Brain-dead pregnant woman kept on life support

In February, Adriana Smith, a 31-year-old Black woman who was roughly nine weeks pregnant at the time, began experiencing severe headaches, leading her to seek treatment. At a hospital, Smith was given medication, but no scans or tests were conducted.

The next day, Smith's condition worsened when she started gasping for air and making a gurgling sound in her sleep. A CT scan later revealed that she had multiple blood clots in her brain. By the end of the day, Smith was declared brain-dead and placed on a ventilator.

Although Smith was declared brain-dead, the hospital told Smith's family that she had to be kept on life support due to Georgia's strict abortion laws.

In 2019, Georgia introduced the Living Infants Fairness and Equality (LIFE) Act, also known as the "heartbeat law," but it was not enacted until 2022 after Roe v. Wade was overturned. The LIFE Act recognizes a fetus as a person and bans abortions after roughly six weeks of pregnancy, with only limited exceptions for medical emergencies or cases of rape or incest.

According to Smith's mother April Newkirk, while the family may not have chosen to terminate Smith's pregnancy, they should have been the ones to make the decision about whether to keep her on life support, not the hospital.

"It's torture for me. I come here and I see my daughter breathing ... but she's not there," Newkirk said. "It should've been left up to the family."

In a statement, a spokesperson for the hospital said its top priorities "continue to be the safety and wellbeing of the patients and families we serve" and that it "uses consensus from clinical experts, medical literature and legal guidance to support our providers as they make medical recommendations."

Baby delivered by emergency C-section

The hospital originally planned to deliver Smith's baby when she reached 32 weeks of pregnancy, but doctors had to perform an emergency C-section a few weeks early. The baby boy, whom Smith's family named Chance, weighed around one pound and 13 ounces and is currently in the neonatal intensive care unit.

"He's expected to be OK," Newkirk said. "He's just fighting. We just want prayers for him. Just keep praying for him." 

For example, Georgia state Sen. Ed Setzler (R), who sponsored the LIFE Act, said he supported the hospital's actions. However, the office of Georgia Attorney General Chris Carr (R) said "[t]here is nothing in the LIFE Act that requires medical professionals to keep a woman on life support after brain death" and that "[r]emoving life support is not an action 'with the purpose to terminate a pregnancy.'"

After Smith was removed from life support, three Democratic state representatives introduced a resolution that called on states to repeal abortion bans and clarify fetal personhood measures. According to the representatives, Smith's case led her family to experience a "prolonged ordeal without their consent," which was a "direct result of the Black maternal health crisis."

"Women deserve the ability to give informed medical consent, and when they cannot, their families must be empowered to make decisions with full information and without fear," said Georgia state Sen. Nabilah Islam Parkes (D).

"All women should have a choice about their body," Newkirk said. "I want people to know that."

Advisory Board's women's health resources

For more insights into women's health issues, including maternity care, check out Advisory Board's library of resources, including:

We have several resources on the top drivers of change in the maternal and reproductive health market, as well as the outlook for the women's health service line.

To learn more about ways to improve women's health in the United States, this report outlines six key factors to take into consideration, including the roles of various healthcare stakeholders and the importance of cross-industry collaboration.

Advisory Board also has several resources on how to utilize technology in maternity care, including this cheat sheet on telehealth and maternity care and a case study on how digital solutions can improve access to maternity care.

For resources specifically related to abortion, we offer this infographic explaining the potential health outcomes for individuals denied abortions in their state, as well as an expert insight on the groups that are disproportionately impacted by abortion restrictions. This expert insight also explains how leaders can help their clinical workforce amid changing abortion laws.