RHONE: Pregnant, on life support and left with no choice

But of course, this is real. And I should have known it was real because it has happened before. Then, as now, it has led us smack into a convoluted debate about law, medical ethics, and abortion.

In 2014, the case of Marlise Muñoz made international headlines. Muñoz, 33, of Texas, was declared brain-dead at 14 weeks pregnant. Doctors kept her alive and continued treating her against the family’s wishes until a judge ordered the hospital to end life support. Muñoz died. The pregnancy wasn’t viable, and years later, her traumatized family continued fighting to change the Texas law that limited the rights of pregnant women.

When my sister sent the text, media outlets had just begun reporting the story of Adriana Smith, a 30-year-old mother of one and nurse at Emory University Hospital, who had been declared brain-dead since February 19.

Credit: GoFundMe.com

Credit: GoFundMe.com

Days before her death, Smith had sought treatment for severe headaches in the emergency room at Northside Hospital, her mother, April Newkirk, told media outlets.

Instead of conducting tests, Newkirk said doctors sent her daughter home with medication.

The next day, Smith woke up gasping for air. Her partner called 911. She was taken to Emory, where a CT scan revealed multiple blood clots in her brain, Newkirk said. Smith, who was then nine weeks pregnant, was declared brain-dead.

This is just one way that we have failed Smith and so many other pregnant women.

Research has shown, time and again, that Black and Native American women are more likely to die during pregnancy or delivery than any other group of women, according to the Patient Centered Outcomes Research Institute.

Some blame the maternal mortality disparity on factors like genetics or behavior, but when it impacts Black women at every level, regardless of wealth, health, or social status, we can’t ignore the effect of race.

Once Smith was pronounced dead, the hospital told her family they had to keep her on life support until the fetus reaches viability to comply with Georgia law, which prohibits abortions once cardiac activity is detected at around six weeks of pregnancy.

Smith has been on life support for three months, with an additional 11 weeks to go before the fetus reaches a point where it can survive outside of her body.

While the family doesn’t know if they would have opted to terminate the pregnancy, Newkirk was clear in statements to the press that they never had a choice.

Sen. Ed Setzler, the Republican lawmaker from Acworth who sponsored the Georgia abortion law, offered cold comfort to any woman who may find herself trapped in the gray area created by state laws designed to protect fetuses rather than pregnant women.

Researchers who have studied this rare instance in which pregnant women are pronounced brain-dead and kept on life support to give birth identified 30 to 35 cases over several decades.

Depending on the study, the possibility of a live birth with a viable infant ranges from 50% to 77%. The length of time the mother is on life support while brain-dead and pregnant is a determining factor in the outcomes of the child, according to researchers. Most of the past cases on record have involved shorter periods than Smith.

Cost estimates for these cases have ranged from $217,000 in 1983 to $1 million in 2014. To cover expenses, Smith’s family set up an online fundraiser, which is currently more than $90,000.

In the past, lawmakers, responding to the trauma that families are forced to endure, have blamed health professionals for misinterpreting the law.

So it was no surprise on Monday when Attorney General Chris Carr’s office released a statement that clarified that Georgia’s LIFE Act does not require hospitals to keep a brain-dead woman on life support. Removal of life support is not an action designed to terminate a pregnancy, the statement said.

Some have pointed to Georgia’s advance directive for health care as the problem. The statute restricts doctors from withdrawing life support from a pregnant patient unless the fetus is both nonviable and the patient has a written directive requesting such action.

Several states adopted these laws in the 1980s as advance directives grew in popularity. The provision for pregnant patients was designed to satisfy concerns of the Roman Catholic Church and other pro-life groups.

But both laws amount to the same problem − limiting the rights of pregnant women while reducing them to vessels or incubators.

Smith’s death never should have happened, but her family should at least be afforded dignity and compassion to make choices about her future. Dismissing the true impact these laws have on women and families is tragic.

Smith and all pregnant women deserve better.

Read more on the Real Life blog (www.ajc.com/opinion/real-life-blog/) and find Nedra on Facebook (www.facebook.com/AJCRealLifeColumn) and X (@nrhoneajc) or email her at nedra.rhone@ajc.com.