Adriana Smith’s Case Isn’t Fiction — It’s Forced Pregnancy In Real Time

A 30-year-old woman was found unresponsive after days of complaining  about headaches. She’s rushed to the nearest hospital, where she is pronounced brain-dead. Her grieving family — including her mother and 7-year-old-son — are weighing their options when hospital officials tell them they do not have any options. Because the woman was nine weeks pregnant, she and her unborn fetus are considered two individual patients. The mother must remain on life support to protect the life of the second patient, whether her family wants that or not. No, this is not Season 3, Episode 9 of the Handmaid’s Tale. It is the reality of a Black woman in 21st century Georgia and the woman’s name is Adriana Smith. 

So who is to blame for this callous disregard of patient’s and her family’s grief? That would be Georgia’s Living Infants Fairness and Equality (LIFE) Act — a three-year old abortion ban also known as a heartbeat law. First introduced in 2019 but not enforced until the fall of Roe v. Wade in 2022.

The legislation prohibits terminating a pregnancy once cardiac movement is detected, which can happen anywhere from weeks six through nine of pregnancy. In Adriana Smith’s case, this law means her body is no longer her own. She is now being treated as an incubator. Since she is already in a coma, the few exceptions to the LIFE Act — like protecting the mother’s health — don’t apply. Smith is now approximately halfway through her pregnancy and will remain in this liminal space for at least another twelve weeks. 

Renee Bracey Sherman,co-author of Liberating Abortion, a book that delves deep into the racist and sexist history of abortion legislation, details the resulting abortion stigma many birthing people endure, and charts a path forward for reimagining reproductive justice and abortion care. As she and her co-author, Regina Mahone, write in their introduction: “People of color are the canaries in the coal mines: whatever bad happens, happens to us first.”

When discussing this case in particular, Sherman noted that this case highlights the ways our bodies are not valued beyond our capacity to give birth. While conservatives celebrate the move as a victory for local abortion bans, including Georgia State Sen. Ed Setzler who sponsored the LIFE Act, a woman’s life hangs in the balance and her family’s ability to make informed decisions has been robbed from them. Sherman puts it bluntly that child-bearing is heralded in such a toxic way, Adriana isn’t able to die with dignity because of the perceived value of her body as a carrier. 

The core of this issue is agency and the removal of all options and personal choices by people disconnected from Adriana and her family’s needs. “I’m not saying that we would have chose to terminate her pregnancy, but [what] I’m saying is: We should have had a choice,” said Smith’s mother, April Newkirk.

The hospital’s official response? “Our top priorities continue to be the safety and wellbeing of the patients we serve,” an Emory Hospital spokesperson told NBC News. But that can’t be true because the safety and well-being of Adriana Smith has been cast aside along with the potential ramifications for the unborn child. According to Newkirk, doctors have seen fluid in the child’s brain which can lead to blindness, immobility or even death. After months of being forced to continue this pregnancy, Smith’s family may very well have to grieve with another loss against their will. 

Kwajelyn Jackson, executive director of Atlanta’s Feminist Center for Reproductive Liberation, has been on the frontlines too many times in the fight against repressive reproductive legislation and the ways Black women are dismissed in matters of their own healthcare. “Adriana lost her life because her symptoms were ignored when she initially sought care,” Jackson says.

“She complained of headaches and was sent home without a full evaluation. [Now,] Smith’s body has been kept on life support machines in an attempt to sustain the pregnancy despite her death.” For Jackson this is confirmation of what she has seen across her career: that Georgia lawmakers’ interpretation of “pro-life” doesn’t include the lives of everyone and certainly not Black, queer, transgender or low-income people.

“When policies and attitudes are not rooted in lived, layered, human experience, outcomes like Adriana Smith’s are not anomalies — they are devastatingly inevitable results,” says Cheyenne Varner, founder of The Educated Birth. Varner is a certified doula and health equity advocate who pushes for well-informed patients to be partners in their personalized care. Unfortunately, restrictive legislation like the LIFE Act and other abortion bans prevents people from having a voice when it comes to their own bodies. “Black women and birthing people’s lives, bodies, and families remain vulnerable in a system that was never designed — and is still not upheld — with our dignity in mind,” Varner underscores.

The other harrowing concern at the center of this devastating situation is the question of who is responsible for the months Adriana Smith is spending on life support and the birthing process to retrieve her unborn child. In an interview with NBC News, April Newkirk seemed to allude that the family is bearing at least some of that burden. “Every day that goes by, it’s more cost, more trauma, more questions,” she said. “The only winners here are the politicians who supported the six-week abortion ban,” says Dr. Mia Robbins-Aguilar, co-founder of Middle Georgia 4 Choice. “The rest of us suffer the indignities and injustices while fighting for reproductive justice.”

Robbins-Aguilar works on the frontlines of non-discriminatory reproductive healthcare and knows  this case is just one example of how a family’s pain is compounded by the financial burden they endure, along with the long term medical and developmental issues they may potentially face as the fetus continues to progress.

To navigate the murky waters ahead, the family has created a GoFundMe, another sign of just how much they’ve been left to work through this heartbreak. The GoFundMe platform was initially created to help users secure resources for their next great ideas. Now, the same platform has now become a last resort to so many emergency healthcare needs that it has been normalized as a supplement to insurance.

In 2021, even GoFundMe made a statement on Twitter acknowledging  the uncomfortable truth: “Millions of Americans are struggling to pay for life's essentials right now... But GoFundMe was never made to be a source of support for basic needs, and it can never be a replacement for robust federal relief.” Now as April Newkirk has had her hands tied behind her back, that same “pro-life” government is doing little to nothing to assist her with the fallout of the decision they have forced upon her. Moments and situations like this can stop us in our tracks and make us feel helpless, but we do have power and it lives in how we respond. We must reiterate that policies like these do not serve the people they’re intended to protect.

“We may not be able to change these laws as swiftly as we feel the urgency to do so — but we can change how we educate, how we train providers and how we resource parents and birth workers to see these patterns for what they are,”  Varner emphasizes. “We can refuse frameworks of “protection” that rob families of autonomy,” she continues. “We can build tools, tell stories and implement systems that honor full-spectrum reproductive justice — including the right not to be overridden or used by any other person or entity in life or in death.”

We can and must also champion a proactive vision of better care than our current system provides through electoral politics as well. “Reproductive justice invite[s] curiosity,” Bracey Sherman and Mahone write in their book. “The reproductive justice founders provided a framework for activists to bring into being a world in which every person has the ability to decide if, when, and how to become a parent.” 

Anyone running for office with even the slightest oversight to reproductive care needs to be thinking of how to make that a reality, as Rep. Lauren Underwood did when introducing the Black Maternal Health Momnibus Act of 2021. If passed, this legislation would expand access to midwives and doulas, extend care for postpartum and breastfeeding periods, invest in research to address maternal mortality and mitigate risks to birthing people and their children. Acts like this are just the beginning. We need to codify a national standard of bodily autonomy and do away with cookie-cutter abortion bans that don’t account for our range of needs and desires.

Above all, we must continue to seek affirming healthcare from those who understand and see us in our fullness. “We are still seeing patients and still providing abortions in accordance with the law,” Jackson reminds us. “The ban is extreme, but it is not a total ban.” By continuing to seek care and fund spaces devoted to our needs, we force the nation to recognize that reproductive care is healthcare and that one isn’t complete without the other.

“It is easy to become despondent in a vacuum but when we gather and share stories, we fuel each other in more ways than one,” encourages  Robbins-Aguilar as she harkens back to the 1970s. “As a psychologist, I encourage people to be mindful of their boundaries but to also push themselves to find creative ways to contribute to the efforts to regain reproductive freedom.”

The more we speak out about Adriana Smith and others negatively affected by abortion bans, we create a culture where these laws can be repealed and replaced by putting pressure on lawmakers to answer for the policies they’ve created that weaponize our bodies. The more we insist on designing our own political futures, the more likely we are to get one worth living in.