UPDATE: TDD #29: Why is a Brain-Dead Pregnant Woman in Georgia Being Kept Alive?
Because the law requires it, but not the law pro-abortion activists are citing.
Welcome to another edition of The Dobbs Digest, a newsletter of Confessions of a Truthaholic.
Abortion may be the most divisive and intractable topic in contemporary American politics. And the inflammatory rhetoric, which reached boiling point after Roe v. Wade was overturned in the summer of 2022, isn’t simmering down anytime soon. But most of what I read and hear is sky-high on emotion but very low on facts, so bear that in mind as you scroll.
My sole purpose with this newsletter is to question the assumptions of the media narratives shaping abortion discourse and to unpack the actual issues raised in the courts to get us to a shared understanding of the reality on the ground.
If you’re new to this newsletter, please read our welcome post here so you’re in the know. So glad to have you here.
Update: June 18, 2025
According to news reports, 30 year old Adriana Smith’s son, Chance, was born via C-section on June 13 and weighed in at 1 lb, 13 oz. He is currently in the NICU and per Adriana’s mom, is expected to be okay. She said “[h]e’s just fighting. We just want prayers for hum. He’s here now.” Adriana, who turned 31 over the weekend, was removed from life support earlier today.
God bless Chance, his father, grandmother, and the rest of his family during a very difficult time full of mixed emotions, celebrating the birth of one and the loss of another.
My sister’s twins (my niece and nephew) were super preemies too, and now they’re gorgeous and thriving 22 year old college students about to begin their adult lives.
Nine Weeks Pregnant and Brain Dead
In early February, 30 year-old Adriana Smith was about nine weeks pregnant when she sought medical attention for severe headaches. Adriana lives in Georgia. Unfortunately, despite visiting at least two different hospitals, Adriana was sent home without as much as a CT scan. Days later, on February 19, 2025, she was declared brain-dead. Apparently, Adriana had several undiagnosed blood clots in her brain. But because she was pregnant at the time of her brain death, she’s being kept alive through life support so her unborn son can be delivered as soon as he’s able to survive outside her womb. The longer he gestates, the better his chances for survival. Once he’s safely delivered, her support can be pulled.
Before looking at the legal issues in this case, let’s acknowledge that it’s nothing short of a terrible tragedy. We have a young mom pregnant with her second child who is brain-dead and being kept alive long enough for her son to be born. If this isn’t an unspeakable trauma, I don’t know what is. Despite media coverage to the contrary, this is a story about Adriana, her unborn son, and the family she leaves behind.
Also, I just read that Adriana’s mom, April Newkirk, has named her unborn grandson Chance and will be taking him in once he’s born. A GoFundMe campaign has also been setup to support Adriana and her family, which you can find here.
Back to Adriana …
Why is Adriana Being Kept Alive?
Adriana’s story has been plastered all over the news the last couple of weeks. Regardless of your news source, you’ll probably read that Georgia’s heartbeat law [The LIFE Act (HB 481)], which bans abortions after the detection of a fetal heartbeat, or at six weeks, is the only reason Adriana is being kept alive. It is widely reported that various doctors affiliated with Emory University who have treated (or are treating) Adriana and Chance told the family that the LIFE Act specificaly requires them to sustain Adriana’s life until the baby is born.
The argument seems to go like this:
At the time Adriana was declared brain dead, her baby had a detectable heart beat and she was certainly more than six-weeks pregnant. As such, according to Georgia’s LIFE Act, physcians cannot withdraw life support from Adriana since it would also cause the baby, who is too far along, to pass away, unless he could survive outside the womb.
But, the LIFE Act is an abortion statute.
And it has nothing to do with provision or withdrawal of life-support.
So why is it being invoked in this case?
Let’s unpack …
Per Georgia’s LIFE Act (HB 481), aka the heartbeat law, the term ‘Abortion’ means the act of using, prescribing, or administering any instrument, substance, device, or other means with the purpose to terminate a pregnancy with knowledge that termination will, with reasonable likelihood, cause the death of an unborn child; provided, however, that any such act shall not be considered an abortion if the act is performed with the purpose of removing a dead unborn child caused by spontaneous abortion; or removing an ectopic pregnancy.
Is withdrawing life support from a brain dead pregnant woman the same as performing an abortion?
According the plain language of the law, and as confirmed by the Georgia Attorney General’s office, “[t]here is nothing in the LIFE Act that requires medical professionals to keep a woman on life support after brain death … [r]emoving life support is not an action ‘with the purpose to terminate a pregnancy.'”
So, the answer is no.
Withdrawing life support from a brain dead pregnant woman is not the same as performing an abortion, regardless of the age of the unborn child, so the the LIFE Act, which addresses abortion and abortion only, is unrelated to this case.
SIDEBAR » I also wrote about the LIFE Act the last time it was blamed for the deaths of two post-abortive women last year. You can read the piece here.
Pregnancy After Brain Death
With inspiration from Inigo Montoya in The Princess Bride, I say—you keep blaming that law (the LIFE Act), I do not think it means what you say it means.
Whether in good faith or bad, there’s a misunderstanding as to which law binds the hospital in Adriana’s case. Rather than the LIFE Act, the actual law in play is the Georgia Advance Directive for Health Care Act, passed by the Georgia state legislature in 2007, long before Roe v. Wade was overturned and the LIFE Act became effective in 2022.
What is an advance directive?
Advance directives are signed written statements about someone’s wishes for life-saving or life-sustaining treatment should they require it but are decisionally incapacitated at the time. An advance directive can also be a living will, health care power of attorney, or durable power of attorney, which not only expresses the individual’s wishes regarding medical treatment but also appoints someone to make medical decisions in their stead.
SIDEBAR » All 50 states, plus DC, have laws addressing implementation of advance directives for individuals who cannot make their own medical decisions, but not all of them specifically address how to handle advance directives for incapacitated pregnant women. A 2019 study published in the Journal of the American Medical Association analyzed each state’s statute to determine what, if anything, they say on this topic. Per the study, 39 states indicate that pregnancy status is relevant to implementing life-sustaining care. Of these states, 26 have some type of pregnancy exclusion, meaning that it’s illegal to withdraw life support from an incapacitated pregnant woman, unless other factors are present, including, for example, (1) there’s an advance directive with the patient’s clear instructions to withdraw life-saving treatment, and (2) the fetus is nonviable at the time she is declared brain dead. Georgia’s advance directive law follows this pattern.
Let’s look at the first part of the advance directive statute, which includes the pregnancy exclusion language (bold text and all caps are inserted by me). The statute isn’t very long and you can read it in full here.
GA Code § 31-32-9 (as of 2024)
(a) Prior to effecting a withholding or withdrawal of life-sustaining procedures or the withholding or withdrawal of the provision of nourishment or hydration from a declarant pursuant to a declarant's directions in an advance directive for health care, the attending physician:
(1) Shall determine that, to the best of that attending physician's knowledge, the declarant is not pregnant, or if she is, that the fetus is not viable AND that the declarant has specifically indicated in the advance directive for health care that the declarant's directions regarding the withholding or withdrawal of life-sustaining procedures or the withholding or withdrawal of the provision of nourishment or hydration are to be carried out …
So, per Georgia law, if the two criteria mentioned in the text had been met at the time of brain death, Adriana’s physicians would have been authorized to remove her from life support.
Those criteria are:
(1) her pregnancy had to be unviable at the time she became brain dead, and
(2) she had prepared an advance directive indicating her desire not to have life-sustaining treatment due to a permanent incapacitation.
Let’s look at the facts:
(1) her unborn son was just nine weeks along at the time she was declared brain dead and was therefore unviable outside the womb (this criteria was met); and
(2) but she did not have an advance directive declining life-sustaining treatment (this criteria wasn’t met).
This case isn’t about abortion; it’s about treating a brain dead pregnant woman who, but for her condition, intended to carry her unborn child to term. Adriana didn’t seek an abortion and she didn’t declare her desire not to receive life-sustaining care.
There’s no question that this scenario presents an ethically challenging issue, but it has nothing to do with abortion or the LIFE Act or the “pro-life movement’s agenda” to establish fetal personhood.
Of course, a little honesty in research and reporting would reveal that.
—
There’s a lot of news in this space and I’ll be covering it methodically over the coming weeks and months.
Meanwhile, let me know if you have any questions!
In service to the truth, the whole truth, and nothing but the truth …
I am,
yours truly,
Kelley
May 23, 2025