A doctor who treated Sandra Birchmore through her early pregnancy told jurors in Matthew Farwell’s federal murder trial that she was surprised to hear that the 23-year-old had reportedly committed suicide.
At the center of Farwell’s case is whether Birchmore killed herself or the former Stoughton Police officer — who allegedly started a sexual relationship with Birchmore when she was 15 — strangled her and staged her body to make it look like a suicide.
A medical examiner initially reached a finding of suicide as her cause of death, but later changed her manner of death to undetermined.
Dr. Priyanka Venkataraman, a licensed obstetrician and gynecologist, testified Tuesday that she had an appointment with an eight-weeks-pregnant Birchmore on Jan. 29, 2021. Less than a week later, on Feb. 4, Birchmore was found dead in her Canton apartment hanging, partially suspended, from a closet door knob.
Venkataraman had prescribed Birchmore Zoloft for anxiety earlier in January, but as of her last telehealth visit, the doctor told the jury, “we had no indication of her destabilizing.”
Birchmore never expressed suicidal ideation or thoughts of harming herself and was “doing everything you would expect an adult person would do,” Venkataraman said, like going to doctor’s visits and following up, working, and attending therapy appointments, which Birchmore had twice a week.
“This was a desired pregnancy,” she said, describing an appointment with Birchmore in 2019 when the young woman first expressed the desire to have a baby.
When Birchmore realized she was pregnant in December 2020, she started messaging Venkataraman and other providers through a telehealth portal frequently.
Birchmore expressed “concerns that she was doing right by her pregnancy,” the doctor said.
A lot of Birchmore’s anxiety during that time surrounded spotting, bleeding, and cramps she started to experience in January, the doctor said. Ultrasounds also showed a hemorrhage on her uterine wall, Venkataraman explained, which could have been causing those symptoms.
“It’s like a bruise,” Venkataraman told the jury, saying that it was something to watch but is a pretty common occurrence and can resolve itself.
Birchmore’s mental health and family history of preeclampsia, not the hemorrhage, contributed to Venkataraman categorizing the pregnancy as high risk.
Venkataraman noted by her last visit, Birchmore reported she was no longer bleeding.
On cross-examination, Farwell’s attorney Kimberly Stevens asked questions about “black box” warnings for Zoloft and other selective-serotonin re-uptake inhibitors (SSRIs).
Venkataraman said that warnings let patients know that those types of medicines can increase suicidal ideation in people 24 years old and younger, especially at the start of treatment or as doses are increased.
Birchmore was on 25 mg, down from an initial dosage of 50 mg which caused her to be jittery, Venkataraman said, telling jurors it was far from a therapeutic dose.
Stevens pointed out that Birchmore never told the doctor about a bipolar diagnosis she got as a child or a purported suicide attempt she’d written about in a diary four years earlier and asked whether that information would have affected the doctor’s treatment.
Someone with bipolar could be negatively impacted by taking an SSRI, she said, but as for any suicide attempts, what was important to the doctor was that Birchmore wasn’t expressing any suicidal ideation during their treatment.
If Birchmore had, Venkataraman would have had her admitted to the emergency room, she said.
‘Forget about the call’
Former Stoughton Police dispatcher James Fitton also took the stand Tuesday to describe a call he received on the department’s non-emergency line a few weeks before Birchmore died that alluded to her relationship with Farwell.
Fitton said on the stand that he couldn’t remember most of the details but that the female caller had asked to speak with Farwell on Jan. 20, 2021.
When Fitton told Farwell in the detective’s office about the phone call, “He got visibly and audibly upset… His facial expression changed to anger and then he told me, including expletives, to never talk about this again, to never tell anyone about this again,” the witness said.
Fitton returned to dispatch and told a lieutenant, who “told me to forget about the call,” Fitton said.
Later that night, Farwell texted Fitton: “Let’s never discuss that again, that girl is [expletive] insane, well both of them are.”
“Don’t worry, I won’t bring it up again,” the former dispatcher had texted back.
On cross examination, defense attorney Joanne Daley asked whether the woman calling had reported a crime, and Fitton said no, it had seemed like a personal call and so it was never logged for response or further investigation.
‘Made with love’
On the night that Birchmore died, she was texting with a former school mate about some onesies she’d commissioned for her unborn child.
Mackenzie Palma, registered nurse who has an etsy store on the side, said on the stand that she’d gone back and forth with Birchmore on the design of the baby clothing and also a birth announcement sign earlier that month.
Palma had already crafted the Valentine’s-themed announcement and a onesie that read, “Made with love.”
On Feb 1., the last night Birchmore was seen alive, she’d texted Palmer just before 8 p.m., asking if she could send the pictures of the two other onesies she’d asked for when they were finished.
About an hour and a half later, Palma sent one that included a hand painted Winnie the Pooh.
Birchmore, who’d responded sometimes less than a minute later to other messages with Palma, never replied.
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