Adriana Smith: A Posthumous Pregnancy & the Biopolitics of Consent

Nishita Rao
Jun 11
5 min read

Updated: Jun 17

Patient: Adriana Smith

Black cisgender woman, age 30

Profession: Registered Nurse, mother of 2

Gestational Age at Time of Incident: 23 weeks

Presenting Symptoms:

Adriana Smith had initially visited the hospital for severe headaches and was sent home.
Her symptoms quickly worsened. "She was gasping for air in her sleep, gargling," Smith's mother told the station. "More than likely it was blood."
She was admitted to Emory Decatur Hospital following acute respiratory failure. The underlying cause was linked to a severe asthma attack.
Emergency medical intervention was unsuccessful in reviving cognitive or neurological function. She was declared legally brain-dead within hours of arrival.
Life support was continued not on medical grounds, but due to her pregnancy and Georgia’s interpretation of fetal personhood laws.

Timeline of Events:

February 2025: Adriana Smith, a 30-year-old nurse who was approximately nine weeks pregnant, went to Northside Hospital in Atlanta due to severe headaches. She was given medication and released.
Within 24 hours: Smith was rushed back to the hospital, Emory University Hospital Midtown, when she woke up gasping for air. A CT scan revealed blood clots in her brain.
Shortly after: Smith declared brain-dead. Hospital confirms zero brain activity.
More than 90 days after being declared brain-dead: Adriana Smith was still on life support at Emory University Hospital Midtown, where doctors were attempting to sustain her pregnancy.
Following Days: Life support was sustained due to her pregnancy and Georgia abortion law (HB 481).
May 2025: News reports emerged about Adriana Smith's case, highlighting the ethical and legal questions surrounding her situation.
May 20–30: Family disputes hospital’s decision, seeks ethical and legal counsel.
As of late May 2025: Adriana Smith was approximately 22 weeks pregnant.
Doctors' Plan: Doctors plan to keep Smith on life support until early August to deliver her child via C-section.
Public Outcry: Social media and major media platforms highlight the case; feminist and reproductive justice groups intervene.
Hospital Response: States compliance with Georgia law prohibiting termination of pregnancy post-six weeks.
Fetal Viability Questioned: Medical professionals voice concern over fetal survival in a brain-dead host body, pointing out potential congenital abnormalities, uterine distress, and systemic infection risk.
June 13, 2025: <Updated> The baby was delivered via C-section, prematurely (6 months), 1lb 13oz, and now in the neonatal intensive care unit (NICU)

Legal-Ethical Context:

Georgia’s HB 481 (passed post-Roe) defines a fetus as a legal person at six weeks gestation, a clause central to the hospital’s refusal to withdraw life support from a legally dead woman. This law overrides next-of-kin rights, informed consent documentation, and established protocols for brain death. The law includes no clear exception for brain-dead pregnant patients.

Family members report that Adriana had no advance directive. However, her sister, fiancé, and mother conveyed that she would never have consented to this torture of the body. Her death was eclipsed by a legal fiction: that her uterus was still alive, her body still useful.

Georgia joins Texas and Alabama in a legal regime where gestational mandates strip patients—especially women of color—of bodily sovereignty, even in death. Her case was not isolated, but part of a growing pattern of Black women being posthumously coerced into reproductive labor.

CRITICALLY ANALYZED

Clinical Concerns:

Brain-dead individuals cannot regulate temperature, fluid balance, or hormonal function, making long-term fetal gestation extremely risky and often unsuccessful.
Fetal exposure to declining organ systems and pharmacologic interventions (e.g., vasopressors, antibiotics) may result in long-term neurodevelopmental disorders or death.
The ethical framework of beneficence was violated when life support is continued without consent and without meaningful benefit to the fetus.

Assumptions Underlying Action:

The fetus’s right to life supersedes the personhood and death of the pregnant individual.
The uterus is a vessel of the state, even when the individual is dead.
The family’s grief is less important than legal compliance.
Black women’s bodies can be ethically repurposed if pregnant.

Implications:

The Adriana Smith case opens a new chapter in post-Roe reproductive violence. It redefines the labor of childbirth as a civic obligation—not merely of the living, but now the dead. This practice weaponizes medical technology to sustain reproductive labor after life has ceased. Such policies echo slavery-era ideologies, where the utility of Black women's bodies was defined by reproduction, not autonomy.

What was being incubated was not merely a fetus, but a biopolitical precedent: consent no longer matters. Death no longer ends legal governance of the female body. And personhood is no longer intrinsic—it is conditional, measured by uterine productivity. The baby was delivered via C-section on 13th June 2025, born prematurely, as Adriana was only 6 months into her pregnancy—the baby is housed in the NICU and the family is expected to front the medical costs.

Ethical and Policy Considerations:

Bioethics Violations: The four core principles (autonomy, beneficence, non-maleficence, justice) are all compromised.
Legal Oversight: No provision in Georgia law addresses medical futility in such cases or creates safeguards for end-of-life autonomy.
Racial Disparities: Data shows Black women are disproportionately impacted by maternal morbidity and lack of consent-based care. Adriana’s treatment reflects both systemic neglect and reproductive coercion.
Professional Dissent: The American College of Obstetricians and Gynecologists and American Medical Association have previously condemned such use of brain-dead patients as "non-consensual and unethical."

Comparative Precedents:

Marlise Muñoz (Texas, 2013): Brain-dead woman forced to remain on life support due to similar fetal personhood law. Husband sued and won the right to discontinue.
Valentina Milluzzo (Italy, 2016): Died after being denied abortion due to heartbeat laws.
Poland & El Salvador Cases: Legal regimes criminalizing abortion have repeatedly resulted in the deaths of women unable to terminate doomed pregnancies.

The questions we need to start asking are:

Is Coverture dead or kept alive under a mask of legislature?
Does a woman have truly have a right to their own bodies?
Can we stop assessing the utility of women on the basis of their positioning on the reproductive scale?

Arnold, D. (2025, May 30). Adriana Smith is far from the first incubator. BMJ Medical Ethics Blog.

Associated Press. (2025, June 17). Baby delivered prematurely from brain-dead woman on life support in Georgia.

Bioethics Today. (2025, May 30). The Adriana Smith Case: Unfolding in Atlanta Raises Many Questions.

Axios Atlanta. (2025, May 20). Georgia abortion law tested in brain-death case.

AP News. (2025, May 22). Brain-dead pregnant woman kept alive in Georgia despite family protest.

The Cut. (2025, June 1). Adriana Smith Is Dead. Her Pregnancy Is Not.

11Alive. (2025, May 21). The family of a 30-year-old metro Atlanta mother and nurse said she was declared brain-dead but is being kept alive because of the state's abortion ban.

@DemWomenCaucus. (2025, May 22). Twitter/X post highlighting racial injustice in Georgia's reproductive laws.