One day after smoking meth and marijuana, a Miller County woman gave birth to her baby in a toilet. Seven or eight minutes later, she later told authorities, she pulled the baby out of the water. Finding the newborn dead, the woman wrapped her baby in a plastic bag, put her in a tote bag, and stowed her in the trunk of a car. During a drug bust two weeks later, authorities found the decomposing body in the car.

That was 2009, and the woman, Emily Usnick, of St. Elizabeth, was charged with second degree murder and involuntary manslaughter in 2012. She was ultimately convicted of first degree involuntary manslaughter, in 2017, and sentenced to five years in prison. She was also convicted in a separate trial on a drug-related crime and sentenced to five years, to be served concurrently with her manslaughter sentence. But this week, the Missouri Western District Court of Appeals overturned the manslaughter charge, saying the state had not found enough evidence that Usnick actually committed a crime resulting in her newborn daughter’s death.

The baby’s name was Hannah Eden Usnick. Emily Usnick said she had plans to give the baby up for adoption. "She was so beautiful," she wrote in a statement submitted to detectives on July 6, 2009. "I really hate that things turned out this way. I wanted her to have a life, a good life and that is why I had the intention of putting her up for adoption. I will forever regret the poor decisions I’ve made not only leading up to that night, but especially that night. I have come to believe that it is possible with the time frame that Hannah may have drowned or suffocated while she was submerged in the water."

The three physicians who testified at Usnick's trial concluded with certainty:

1) Baby Hannah had been alive while Emily was in labor and died either during or shortly after delivery.

2) A large and “potentially lethal” amount of methamphetamine was found in Baby Hannah’s body, which would have required medical attention at the time of birth for Hannah to continue living.

3) The cause of death was “hypoxia,” a general term referring to oxygen deficiency.

Those facts were presented to the Johnson County jury (after the case was moved from Miller County on a change of venue request), who felt they were sufficient to convict Usnick of involuntary manslaughter, but not second degree murder. However, at the trial, Usnick’s attorney asked for an acquittal based in part on the state’s failure to demonstrate exactly how Baby Hannah had died. The appeals court ultimately agreed.

“Given that we find that the State failed to present sufficient evidence from which a jury could determine that Usnick either purposefully or recklessly caused the death of Baby Usnick the trial court erred in overruling Usnick motion for acquittal at the close of State’s evidence,” the appeal’s court’s June 18, 2019 opinion stated.

Crucially, the appeals court noted:

1) While one doctor said the baby could have been resuscitated if born at a hospital, “there is no duty imposed on expectant mothers to have a medically attended birth, at the risk of criminal prosecution. Many mothers voluntarily choose to give birth at home without medical assitance and others don’t make that conscious choice but the unpredictability of child birth forces them to give birth wherever they may happen to be when the natural process results in birth before they can reach medical assistance… Other courts have largely disfavored imposing such liability for multiple reasons including that it violates a woman’s constitutional rights to refuse medical treatment.”

2) While a “potentially lethal” amount of meth was found in the baby’s system, the court held in State v. Wade that Missouri Statute 1.205.4 “precludes any effort to prosecute a mother who causes indirect harm to her fetus by ingesting illegal drugs during her pregnancy…”

3) The cause of Baby Hannah’s hypoxia was never proven: whether it was a criminal act or a “natural peril of child birth.” In other words, the court pointed out—and Dr. Stacy, who conducted the autopsy, agreed at trial—it was unclear whether Hannah had died from the natural perils of childbirth or from a criminal act committed by Emily Usnick. “No, I don’t have a cause of death,” Dr. Stacy said at trial.

The cause of death was unknown, but the state had pointed to several different potential criminal causes of death of which there was some evidence and argued the jury should have been able to determine Hannah’s death was criminal in nature. And while the appeals court agreed medical expert testimony is not always required in order for a jury to determine whether a death was caused by a crime or something else, the court pointed out, “An average juror is not familiar with the possible causes of death surrounding child birth of the causes of hypoxia during child birth. Where even the experts were unable to determine within a reasonable degree of medical certainty a clear cause of death we cannot say that a lay juror would be able to make a determination that this death was caused by a criminal act as opposed to natural causes.” Therefore, the court said, “the case should not have been submitted to the jury.”

“To prove that Usnick caused the death of Baby Usnick, it was therefore necessary for the State to prove that the cause of Baby Usnick’s death was Usnick’s failure to seek medical assistance after the delivery, or Usnick’s placement of Baby Usnick into a plastic bag. Correspondingly, the State was obligated to prove that Baby Usnick did not die naturally. The State’s evidence did not sustain this burden,” the appeals court wrote.

In a press release about the opinion on Tuesday, Miller County Prosecutor Ben Winfrey wrote, “The Miller County Prosecutor’s Office is reviewing the Court’s decision and will act accordingly.”

The court’s full opinion is below. (Reader warning: graphic details are included in the document below)