpenter’s contention that the People’s prosecution of
her in this case is prohibited because the evidence consists entirely of conduct
protected by sections 123462 and 123467. To do so, we must interpret the
statutes to determine whether and how they apply here. Our fundamental
task in interpreting a statute is to ascertain the Legislature’s intent so as to
effectuate its purpose. (Cummins, Inc. v. Superior Court (2005) 36 Cal.4th
478, 487.) In determining that intent, we “look first to the words of the
statute, which are the most reliable indications of the Legislature’s intent.”
(Ibid.) We do not construe those words in a vacuum; we consider the
provisions at issue “in the context of the statutory framework as a whole.”
(Ibid.) “ ‘If the statutory language is unambiguous, then its plain meaning
controls. If, however, the language supports more than one reasonable
construction, then we may look to extrinsic aids, including the ostensible
objects to be achieved and the legislative history.’ ” (Kim v. Reins
International California, Inc. (2020) 9 Cal.5th 73, 83.)

                                         19
A. Assembly Bill No. 2223
      The day after Carpenter’s preliminary hearing, Governor Newsom
signed several bills relating to reproductive health care access and privacy
into law. One of these was Assembly Bill No. 2223 (2021–2022 Reg. Sess.),
which went into effect on January 1, 2023 (Assembly Bill 2223). It made
several changes to the Reproductive Privacy Act, including amending section
123462 and adding section 123467 to the Health and Safety Code.
Substantively, these changes included: prohibiting a person from being
subject to civil or criminal liability based on their actions or omissions with
respect to their pregnancy or actual, potential, or alleged pregnancy outcome,
or based solely on their actions to assist a pregnant person exercising their
reproductive rights; clarifying that an abortion is not unauthorized if
performed by the pregnant person; authorizing a party whose rights are
protected by the Reproductive Privacy Act to bring a civil action against an
offending state actor when those rights are interfered with; and authorizing a
person aggrieved by a violation of the Reproductive Privacy Act to bring a
civil action pursuant to the Tom Bane Civil Rights Act. Assembly Bill 2223
also amended the Government Code relating to coroners’ handling of fetal
deaths, and prohibited the use of a coroner’s statements on the certificate of
fetal death to establish, bring, or support a criminal prosecution or civil cause
of damages against a person immune from liability relating to their
pregnancy or actual, potential, or alleged pregnancy outcome as set forth in
the Reproductive Privacy Act.
B. Statutory Language
      We turn first to the language of the relevant portions of sections
123462 and 123467. Section 123462 sets forth the Legislative findings and
declarations with respect to the Reproductive Privacy Act, which was first

                                       20
enacted in 2002 and originally provided, in relevant part: “The Legislature
finds and declares that every individual possesses a fundamental right of
privacy with respect to personal reproductive decisions.” (§ 123462, Stats.
2002, ch. 385 (Sen. Bill 1301), § 8.) Assembly Bill 2223 amended this
provision to add language defining “personal reproductive decisions” as
entailing “the right to make and effectuate decisions about all matters
relating to pregnancy, including prenatal care, childbirth, postpartum care,
contraception, sterilization, abortion care, miscarriage management, and
infertility care.” (§ 123462, italics added.) “Pregnancy” is defined in section
123464, subdivision (b), as “the human reproductive process, beginning with
the implantation of an embryo.”
      Assembly Bill 2223 also added Section 123467 as follows:
“Notwithstanding any other law, a person shall not be subject to civil or
criminal liability or penalty, or otherwise deprived of their rights under this
article, based on their actions or omissions with respect to their pregnancy or
actual, potential, or alleged pregnancy outcome, including miscarriage,
stillbirth, or abortion, or perinatal death due to causes that occurred in utero.”
(§ 123467, subd. (a), italics added.)
      Health and Safety Code section 123464 does not define “perinatal,” but
Welfare and Institutions Code section 14134.5 defines it as “the period from
establishment of pregnancy to one month following delivery.” (Welf. & Inst.
Code, § 14134.5, subd. (b).) Elsewhere in the Health and Safety Code, the
Legislature defines “perinatal care” as “care received from the time of
conception through the first year after birth.” (Health & Saf. Code, § 123485,
subd. (d).) The International Encyclopedia of Public Health provides that the
term “perinatal” is generally used to describe the period from approximately
22 completed weeks of pregnancy up to seven completed days of life. (See

                                        21
Assem. Com. on Judiciary, Analysis of Assem. Bill No. 2223 (2021–2022 Reg.
Sess.) Apr. 5, 2022, p. 10 [citing L.S. Bakketeig, P. Bergsjø, “Perinatal
Epidemiology” (2008), p. 45].)
      We need not decide which of these definitions applies here. Following
any of them, the plain language of the statute clearly encompasses actions or
omissions during pregnancy alleged to have caused Kiera’s death within
hours of her birth. There is thus no question that the statute prohibits the
prosecution of Carpenter for any effect that her alleged drug use or lack of
prenatal care may have had on Kiera, or her decision to have a home birth
(which is also separately protected because section 123467 mandates that a
person may not be deprived of their right under section 123462 “to make and
effectuate decisions about all matters relating to pregnancy,
including . . . childbirth”)—regardless of whether such acts or omissions may
have contributed to Kiera’s death. All of these acts fall within the plain

language of the immunity established by section 123467.3

3     At oral argument, counsel for Carpenter argued that cutting the
umbilical cord is an “action[] . . . with respect to [her] pregnancy” as
contemplated by section 123467 and is therefore also protected conduct under
the statute. Read in isolation, we acknowledge that this is one possible
interpretation of the statutory phrase “with respect to their pregnancy,”
which the Legislature has not further defined. We also agree with Carpenter
that pregnancy and childbirth exist along a continuum. It is thus difficult to
pinpoint the precise moment at which a pregnancy ends and actions can no
longer be characterized as being taken “with respect to” the pregnancy.
Under Carpenter’s broad interpretation, however, the statute would confer
immunity even if she had deliberately decided not to clamp the umbilical cord
for the purpose of causing her baby to bleed to death. We do not believe the
Legislature intended to create such immunity for perinatal deaths. Based on
the statutory language read as a whole, we conclude that the Legislature
intended to limit the immunity for perinatal deaths to “causes that occurred
in utero.” (§ 123467, subd. (a).) As we will further explain, any ambiguity in
the statutory language is resolved by the legislative history, which indicates
                                       22
      The People do not dispute this conclusion as it relates to the actus reus
of the charges filed against Carpenter. Rather, they contend that: (1) the
phrase “perinatal death due to causes that occurred in utero” renders section
123467 inapplicable to this case, because it is Carpenter’s acts and omissions
after Kiera’s birth, not while she was in utero, that form the basis of the
charges against Carpenter, and the prosecution therefore falls outside the
purview of Assembly Bill 2223; and (2) although Carpenter cannot be
prosecuted for her acts or omissions during her pregnancy prior to Kiera’s
birth, such conduct can be used to demonstrate the necessary mens rea—
here, implied malice.
      Carpenter, on the other hand, contends that the magistrate’s
consideration of the evidence of her conduct during pregnancy was consistent
with the People’s now unlawful theory of the case: that she made a criminal
error in deciding, against the advice of others, to give birth at home alone;
and that decision, along with her drug use, resulted in the death of her baby.
(See §§ 123462 and 123467, subd. (a).) According to Carpenter, the People
have now pivoted to a new theory based on her conduct after Kiera’s birth,
but there is no way to extricate her conduct during pregnancy from the effect
that conduct allegedly had on her pregnancy outcome. She argues that
evidence of her pre-birth conduct is therefore inadmissible, because allowing
the People to present such evidence to prove the intent element of her
allegedly criminal post-birth conduct would undermine the legislative intent
of Assembly Bill 2223.
      We conclude first that sections 123462 and 123467, subdivision (a), do
not prohibit the People’s prosecution of Carpenter for post-birth acts or

that the Legislature passed this statute mainly with the intent of providing
immunity for adverse pregnancy outcomes due to self-managed abortions or
drug use during pregnancy. (See Section II.C., post.)
                                       23
omissions that may have led to Kiera’s death. Any such cause of perinatal
death would necessarily not have “occurred in utero,” and thus does not fall
under the types of pregnancy outcomes shielded from prosecution by section
123467. (§ 123467, subd. (a).) Section 123462 protects Carpenter’s right to
have a home birth and make decisions regarding her childbirth, but there is
no indication from the statutory language that the Legislature intended to
also immunize all otherwise criminal acts or omissions occurring after a live
birth.
         The evidentiary use of Carpenter’s pre-birth conduct presents a more
challenging issue. Though it is a close call, we believe the People have the
better argument here and conclude there is no categorical exclusion of pre-
birth evidence.
         First, the plain language of Assembly Bill 2223 does not prohibit the
use of a person’s conduct during pregnancy as evidence of implied malice or
any other criminal intent if the person is not otherwise immune to
prosecution. We will not infer from the statute an evidentiary rule not
expressly stated. (See Cornette v. Department of Transportation (2001) 26
Cal.4th 63, 73–74 (Cornette) [“A court may not rewrite a statute, either by
inserting or omitting language, to make it conform to a presumed intent that
is not expressed.”].)
         Carpenter’s argument is further undermined by the fact that elsewhere
in Assembly Bill 2223, the Legislature included express language similar to
the rule she implicitly argues for here. The bill amended section 103005,
which requires a coroner to include certain facts on a fetal death certificate,
to add the following: “This section shall not be used to establish, bring, or
support a criminal prosecution or civil cause of action seeking damages
against any person who is immune from liability under Section 123467.”

                                         24
(§ 103005, subd. (b), italics added.) Thus, had the Legislature intended to
enact a similar evidentiary rule relating to conduct during pregnancy, it
“clearly knew” how to do so and could have explicitly so stated. (People v.
Albillar (2010) 51 Cal.4th 47, 56; see also Cornette, supra, 26 Cal.4th at p. 73
[“When one part of a statute contains a term or provision, the omission of
that term or provision from another part of the statute indicates the
Legislature intended to convey a different meaning.”].)
      Moreover, taking Carpenter’s interpretation of the statute to its logical
conclusion would lead to absurd consequences. What if, for example, a
defendant made statements while pregnant that she intended to smother her
baby to death once it was born and thought it would be easier to get away
with the act at home than in the hospital, and then in fact did so in the hours
after the baby was born? We do not believe the Legislature intended through
Assembly Bill 2223 to prevent the prosecution from using such statements as
evidence of intent to kill simply because they were made during pregnancy,
but that would be the result compelled by Carpenter’s statutory
interpretation. We therefore conclude, based on the statutory language and
principles of statutory construction, that the prosecution is not categorically
precluded from using pre-birth conduct as evidence of Carpenter’s intent.
C. Legislative History
      Even if the statutory language were ambiguous, the legislative history
of Assembly Bill 2223 further supports our conclusion that sections 123462
and 123467 do not categorically prohibit the People’s prosecution of
Carpenter or their reliance on her statements during pregnancy as evidence
of intent in this case. There is nothing in the legislative history to indicate
that the Legislature intended to immunize all post-birth conduct associated
with pregnancy and home birth.

                                       25
      Assembly Bill 2223’s findings and declarations define reproductive
justice as “the human right to control our bodies, sexuality, gender, work, and
reproduction,” which at its core is “the belief in the right to bodily autonomy,
the right to have children, the right to not have children, and the right to
parent the children we have with dignity and respect in safe and sustainable
communities.” The bill explains that the prohibition of “civil and criminal
penalties for people’s actual, potential, or alleged pregnancy outcomes” is
critical to making reproductive justice a reality for all Californians. Indeed,
Assembly Bill 2223 was passed in part in response to criminal prosecutions
across the country of people for “having miscarriages or stillbirths or for self-
managing an abortion,” and the bill’s findings and declarations, drafted by
the bill’s author, note that “California has not been exempt. Despite clear
law that ending or losing a pregnancy is not a crime, police have investigated
and prosecutors have charged people with homicide for pregnancy losses. For
example, the District Attorney in the County of Kings prosecuted two women
for murder after they suffered stillbirths.” Each woman was prosecuted (and
imprisoned) based on the theory that her drug use during pregnancy caused
the death of her fetus. (Sen. Com. on Judiciary, Analysis of Assem. Bill
No. 2223 (2021–2022 Reg. Sess.) May 19, 2022, p. 8.) This background
provides useful context and further elucidates that one of the Legislature’s
main goals in passing the bill was to prohibit the criminalization of adverse
pregnancy outcomes due to self-managed abortions or drug use during
pregnancy.
      Underscoring these points are the June 20, 2022 bill analysis
comments from the Senate Rules Committee: “Even though existing state
law does not criminalize a person’s own actions that might result in a
pregnancy loss, two women were recently charged and imprisoned for their

                                       26
pregnancy losses in California. In response to this, the bill reaffirms and
strengthens protections in existing state law that prohibit civil or criminal
liability for the acts of a pregnant person in relation to their pregnancy
outcomes.” (Sen. Rules Com., 3d reading analysis of Assem. Bill 2223 (2021-
2022 Reg. Sess.) as amended June 20, 2022, p. 4, italics added.) The
comments additionally note that, “in response to” the United States Supreme
Court’s recent opinion in Dobbs v. Jackson Women’s Health (June 24, 2022)
__ U.S. __ 142 S.Ct. 2228 overturning “almost 50 years of precedent that the
right to an abortion was protected under the U.S. Constitution” and a recent
Texas law banning abortions beginning six weeks after a person’s last
menstrual period, Assembly Bill 2223 “seeks to ensure that no one in the
State of California is investigated, prosecuted, or incarcerated from ending a
pregnancy or experiencing a pregnancy loss and that their right to
reproductive freedom is protected.” (Sen. Rules Com., 3d reading analysis of
Assem. Bill No. 2223 (2021–2022 Reg. Sess.) as amended June 20, 2022,
pp. 4–5.)
      Moreover, comments from the analysis for the April 5, 2022 hearing of
the Assembly Committee on Judiciary specifically address the People’s
argument that the statute does not immunize a pregnant person from
prosecution for all pregnancy outcomes during the perinatal period. The
phrase “due to causes that occurred in utero” in section 123467 was not
initially included in the statutory language. (See Assem. Com. on Judiciary,
Analysis of Assem. Bill No. 2223 (2021–2022 Reg. Sess.) Apr. 5, 2022, p. 9.) It
was added via amendment to address concerns from opponents to the bill who
argued that the “perinatal death” language could preclude criminal
investigation of an infant’s death regardless of the alleged cause. (Id. at
pp. 9–10.) The bill’s author noted that the statutory language as initially

                                       27
drafted “may not be sufficiently clear that ‘perinatal death’ is intended to be
the consequence of a pregnancy complication. Thus, the bill could be
interpreted to immunize a pregnant person from all criminal penalties for all
pregnancy outcomes, including the death of a newborn for any reason during
the ‘perinatal’ period after birth, including a cause of death which is not
attributable to pregnancy complications, which clearly is not the author’s
intent.” (Id. at p. 10, italics added.)
      The author therefore proposed the following language for section
123467, subdivision (a): “Notwithstanding any other law, a person shall not
be subject to civil or criminal liability or penalty . . . based on their actions or
omissions with respect to their pregnancy or actual, potential, or alleged
pregnancy outcome, including miscarriage, stillbirth, or abortion, or perinatal
death due to a pregnancy-related cause.” (Assem. Com. on Judiciary, Analysis
of Assem. Bill No. 2223 (2021–2022 Reg. Sess.) Apr. 5, 2022, p. 10.) The
phrase “due to a pregnancy related cause” was ultimately revised to “due to
causes that occurred in utero.” (See § 123467, subd. (a).)
      Seeking to avoid the obvious conclusion resulting from this legislative
background, Carpenter argues that her situation exemplifies the
Legislature’s public health concerns and is precisely the type of scenario the
Legislature sought to avoid in enacting Assembly Bill 2223: she planned a
home birth because she reasonably and justifiably feared CWS would remove
her children from her custody based on her substance use disorder as had
happened in the past.
      But her description of the legislative intent is not quite accurate.
Assembly Bill 2223’s declarations and findings state: “The threat of criminal
prosecutions or civil penalties on pregnant people through child welfare,
immigration, housing, or other legal systems has a harmful effect on

                                          28
individual and public health. When a person fears state action being taken
against them related to their pregnancy, they are less likely to seek medical
care when they need it. If they do seek care, punishing them for actual,
potential, or alleged pregnancy outcomes interferes with professional care
and endangers the relationship between providers and patients.” The
various committee analyses of the bill include commentary from the bill’s co-
sponsors noting that the “threat of criminal prosecution has a harmful effect
on individual and public health, because people who fear prosecution due to
their health issues are deterred from seeking care.” (See, e.g., Sen. Com. on
Judiciary, Analysis of Assem. Bill No. 2223 (2021–2022 Reg. Sess.) May 19,
2022, p. 9; Assem. Com. on Health, Analysis of Assem. Bill No. 2223 (2021–
2022 Reg. Sess.) Apr. 19, 2022, p. 6.) This indicates that the Legislature and
sponsors of the bill sought to protect pregnant people from criminalization of
their pregnancy outcomes, not those who avoid seeking medical care because
they are afraid of having their child removed by CWS.
      Indeed, the legislative comments confirm that Assembly Bill 2223 does
not affect the ability of the state to consider, under already-existing child
welfare laws, “a parent’s dangerous acts during pregnancy because those acts
could affect the welfare of a child who is born after the pregnancy. . . . Thus,
a pregnant person’s actions during pregnancy could ultimately affect their
parenting rights and result in the deprivation of those rights.” (Assem. Com.
on Judiciary, Analysis of Assem. Bill No. 2223 (2021–2022 Reg. Sess.) Apr. 5,
2022, p. 9.) The bill’s author proposed adding the phrase “under this article”
to the original language “to clarify that the immunity provided by the bill
only extends to the deprivation of rights related to pregnancy.” (Id. at p. 10.)
The provision as enacted therefore states that a person “under this article,
based on their actions or omissions with respect to their pregnancy or actual,

                                       29
potential, or alleged pregnancy outcome . . . .” (§ 123467, subd. (a), italics
added.) Under the now-effective law, CWS can still remove a child from their
parent’s custody after they are born based on conduct that occurred during
pregnancy, including drug use.
      Viewed against this backdrop, it is clear that the focus of Assembly Bill
2223 was on ensuring no one in California is prosecuted or subject to civil
penalties for ending a pregnancy or experiencing a pregnancy loss, including
due to self-managed abortions or drug use during pregnancy. We therefore
conclude that Health and Safety Code sections 123462 and 123467 do not
automatically preclude prosecution of Carpenter under Penal Code sections
187 and 273a, subdivision (a), for any post-birth conduct that allegedly
caused Kiera’s death, nor do they preclude use of her conduct during
pregnancy as evidence of intent.
      Our determination on this point does not, however, compel us to also
conclude that the People are not at all constrained by Health and Safety Code
sections 123462 and 123467 in terms of the evidence they may rely on in this
case. To the contrary, and as we explain in more detail below, some of the
evidence presented at the preliminary hearing may not be admissible to
demonstrate implied malice for Carpenter’s post-birth conduct, because it
relates to conduct now protected under Assembly Bill 2223.
                                       III
      Having concluded that sections 123462 and 123467 do not
automatically immunize Carpenter from prosecution for Kiera’s death, we
must now determine whether the allowable evidence presented at the
preliminary hearing was sufficient to demonstrate implied malice murder
such that Carpenter was properly bound over on the murder charge.

                                        30
A. Implied Malice Murder
      Murder is the unlawful killing of a person with malice aforethought.
(Pen. Code, § 187, subd. (a).) Malice aforethought can be either express or
implied, with the latter defined as “when no considerable provocation
appears, or when the circumstances attending the killing show an abandoned
and malignant heart.” (Pen. Code, § 188, subd. (a)(2).) The Supreme Court
has interpreted implied malice to have “both a physical and a mental
component. The physical component is satisfied by the performance of an act,
the natural consequences of which are dangerous to life.” (People v. Chun
(2009) 45 Cal.4th 1172, 1181 (Chun), internal quotation marks omitted.) It is
also satisfied by the failure to act where the defendant has a legal obligation
to act. (People v. Werntz (2023) 90 Cal.App.5th 1093, 1115 (Werntz).)
Carpenter had such an obligation here, as “parents have a common law duty
to protect their children and may be held criminally liable for failing to do
so.” (People v. Rolon (2008) 160 Cal.App.4th 1206, 1219; see also Werntz, at
p. 1116 [finding physical component of implied malice murder satisfied where
mother failed to protect her daughter].)
      The mental component is satisfied where the defendant knows that
their “ ‘conduct endangers the life of another and . . . acts with a conscious
disregard for life.’ ” (Chun, supra, 45 Cal.4th at p. 1181.) The standard is
subjective—the defendant must have “actually appreciated the risk involved.”
(People v. Watson (1981) 30 Cal.3d 290, 297 (Watson).) Given that there is
rarely direct evidence of subjective awareness, it often must be proved by
circumstantial evidence. (See Valenzuela, supra, 73 Cal.App.5th at p. 502.)
      Thus, to establish implied malice, the People must prove four elements:
(1) Carpenter intentionally committed the act in question or intentionally
failed to act; (2) the natural and probable consequences of which were

                                       31
dangerous to human life; (3) at the time she acted or failed to act, she knew
her act or failure to act was dangerous to human life; and (4) she deliberately
acted or failed to act with conscious disregard for human life. (See Chun,
supra, 45 Cal.4th at p. 1181; Werntz, supra, 90 Cal.App.5th at pp. 1115–
1116.)
B. Analysis
      Carpenter contends that the People failed to present evidence of two of
the required elements of implied malice murder: (1) the mental component, or
subjective knowledge of danger to life; and (2) causation. In this procedural
posture, we do not determine whether there is substantial evidence satisfying
these components of implied malice; rather, we must determine whether,
“[c]onsidering all the evidence and reasonable inferences at this stage of the
proceedings, there is ‘some rational ground for assuming the possibility’ ” that
there is sufficient evidence in support of these elements. (Valenzuela, supra,
73 Cal.App.5th at p. 504, italics added.) We conclude that there is.
      1. Sufficiency of the Evidence of Causation
      The People rely mainly on Carpenter’s act of cutting Kiera’s umbilical
cord without properly securing it as well as her alleged failure to timely call
911 to support the physical component of the implied malice murder charge.
Carpenter does not dispute the fact that she cut the umbilical cord or the
timing of her call to 911. Instead, she argues that there is a lack of evidence
showing that her action or inaction caused Kiera’s death. We find that
sufficient evidence was presented at the preliminary hearing to demonstrate
probable cause that Carpenter’s failure to properly secure the umbilical cord

                                       32
and/or seek medical attention for Kiera after she continued bleeding caused

her death.4
      Dr. Park, the medical examiner who conducted Kiera’s autopsy,
testified at the preliminary hearing that her determination as to Kiera’s
cause of death was “perinatal death associated with methamphetamine and
buprenorphine toxicity and unattended delivery.” She stated that
“unattended delivery” was “meant to describe the fact that improper
procedure was performed in order -- at the time of delivery, which included
not clamping the umbilical cord upon cutting the cord. In addition, no sterile
procedure was used to cut the cord, and there was no medical personnel to --
present to monitor the fetus upon delivery. Typically, you have fetal
monitoring during the time of delivery too. And, in essence, also to describe
the hemorrhaging at the umbilical stump which was apparent at the time of
the autopsy.” She also testified to seeing dried blood around the umbilical
stump and the baby’s abdomen, that Kiera had been “wrapped in a hospital
blanket” that was “soaked” in blood, and that her diaper “was also covered in
blood.”
      Dr. Park further described her review of Tri-City Medical emergency
records, including a report from one of the doctors who attempted to save

4     However, we reject the People’s contentions that two of the specific
omissions by Carpenter that were dangerous to Kiera’s life were (1) her
refusal to call 911 when Kiera would not latch and (2) her decision to wait 30
minutes to call 911 after waking up to Kiera’s lifeless body. First, we agree
with Carpenter that a baby’s inability to latch and breastfeed within hours of
being born does not present an emergency dangerous to life, and Kiera’s
death therefore cannot be attributed to the fact that Carpenter did not call
911 when Kiera was unable to latch. Second, the People do not argue—and
presented no evidence—that Kiera was still alive when Carpenter awoke.
The failure to call 911 after the infant had already died cannot, both as a
matter of law and common sense, be a cause of her death.
                                      33
Kiera’s life, stating that the emergency department doctor’s assessment was
that the baby had died due to fatal blood loss from the umbilical stump. She
testified: “I would agree that, yes, the blood loss -- the acute blood loss is
something very substantial and contributed to the death of the baby.” We
conclude that Dr. Park’s testimony is sufficient to meet the “ ‘exceedingly
low’ ” hurdle the prosecution needs to clear at a preliminary hearing in terms
of demonstrating that blood loss from the umbilical stump caused Kiera’s
death. (Abelino, supra, 62 Cal.App.5th at p. 573.)
      In arguing to the contrary, Carpenter points to Dr. Park’s testimony
and medical report stating that the baby’s manner of death was “accidental,”
and her description of the acute blood loss as a mere “contribution” to death,
rather than the cause. While true, these distinctions are not material. First,
Dr. Park’s determination of the manner of death as accidental is a medical,
not legal, conclusion. Even if a death is accidental or unintentional, it may
still have been caused by an act or omission committed with implied malice.
Second, an act or a failure to act causes death “if it is a substantial factor in
causing the death. A substantial factor is more than a trivial or remote
factor. However, it does not need to be the only factor that causes the death.”
(People v. Cornejo (2016) 3 Cal.App.5th 36, 60, quoting CALCRIM No. 520;
see also People v. Jennings (2010) 50 Cal.4th 616, 643 (Jennings) [an act may
be considered the proximate cause of death where it was a “substantial
factor” contributing to the death].)
      Dr. Park testified that she believed Kiera’s blood loss was “something
very substantial” that contributed to the baby’s death. No more is required
at this stage. Thus, because there is some evidence that Carpenter either
caused the blood loss by cutting the umbilical cord without clamping it or
failed to stop the blood loss or call 911 as part of her legal duty to protect

                                        34
Kiera, there is probable cause of causation. (See Jennings, supra, 50 Cal.4th
at p. 643 [“ ‘[A]s long as the jury finds that without the criminal act the death
would not have occurred when it did, it need not determine which of the
concurrent causes was the principal or primary cause of death.’ ”].)
      Carpenter also argues that the only evidence at the preliminary
hearing regarding the point from which Kiera had experienced hemorrhaging
showed that it was at the umbilical cord’s point of insertion into the placenta,
not any allegedly improper cutting of the cord. This is not accurate, as
Dr. Park testified that (1) the ER physician, Dr. Ma, “thought the baby had
died because there was exsanguination or fatal blood loss from the umbilical
stump,” and (2) Dr. Park agreed with Dr. Ma that “the acute blood loss is
something very substantial and contributed to the death of the baby.” But
even where physicians have competing views of the cause of death, and even
if the defense theory is more plausible, the court may “not find an absence of
probable cause simply because it finds the defense witnesses slightly more
persuasive than the prosecution witnesses.” (Cooley v. Superior Court (2002)

29 Cal.4th 228, 257–258 (Cooley).)5
      Moreover, Dr. Park testified that she could state with reasonable
medical certainty that it was “likely that the baby could have survived” if a
third party with medical training had been present at the birth. She based
her opinion on the fact that someone such as a “midwife would have known
how to deliver a baby properly to prevent acute blood loss and to have
monitored the baby upon delivery to make sure that the cord and the
placenta was delivered properly.” Although Carpenter may not be prosecuted

5     Although Cooley involved a determination of probable cause by a
superior court in a sexually violent predator case rather than a preliminary
hearing in a criminal case, the Supreme Court concluded that the standard of
review for each is the same. (Cooley, supra, 29 Cal.4th at p. 257.)
                                       35
for choosing to have a home birth without a midwife or any other medical
professional present, this testimony still supports an inference that, had
Carpenter called 911 after being unable to properly secure Kiera’s umbilical
cord, Kiera would not have experienced fatal blood loss.
      We thus conclude that the People have presented evidence that is
sufficient to support a finding of probable cause that Carpenter’s failure to
stop Kiera’s blood loss—whether by cutting the umbilical cord and failing to
secure the umbilical stump or by not calling for medical assistance when her
baby was bleeding—caused her death. To be clear, however, the prosecution
cannot rely on a theory that Kiera’s death was attributable to
methamphetamine and/or buprenorphine toxicity caused by Carpenter’s drug
use during pregnancy.
      2. Sufficiency of the Evidence of Subjective Knowledge
      Carpenter also contends that the People failed to present evidence that
she had the subjective awareness of danger to life necessary to show that she
acted with implied malice. The People argue that Carpenter’s awareness of
the risk to Kiera’s life is evidenced by: (1) her text messages to and from
people before Kiera was born, with multiple people warning her of the
dangers of having a baby at home alone; (2) her text messages warning others
not to call 911; (3) her attempt to stop Kiera’s bleeding by placing a piece of
tape on the umbilical stump; (4) her statement to Detective Malone that at
one point, she started giving Kiera CPR, but it was not working; and (5) an
article she printed warning of the dangers of having a home birth and
containing instructions not to cut the baby’s umbilical cord. They further
point to evidence presented at the hearing that after Kiera was born, she
turned blue and was having trouble breathing, was bleeding from her
umbilical stump, had a pool of blood in her diaper, had blood on her clothing,

                                       36
and became limp—all of which are visible signs of a medical emergency.
According to the People, these facts demonstrate that Carpenter knew Kiera
was having a medical emergency, but she willfully failed to seek medical
assistance.
      Although we have concluded there is no categorical preclusion of pre-
birth evidence, some of the pre-birth evidence relied on by the People still
raises delicate evidentiary issues because it relates directly to Carpenter’s
protected conduct. For example, any statements from Carpenter’s friends
and family expressing their opinions, before Kiera’s birth, that merely having
a home birth is dangerous go directly to Carpenter’s protected conduct in
choosing to have an unattended home birth. These statements are less
directly relevant (if at all) to the question of Carpenter’s subjective awareness
of the specific danger to Kiera’s life after she was born. And even if relevant,
the admission of this evidence at trial could create a risk of conviction on the
prohibited theory that Carpenter chose to give birth at home with knowledge
of the risks, raising a potential admissibility issue under Evidence Code
section 352. Many of Carpenter’s own pre-birth text messages raise similar
evidentiary issues because they also go to her mental state with respect to
her protected decision to give birth at home on her own. We do not decide
these evidentiary questions, however, because we do not need to rely on any
of this evidence to resolve the probable cause question before us.
      We conclude that the evidence of Carpenter’s statements about what
happened after Kiera was born constitutes probable cause in support of the
subjective knowledge element of the implied malice murder charge.
Carpenter told Officer O’Neill that after she gave birth, “the baby was not
breathing, [and] possibly had a nasal passage blockage.” She told Detective
Malone that “[t]he baby was crying, and she cut the umbilical cord using

                                       37
medical scissors and put some cloth over the end of the umbilical cord and
tried to start nursing the baby. And at that point, the baby seemed like she
was having trouble breathing and started turning blue, so she started giving
the baby CPR but it wasn’t working.”
      Carpenter argues in a footnote that we should ignore Detective
Malone’s testimony on this point because it is contrary to other evidence
presented at the hearing, though she claims not to be asking us to reweigh
the evidence to make a credibility determination. She attempts to thread the
needle between the two by contending that because the magistrate did not
rely on this portion of the record, we may not do so either. She is incorrect.
As we have explained, the magistrate made a legal conclusion regarding the
sufficiency of the evidence, and we are therefore required to conduct an
independent review of the entire record to determine whether the prosecution
presented evidence demonstrating probable cause. (Valenzuela, supra, 73
Cal.App.5th at p. 499.)
      In conducting that review, we conclude that the testimony from
Detective Malone and Officer O’Neill about Carpenter’s statements is
sufficient to demonstrate her subjective awareness of the danger to life for
purposes of the preliminary hearing. A baby that is struggling to breathe
and turning blue is clearly in distress and in need of medical attention, and
Carpenter’s awareness of this fact is further demonstrated by her attempt to

administer CPR to Kiera.6 Carpenter argues that the People improperly rely

6     Although Carpenter also told law enforcement that she could not call
911 because her phone was dead, it is unclear whether she meant that her
phone was dead when she woke up on November 15, or it was already dead
right after she gave birth when Kiera was “not breathing,” she was “turning
blue,” and the CPR “wasn’t working,” and Carpenter passed out before she
was able to charge her phone enough to dial 911. However, at a probable
cause hearing, “[e]very legitimate inference that may be drawn from the
                                       38
on the reasonable person standard instead of Carpenter’s own subjective
awareness, as required to show implied malice. But under these
circumstances, “[i]t takes no leap of logic . . . to conclude that because anyone
would be aware of the risk, [Carpenter] was aware of the risk.” (People v.
Moore (2010) 187 Cal.App.4th 937, 941 (Moore) [concluding that record
contained substantial evidence that the defendant acted with implied
malice].)
      Though a closer call, we conclude that Carpenter’s subjective
awareness of the danger to Kiera’s life can also be inferred from the fact that
the infant was bleeding from her umbilical stump after Carpenter cut the
cord. Carpenter did not expressly state that she was aware Kiera was
bleeding, but that fact can be inferred from the blood that was on the piece of
tape she applied to the umbilical stump, which had pooled in the infant’s
diaper and seeped onto her blanket. Dr. Park testified that the only place on
Kiera’s body the blood could have come from was where her umbilical cord
had been cut. If an hours-old, prematurely born infant continues to bleed
from her umbilical stump despite attempts to stop that bleeding, one can
infer that any parent would be aware that the situation presented a medical
emergency. (See Moore, supra, 187 Cal.App.4th at p. 941.)
      We recognize that there is more than one reasonable interpretation of
the evidence presented at the hearing regarding Kiera’s blood loss. It is
possible, for example, that there was very little bleeding until after Carpenter
passed out, so she did not actually witness an amount of bleeding that would
lead her to believe Kiera was experiencing a medical emergency. Or, as
Dr. Park admitted, it would be reasonable to think that Carpenter, who had

evidence must be drawn in favor of the information.” (Rideout v. Superior
Court (1967) 67 Cal.2d 471, 474 (Rideout).) We must therefore infer that
Carpenter could have called 911 but did not do so.
                                       39
been bleeding profusely herself after giving birth, had transferred some of her
own blood to Kiera’s diaper before putting it on the infant. Again, however,
we must draw every legitimate inference that can be drawn from the
evidence in favor of the prosecution. (Rideout, supra, 67 Cal.2d at p. 474.)
The question at this point is not whether the prosecution’s evidence will
support a conviction, or even whether it is persuasive, but whether it
demonstrates probable cause. (See id. at p. 475.)
      The People also contend that the article found at Carpenter’s home
containing instructions on what to do in an emergency home birth, including
a warning not to cut the umbilical cord, further demonstrates her subjective
awareness that cutting the cord presented a danger to human life. Carpenter
argues that the inference the People seek to draw from the presence of this
article in her apartment is purely speculative, pointing to the fact that the
prosecutor herself admitted at the preliminary hearing that, “of course I have
no idea and I cannot speculate whether or not she actually read [the article.]”
But other evidence presented at the hearing supports the inference that
Carpenter read the article.
      For example, Carpenter told Shannon that she had previously read
online about “the percentages of the bad things happening during home
births”; she told Ken that she had been “studying” for months in preparation
for a home birth; and she appears to have tabbed or highlighted other reading
materials related to parenting that were found at her apartment. At this
stage, such facts are sufficient to draw the inference that Carpenter also read
the article, which she appears to have printed from a website, warning not to
cut the umbilical cord before seeking medical assistance. There is thus
“ ‘some rational ground for assuming the possibility’ ” that there will be

                                       40
sufficient evidence at trial showing her subjective awareness of the risk to
Kiera’s life. (See Valenzuela, supra, 73 Cal.App.5th at p. 504.)
      We agree with Carpenter that the situations in People v. Burden (1977)
72 Cal.App.3d 603 (Burden) and People v. Latham (2012) 203 Cal.App.4th
319 (Latham), which the People analogize to this case, are easily
distinguishable from the facts presented here. The father in Burden allowed
his five-month-old son to slowly die of starvation and admitted that he did
not feed the child or do anything to help him because he “ ‘just didn’t care’ ” if
his son lived or died. (Burden, at p. 609.) This, along with photographs
showing that the infant was obviously “in a state of terminal starvation”
when he died, was sufficient to support a finding of implied malice. (Id. at
p. 620.) In Latham, a diabetic 17-year-old died of diabetic ketoacidosis after
her parents allowed her condition to deteriorate over the course of five days
without seeking medical treatment. (Latham, at p. 323.) The court found
that there was substantial evidence to support the parents’ conviction for
implied malice murder because the girl had been hospitalized in the past, the
parents had received training to recognize the symptoms of diabetic
ketoacidosis, multiple people who saw the girl in the days leading up to her
death told her parents she needed to go to the hospital, and testimony
indicated that the parents did not seem to care about their daughter’s
condition. (Id. at pp. 328–331.)
      Carpenter’s actions, or alleged lack thereof, do not come close to
showing the same “lack of concern as to the victim’s survival” that was
present in Burden and Latham, as the People argue. The conduct of a father
who watches his five-month-old infant slowly starve to death over the course
of several weeks—or of parents who watch their diabetic 17-year-old
daughter slip into a coma over the course of five days—is fundamentally

                                        41
different from a mother who has just endured the pain and trauma of going
through childbirth prematurely and alone, yet still attempts to bathe, feed,
and clothe her newborn before apparently passing out due to sheer
exhaustion and blood loss.
      Nevertheless, the court “may not substitute its own personal belief as
to the ultimate determination to be made at trial for that of a reasonable
person evaluating the evidence.” (Cooley, supra, 29 Cal.4th at p. 258.)
Unless the prosecution has presented evidence that is “inherently
implausible,” its witnesses were “conclusively impeached,” or “no reasonable
person would find [the witnesses] credible,” we may not reject its evidence at
this stage. (Ibid.) We are not presented with such a situation here, and we
therefore accept the prosecution’s evidence as sufficient to show probable
cause of Carpenter’s subjective awareness.
                                        IV
      The same facts that support our conclusion that the prosecution has
presented evidence of implied malice murder sufficient to show probable
cause support the same conclusion as to the charge of felony child
endangerment under Penal Code section 273a, subdivision (a). This statute
applies to a person who “under circumstances or conditions likely to produce
great bodily harm or death, willfully causes or permits any child to suffer, or
inflicts thereon unjustifiable physical pain or mental suffering, or having the
care or custody of any child, willfully causes or permits the person or health
of that child to be injured, or willfully causes or permits that child to be
placed in a situation where his or her person or health is endangered . . . .”
(Pen. Code, § 273a, subd. (a).)
      For the same reasons we have already explained, we reject the People’s
assertion that Carpenter caused or permitted her infant to suffer

                                        42
unjustifiable physical pain by being unable to successfully breastfeed her
within hours of her birth and by texting others before calling 911 after she
awoke to her lifeless baby. However, the People have presented evidence
that Carpenter cut the baby’s umbilical cord without properly securing the
stump, allowed it to continue bleeding, saw that Kiera was struggling to
breathe and that CPR was not working, and failed to call 911. The evidence
presented provides “some rational ground for assuming the possibility” that
these acts and omissions by Carpenter were taken willfully under
circumstances likely to result in death or injury or endanger Kiera’s health—
and did, in fact, result in Kiera’s death. (See San Nicolas, supra, 34 Cal.4th
at p. 654.) We therefore find that the People have made the exceedingly low
showing required to defeat the section 995 motion as to the felony child
endangerment charge.
                                       V
      Carpenter also contends that construing Penal Code sections 187 and
273a to permit prosecution of this case renders those statutes
unconstitutionally vague and a violation of her federal due process rights as
well as her right to privacy and equal protection under the California
constitution.
      Her first argument is that Penal Code sections 187 and 273a fail to
provide notice to a pregnant person of what conduct constitutes murder or
felony child endangerment if they choose to have an unattended home birth
and the outcome “is ultimately not positive.” The United States Supreme
Court has explained that laws must “give the person of ordinary intelligence
a reasonable opportunity to know what is prohibited, so that he may act
accordingly” because, among other reasons, “[v]ague laws may trap the
innocent by not providing fair warning.” (Grayned v. City of Rockford (1972)

                                      43
408 U.S. 104, 108.) We agree with the People that a person of ordinary
intelligence would know that intentionally failing to call 911 when their
infant is struggling to breathe and bleeding after their umbilical stump has
been cut without being properly secured is an abdication of parental duty
that could result in criminal penalty. To the extent the People are able to
prove the set of facts they allege based on Carpenter’s acts and omissions
after Kiera was born, we conclude that the application of the statutes is not
impermissibly vague.
      Carpenter next argues that prosecution of this case violates her rights
to privacy and equal protection under Article I, section 1.1 of the California
Constitution, which is titled “Reproductive Freedom” and provides: “The
state shall not deny or interfere with an individual’s reproductive freedom in
their most intimate decisions, which includes their fundamental right to
choose to have an abortion and their fundamental right to choose or refuse
contraceptives. This section is intended to further the constitutional right to
privacy guaranteed by Section 1, and the constitutional right to not be denied
equal protection guaranteed by Section 7. Nothing herein narrows or limits
the right to privacy or equal protection.” According to Carpenter, the People
are prosecuting her for choosing to have a home birth, which is a right
protected under California law.
      The People, on the other hand, claim to “fully recognize and honor the
rights clarified and strengthened in Health and Safety Code sections 123462
and 123467” and contend that Carpenter is not being prosecuted for her
choice to have a home birth. Rather, she is being prosecuted for the acts and
omissions that jeopardized Kiera’s life after she was born and then
experienced a medical emergency.

                                       44
      We again agree with the People. Carpenter’s argument on this point
fails for the same reasons set forth in Section II, ante. California law protects
Carpenter from interference with her reproductive freedom, including her
right to have a home birth and make other decisions about her childbirth, but
this does not mean the state also immunizes all post-birth acts and omissions
related to those decisions that would otherwise be subject to criminal or civil
penalty. We thus conclude that prosecution of this case does not violate
Carpenter’s constitutional rights.
                                       VI
      We agree with Carpenter that she is not “similar to a parent who gives
birth and abandons her baby in a dumpster,” an analogy made by the People
which she fairly describes as unfounded, inflammatory, and unhelpful. But
this is also not a case where the baby’s death is attributable solely to causes
that occurred in utero, which would render the prosecution prohibited under
section 123467. Regardless of the difference in the People’s characterization
of their argument at the time of the preliminary hearing and now on appeal,
there was evidence presented at the hearing of Carpenter’s conduct after her
daughter’s birth sufficient to find probable cause to bind her over on the
charges filed against her under current law.
      We find the Supreme Court’s words in Watson fitting here: “We do not
suggest that the foregoing facts conclusively demonstrate implied malice, or
that the evidence necessarily is sufficient to convict defendant of second
degree murder. On the contrary, it may be difficult for the prosecution to
carry its burden of establishing implied malice to the moral certainty
necessary for a conviction. Moreover, we neither contemplate nor encourage
the routine charging of second degree murder in [these types of] cases. We
merely determine that the evidence before us is sufficient to uphold the

                                       45
second degree murder counts in the information, and to permit the
prosecution to prove, if it can, the elements of second degree murder.”
(Watson, supra, 30 Cal.3d at p. 301.) Nothing more is required to survive a
Penal Code section 995 challenge, and we therefore deny Carpenter’s petition
at this early stage of the proceedings.
                                DISPOSITION
      The petition is denied. The stay issued by this court on March 14,
2023, is vacated.

                                                              BUCHANAN, J.

WE CONCUR:

McCONNELL, P. J.

HUFFMAN, J.

                                          46