A pregnant woman in Georgia was declared brain-dead after a medical emergency and has been kept on life support for three months by doctors to allow enough time for the baby to be born and comply with Georgia’s strict anti-abortion law, family members say.
The case is the latest consequence of abortion bans introduced in some states since the Supreme Court overturned Roe v. Wade three years ago.
Adriana Smith, a 30-year-old mother and nurse, was declared brain-dead — meaning she is legally dead — in February, her mother, April Newkirk, told Atlanta TV station WXIA.
Newkirk said her daughter had intense headaches more than three months ago and went to Atlanta’s Northside Hospital, where she received medication and was released. The next morning, her boyfriend woke to her gasping for air and called 911. Emory University Hospital determined she had blood clots in her brain and she was later declared brain-dead.
Newkirk said Smith is now 21 weeks pregnant. Removing breathing tubes and other life-saving devices would likely kill the fetus.
Neither hospital immediately responded to emails Thursday from The Associated Press.
Georgia’s abortion ban
Smith’s family says Emory doctors have told them they are not allowed to stop or remove the devices that are keeping her breathing because of a provision in state law that bans abortion after cardiac activity can be detected — generally around six weeks into pregnancy.
The law was adopted in 2019 but not enforced until after the U.S. Supreme Court overturned Roe v. Wade in 2022, opening the door to state abortion bans. Georgia’s ban includes an exception if an abortion is necessary to maintain the life of the woman.
Smith’s family, including her five-year-old son, still visit her in the hospital.
Newkirk said doctors told the family that the fetus has fluid on the brain and that they’re concerned about his health.
“She’s pregnant with my grandson. But he may be blind, may not be able to walk, may not survive once he’s born,” Newkirk said. Newkirk has not commented on whether the family wants Smith removed from life support.
Who has the right to make these decisions?
Monica Simpson, executive director of SisterSong, which is the lead plaintiff in a lawsuit challenging Georgia’s strict abortion law, said the situation is problematic.
“Her family deserved the right to have decision-making power about her medical decisions,” Simpson said in a statement. “Instead, they have endured over 90 days of retraumatization, expensive medical costs, and the cruelty of being unable to resolve and move toward healing.”
Lois Shepherd, a bioethicist and law professor at the University of Virginia, said she does not believe Georgia’s law requires life support in this case.
But she said whether a state could insist Smith remains on the breathing and other devices is uncertain since the 2022 ruling in Dobbs v. Jackson Women’s Health Organization, which overturned all the parts of the Roe ruling, including the finding that fetuses do not have the rights of people.
“Pre-Dobbs, a fetus didn’t have any rights,” Shepherd said. “And the state’s interest in fetal life could not be so strong as to overcome other important rights, but now we don’t know.”
Georgia’s law confers personhood on a fetus. Those who favor personhood say fertilized eggs, embryos and fetuses should be considered people with the same rights as those already born.
Georgia state Sen. Ed Setzler, a Republican who sponsored the 2019 law, said he supported Emory’s interpretation.
“I think it is completely appropriate that the hospital do what they can to save the life of the child,” Setzler said. “I think this is an unusual circumstance, but I think it highlights the value of innocent human life. I think the hospital is acting appropriately.”
Setzler said he believes it is sometimes acceptable to remove life support from someone who is brain dead, but said the law is “an appropriate check” because the mother is pregnant.
“I think there’s a valuable human life that we have an opportunity to save and I think it’s the right thing to save it,” he said. “To suggest otherwise is to declare the child as being other than human.”
Setzler said the woman’s relatives do have “good choices,” including keeping the child or offering it for adoption.
Abortion laws in other states
The situation echoes a case in Texas more than a decade ago when a brain-dead woman was kept on maintenance measures for about two months because she was pregnant. A judge eventually ruled that the hospital keeping her alive against her family’s wishes was misapplying state law, and life support was removed.
Twelve states are enforcing abortion bans at all stages of pregnancy, with limited exceptions. Georgia is one of four with a ban that kicks in at or around six weeks into pregnancy — often before women realize they’re pregnant.
Last year, the Texas Supreme Court ruled unanimously against a group of women who challenged that state’s abortion ban, saying the exceptions were being interpreted so narrowly that they were denied abortion access as they dealt with serious pregnancy complications. This year, the state Senate has passed a bill that seeks to clarify when abortions are allowed.
South Dakota produced a video to inform doctors about when exceptions should apply. Abortion rights groups have blasted it.
The U.S. Supreme Court heard arguments in December over whether the federal law that requires hospitals to provide abortion in emergency medical situations should apply. A ruling is expected in coming months.
