The heartbreaking case of a dead pregnant woman who is being kept on life support until her foetus can be cut out of her womb has sent shockwaves around the world
A pregnant woman who has been declared legally dead but is being kept on life support to ‘incubate’ her foetus has no chance of recovery – but doctors are refusing to let her go because of harsh anti-abortion legislation. Every day she stays on mechanical ventilation, the greater likelihood her tissue will begin breaking down – and the risk of her foetus dying in the womb increases, according to an expert.
Adriana Smith, a 30-year-old mum-of-one, has been brain-dead since February, when she was nine weeks pregnant. She sought hospital treatment for her intense headache, but was sent home with medication instead of being given a CT scan.
The next morning her boyfriend woke to the sounds of her gasping for air and called for an ambulance. She was rushed to hospital where scans found blood clots on her brain, and hours later the nurse was declared brain dead.
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But thanks to draconian ‘pro-life’ laws in the US state of Georgia, Adriana was hooked up to machines that keep her lungs ventilated and heart pumping blood around her body so that her foetus could stay in her womb and develop.
Now around 22 weeks along, tests have revealed the foetus has hydrocephalus – fluid on the brain – so even if it survives the pregnancy, it will be born with life-limiting disabilities.
Dr Dale Gardiner, an Intensive Care Consultant and member of the Academy of Medical Royal Colleges, said the situation is highly unusual because life-support is not designed to be long-term treatment for brain-dead patients.
“These patients are very physiologically unstable owing to the severity of their brain injury. They are all on intensive care,” he told the Mirror.
“Normally mechanical ventilation and other intensive care interventions are only continued for a very short time to allow family to say goodbye or to enable organ donation (for example, up to a day). It is extremely unusual to continue beyond this point.”
Adriana’s family, including her five-year-old son who thinks his mum is “sleeping”, sadly have no chance of her ever recovering because her brain has stopped working entirely and there is no more blood flowing to it. That means the tissue inside her head will start decomposing.
“The world has been confirming people deceased using neurological criteria for over 50 years. No-one who has been correctly diagnosed and confirmed deceased using neurological criteria has ever woken up or recovered,” said Dr Gardiner.
While oxygen and nutrients are still being pumped around her body by machine, Adriana’s skin will look normal. “If ‘rotting’ is occurring, it would be internal in the brain,” he explained. “However, such patients are not like Sleeping Beauty. They are critically unwell on intensive care, needing medications and mechanical ventilator to maintain their body after death. Without that support their heart will stop rapidly.
“Given that, and that they are not moving, pressure sores and tissue breakdown can occur. They are very difficult patients to nurse and care for.”
Adriana’s foetus is also at risk because its host body is no longer living, although it will be getting what it needs through the placenta for as long as she is on life-support. “There is very high risk for miscarriage, foetal death or birth abnormalities,” says Dr Gardiner. “In general terms from the second trimester, it is the placenta which supplies the growing foetus’ hormones, so growth does not depend on the mother’s brain.”
But while there have been other cases around the world of brain-dead pregnant women kept ‘alive’ for their baby to develop, not one of them has ever recovered.
Once Adriana’s life support is switched off, her body will shut down very quickly. She no longer has capacity for consciousness and she has permanently lost the ability to breathe, so once she’s taken off mechanical ventilation, Adriana’s body will “rapidly lose oxygen and the heart will cease within minutes”.
The mum-of-one’s family have repeatedly said they want Adriana to be taken off life support, while Emory University Hospital in Atlanta have laid out plans to keep her on ventilation until August, when they will deliver her baby by C-section.
Adriana’s mother, April Newkirk, said her unborn grandson – who they have named Chance – may not even survive the birth, but they will “love him just the same”.
“We didn’t have a choice or a say about it,” she added. “We want the baby. That’s a part of my daughter. But the decision should have been left to us – not the state.”
The Smith family will also be liable for Adriana’s mounting medical bills, despite their wishes to have her care withdrawn.
Her case has sparked anger around the world at the USA’s anti-abortion laws, which were swept in at state level after the Supreme Court overturned 50 years of Roe vs Wade in 2022. Under Georgia’s law – brought in by Republican politicians – abortion is banned after cardiac activity can be detected, which is around six weeks gestation.
