“The uterus can slip down and protrude from the vagina if the muscles and ligaments that hold it are weakened and stretched,” Lopez said without any apparent condescension or judgment in her voice or expression. Eve was thankful for that. “And that could cause the uterine lining, particularly if it’s thin, to tear during childbirth. There can be considerable blood loss as a result. That was my initial concern, which is why I called you to check on the welfare of the mother.”
Nan lowered her camera for a moment. “Isn’t a prolapsed uterus something that affects older women who’ve given birth before?”
“It can happen at any age,” Lopez said, “regardless of whether or not the woman has given birth.”
“Is there any other explanation for what you found?” Eve asked.
“Yes. The placenta could have adhered to the uterus, a condition which, if previously undetected, could be fatal for the mother and baby during a vaginal delivery,” Lopez said. “In that case, doctors would perform an emergency C-section and perhaps an immediate hysterectomy after the birth. But that’s not the case here, though it is a relevant example.”
“Relevant in what way?”
“When I resumed my autopsy, I noticed this . . .” She pointed at two very tiny cuts on the top of the baby’s head. “Two nicks. The baby supposedly was born naturally, without any medical equipment, so where did these cuts come from? That’s when I halted the autopsy and called both of you.”
Nan leaned over the baby’s head and took more pictures. “Could the cuts have come from being tossed in the dumpster?”
“No, there would be other, more extreme trauma to the body from that. These nicks are straight, like they came from the edge of a sharp object, the sort of damage you might accidentally do to a product while cutting open the box. That observation prompted me to go back and reexamine the uterus and ovaries more closely.”
She walked over to the tray containing the placenta. “What I observed first is jagged tearing here that could be consistent with a prolapsed uterus.” She pointed to one spot, and then to another. “But not here. Or here. These tears are straight.”
Nan got in close, taking pictures.
Eve didn’t need to see the cuts for herself because she understood the point Lopez was making. “Straight cuts don’t occur naturally.”
“No, they don’t, Detective. I think the nicks on the baby’s head came from the same knife or other sharp object that did this.”
The autopsy continued. It was clinical and detailed and that helped distance Eve from what she was seeing and keep her emotions in check. When Lopez finished her work, she peeled off her gloves and said, “I can conclude, with a reasonable degree of medical certainty, that the baby was not the product of a natural birth and died of asphyxiation in utero, likely as a result of the mother’s death.”
Eve wanted to be sure she correctly understood Lopez’s conclusion. “You’re saying the mother and baby died during a botched C-section?”
“I wouldn’t put it so nicely. This baby was torn out of the womb. And I can tell you if the mother’s body is out there, nobody in Los Angeles County has reported it yet.”
Eve called Duncan as soon as she stepped outside and told him everything.
“You’re saying Anna McCaig cut this baby out of a pregnant woman’s body and pretended it was her own child?” he asked.
“That’s right,” Eve said, trying to keep her voice even and unemotional, to choose her words carefully and not betray her rage. “The actual term for it is ‘fetal abduction’ and it’s an extremely rare occurrence.”
“Thank God for that.”
“The deputy medical examiner has read about such cases but has never dealt with one until now.”
“That makes two of us. I would have liked to retire without ever having heard of or investigated a fetal abduction case, but here we are. But we don’t know for certain that Anna McCaig did it.”
“Did you find reports of any missing pregnant women in Los Angeles?”
“Not in the county or even in the state of California,” Duncan said. “And no women have come into any ERs in Los Angeles or Ventura Counties with injuries consistent with what you described to me before.”
“So it had to be Anna McCaig.”
“Don’t get locked into one theory of the case. It has got you into trouble before.”
That was true, but she knew in her bones that she was right. What other possibilities were there? That someone in the neighborhood just happened to toss a baby in Anna’s dumpster? Anna’s cruel “gift from God”？ Eve didn’t believe it. There was a desperate look in Anna’s eyes, like a cornered animal, when Eve confronted her at the hospital with her inconsistencies. It was the look of a guilty woman.