Adriana Smith, Misogyny and the Cruelty of Forced Birth

Adriana Smith couldn't access competent medical care when she needed it, and it killed her. Now the hospital is forcing 'care' on her by keeping her alive as an incubator due to Georgia's abortion ban

The case of Adriana Smith has shaken me to my core. I hadn’t planned on writing another article this soon, but when I read about what was happening to her family and the egregious failure of the medical system to protect her, I felt compelled to say something.

Reproductive rights is an issue that’s always been near and dear to my heart. When I was in my late teens and early twenties I received a shocking lesson in misogyny, patriarchy and the lack of autonomy granted to those of us who have a uterus.

I was diagnosed with stage four endometriosis and adenomyosis, and the conditions left me completely disabled. Unable to work or function, I spent my days in unrelenting pain. I was in and out of hospitals requiring regular blood and iron transfusions.

I didn’t want children, nor was I healthy enough to be a mother. So I asked my doctor for a hysterectomy.

At the time it seemed a perfectly reasonable request. My uterus was diseased, I had undergone six surgeries which had not improved things, and my quality of life was gone. Why would I keep something in my body that was making me so incredibly sick?

Needless to say I was shocked when I was told ‘No’ and the reason given was ‘you might change your mind and want kids one day.’

Sure, anything is possible. I might also win the lottery, but I’m not counting on it.

I wasn’t given autonomy over my body. I wasn’t allowed to make the choice that was right for me.

I saw a series of doctors over a number of years who all said the same thing. “You might change your mind.”

Many also referenced a hypothetical ‘dream man’ who would leave me if he realized I couldn’t have kids.

At every painful appointment, I was reminded that my life was worth less than a hypothetical future child. That I was a womb, not a person. That the fact that I didn’t want to have children, physically couldn’t care for them and was completely disabled by my uterus didn’t matter because there MIGHT be a man and a baby in my future.

It was a rude awakening into just how badly women are treated by the medical system. This happened in Canada, where we are generally more liberal about autonomy than our neighbours to the south. There also wasn’t a fetus involved. I wasn’t trying to access an abortion, I simply wanted my uterus removed.

The uphill battle I faced to get a surgery I desperately needed inspired me to learn more about abortion access and reproductive rights. It’s why I feel passionately that choice should be given to everyone, and that the government has no business regulating what we do with our bodies.

Which brings me to Adriana, a case so disturbing it’s been keeping me up at night.

Adriana Smith and Georgia’s Abortion Ban

Adriana was a 30 year old mother and nurse who was nine weeks pregnant when she experienced severe headaches which sent her to the ER.

Despite being a healthcare worker herself, she was unable to get proper care. The hospital dismissed her concerns and sent her home. The next day she was pronounced brain dead due to multiple blood clots in her brain.

The hospital immediately placed her on ‘organ and tissue support’ because of Georgia’s abortion ban. They did not ask for permission from her family or give them any say in the matter. They turned Adriana into a human incubator for her fetus.

Having your concerns dismissed in the ER is nothing new to most of us, especially women and marginalized individuals. Misogyny, ableism and discrimination are far more rampant in healthcare settings than we want to believe.

It’s even worse if you’re black. Misogynoir, which is the term given to the sexism and racism experienced by black women, is a serious issue in America. Black women are three times more likely to die in pregnancy because their pregnancy related concerns are frequently dismissed.

This intersection of sexism and racism creates an exceedingly dangerous situation, and it only gets worse in states with abortion bans.

Pregnancy is considered a temporary disability, so Adriana would be considered marginalized in a number of ways. A black, disabled woman struggles to access the healthcare care she needs to survive, only to have ‘care’ we don’t know she would have wanted forced onto her due to the state’s draconian abortion ban.

What are we even doing anymore?

Image Description: A photo of Adriana Smith sitting by a body of water in a blue dress, cradling her pregnant belly.

Strict abortion bans like the one in Georgia have been on the books for many years, but thanks to the protection of Roe v Wade were unable to be enforced. When the Supreme Court overturned Roe, these ‘trigger laws’ immediately went into effect. They’ve already killed at least two women in Georgia that we know of, and now are causing tremendous pain and suffering to the family of Adriana Smith.

There are vanishingly few cases of pregnant people being kept alive after brain death so a fetus can be born. Most of the ones in the medical literature involved a median gestational age of twenty weeks, which reduced the amount of time the fetus needed to remain inside it’s deceased mother.

Adriana was only nine weeks when declared brain dead, meaning they are keeping her alive far longer than is generally medically indicated. They’ve given her family absolutely no say in what happens to her, effectively forcing them to endure the trauma of watching their daughter waste away on machines as hospital staff treat her as nothing more than an incubator.

Her case is a perfect example of why we say that abortion is healthcare. It is a necessary part of reproductive health and one that should never be criminalized. When abortion bans exist, women lose control over their bodies. They no longer get to decide what’s best for them, and Adriana’s case is an extreme example of what can go wrong.

Obviously we can’t possibly know her wishes, and while her family have said this is ‘torture’ for them, they’ve not publicly said whether they would have terminated tissue and organ support.

What we do know is that a hospital failed to provide a pregnant woman with necessary care to save her life, and then forced ‘care’ upon her deceased body in an attempt to save a fetus. They did not get the consent of next of kin to do this, because legally they do not need it.

They made the decision for Adriana’s family, in order to ensure they don’t run afoul of the abortion ban. And that is never going to be ok.

Photo by Gayatri Malhotra on Unsplash

Image Description: A photo of people at a protest. One of them is holding up a sign that reads “Abortion Is Healthcare”

Abortion Is Healthcare

I’m not going to spend a lot of time on this since there are many other incredible writers who dedicate their entire newsletters to explaining the various ways abortion is healthcare.

If you want to learn more I highly recommend starting with

Jessica Valenti

. Her publication “Abortion, Every Day” is a fountain of information on this subject.

That said, it’s important to ensure people understand that many life saving medical procedures are technically classed as ‘abortions’. When abortion is criminalized, women can’t access the care they need to survive.

An example of this would be an ectopic pregnancy. It’s a pregnancy that occurs outside the uterus, and threatens the life of the mother. It’s not viable. A fetus can not survive outside the uterus and must be surgically removed.

In states with abortion bans, healthcare workers have to wait until the mother’s life is in danger before they can intervene. Who makes that call? How sick does a pregnant person need to become before it’s legally ‘ok’ to remove the pregnancy?

These are the questions healthcare workers are wrestling with. If they intervene too early, they risk being charged with a crime. If they wait too long, they risk killing their patient.

Suffice it to say there’s a reason many OBGYNs are leaving states with abortion bans in large numbers. They don’t want to be put in that situation. They don’t want to have to contact the hospital legal team before providing the care they know their patient needs. They don’t want to fear arrest and prosecution for simply doing their jobs.

A similar situation occurs with an incomplete miscarriage, which is a situation where some fetal tissue is left behind following a pregnancy loss. If not removed, the mother can become septic and die. The pregnancy is over and the fetus is no longer viable, yet strict abortion bans say that doctors can’t intervene until the life of the mother is clearly in jeopardy.

Pregnancy is always considered a high risk condition. Anything that you’re at risk for in regular life will be amplified during pregnancy. It’s exceedingly dangerous to force healthcare workers to play a game of chicken with their patient’s life. To insist they get it ‘just right’ with respect to when the life of the mother is in jeopardy.

All too often, when a pregnant patient decompensates, it happens rapidly and can quickly result in death. Why are we forcing healthcare workers to wait until that moment before they can do their job?

Because it’s not about being pro life, it’s about control. The people behind these bans seek to control women. One of the best ways to control us is to remove our autonomy over our own bodies.

Abortion bans keep women trapped in abusive relationships, they jeopardize their health, force them into poverty and traumatize them. That’s without even getting into the discussion about victims of rape and incest, who’ve already had their autonomy violated by their abuser and then end up being violated all over again when they’re forced to keep a pregnancy they do not want.

In Short, Women Have Lost Control Over Their Bodies

When abortion bans exist, or when fetal personhood is granted, women lose all control over their bodies. These laws effectively criminalize pregnancy, and take a condition which already puts a person at high risk and elevates that risk even more.

Fetal “personhood” refers to the idea that a fetus (and sometimes an embryo) is a person under the law with full legal rights. This means that abortion at any stage of pregnancy could be considered murder, and a pregnant person and anyone who helped them access an abortion can be charged with a crime.

In Alabama it’s been taken a step further, with the Supreme Court ruling that frozen embryos are ‘children’ and therefore destroying them is also murder. This has far reaching consequences for the future of IVF and fertility treatments.

Fetal personhood also gives a right to a fetus that no other person has, the right to use another human being’s body without express and ongoing consent. These laws effectively allow a pregnant person’s life to be put at risk whether they agree or not. They force those who don’t wish to be pregnant to carry to term. They strip one person of their autonomy, safety and legal right to choose what’s best for them in order to give rights to another.

It’s not ok, and it’s killing people.

The Government Shouldn’t Get To Decide What We Do With Our Bodies

The abortion debate comes down to one simple issue, autonomy. The government should not get to decide what we do with our bodies. The decision to have an abortion is one to be made between a pregnant person, their partner/spouse (if there is one) and their doctor. It’s no one else’s business.

I think this is something we need to keep calling out. It’s no one else’s business. That includes the government.

Adriana’s case is a perfect example of this. I’ve seen a lot of people saying they ‘need more information’. They want to know whether Adriana had a DNR (Do Not Resuscitate Order), whether her family are prepared to keep and parent their grandchild and whether Adriana ‘wanted’ her baby.

I understand the impulse to want more information. I get that people might find it easier to decide how they feel about this very complex situation if they have all the facts. But we aren’t entitled to her private medical details or the wishes of her family. It’s not our business.

We can’t know what she would have wanted or how her family plan to proceed if the baby survives.

Here’s the most important part, just like we can’t possibly know their wishes, neither can the government.

Please read that again. The government can not possibly know what’s best for this family. They can’t know what’s best for the potential child should it be born. They can’t know if it will be well cared for, if it will survive outside of the womb, if it will have access to what it needs to survive and thrive.

The only people who know these things are the family and the medical team, yet they’re not being permitted to make the decision. Georgia’s restrictive abortion ban has taken it out of their hands.

These bans tell people that they’re competent enough to raise a child, but not to decide for themselves if having a child is the right choice. That will never be ok.

The government has no business regulating our reproductive organs. Abortion bans don’t save lives, they end them. Maternal and infant mortality increase significantly in states with restrictive abortion bans, because people can’t access the care they need to save their own lives and/or the life of their baby.

Adriana’s family deserved to have the right to make the decision that was best for them. They’re already suffering the trauma of losing their daughter to medical neglect, forcing them to watch her waste away on machines as a human incubator without ever asking them if it’s what they want? It’s tantamount to torture. It’s a medical experiment being done without consent.

Adriana also deserved to have the right to make her own decisions regarding end of life care, but even if she had an Advanced Directive or a DNR it likely would have been disregarded. Only eight States currently honour the Advance Directives of pregnant people, the rest have ‘pregnancy clauses’ which take away their autonomy even in death.

If The State Demands Forced Birth, It Should Be Required To Support the Child

This is the last argument I want to make against forced birth, and it’s one that a lot of pro life people seem intent on ignoring.

The United States does not have Universal Healthcare. Their social supports are woefully lacking. They have high rates of poverty and homelessness. They’re the richest country in the world, and yet a study was recently released that showed a majority of Americans can’t afford a MINIMAL quality of life.

The cost of keeping Adriana on organ and tissue support will be astronomical, and we don’t know who’s paying for it. Is the hospital footing the bill or do they intend to bankrupt her parents? Assuming it’s the latter, how are they going to be able to support the baby that the state is forcing them to have?

There’s also the fact that the odds of the fetus having serious disabilities are quite high. It’s already been found to be suffering from hydrocephalus (fluid on the brain) and is incubating inside someone who experienced complete brain death at nine weeks. The medical team have to attempt to regulate Adriana’s hormones, nutrition, cardiac output and more, and it’s simply nowhere near the same as developing inside of a living mother.

Karen Tang, an OBGYN, did some research into similar cases and found that of thirty pregnancies that experienced brain death, only twelve fetuses were viable when born. Of the cases she uncovered, the earliest case of brain death was 16 weeks, a full seven weeks later than Adriana.

Video Courtesy of Karen Tang, MD

This is a medical experiment. We simply cannot know what is being done to the fetus under these incredibly stressful conditions. It’s not right to force a family to sit with these unknowns and watch their brain dead daughter be experimented on because of an abortion ban.

To be clear, I’m in no way saying we should abort fetuses that will be born with disabilities. That’s eugenics which I do not support.

What I’m saying is that the decision can not and should not ever be up to the Government.

If they’re going to take the choice away from pregnant people and their families, they should have a legal and moral obligation to provide full support for the baby they are forcing into the world.

If this were truly about being ‘pro life’ (which we know it’s not) they would ensure that all babies born were being given medical care, food, shelter, education and love.

They don’t do that because it’s not about life. The moment the fetus is outside of the mother, it’s effectively on it’s own. The current US government doesn’t care about what happens to babies, especially if they’re black, poor, disabled or marginalized. They care about controlling women, forcing them to endure a pregnancy and birth that they don’t want, and then they wash their hands of the entire situation.

In case you think I’m being hyperbolic, let’s look at infant mortality rates in Georgia, the State currently forcing Adriana to be an incubator for her fetus.

Their infant mortality is one of the worst in the US, and in 2022 (after the fall of Roe) they saw a 13% increase in infant deaths (compared to a 3% increase overall). Worse still, black babies have the highest rate of infant deaths in the US at 10.86 per 1000 live births.¹

This has never been about protecting babies. The stats speak for themselves.

Where Do We Go From Here?

First, we need to acknowledge that women will never have true equality under the law or be free from oppression until they have autonomy over their bodies and choice when it comes to their reproductive rights.

We do not deserve to be treated as nothing more than incubators, nor should we ever be made INTO an incubator like what’s happening to Adriana.

Abortion is healthcare, and we need to fight to ensure everyone has access to the reproductive healthcare they need and deserve.

Secondly, I encourage everyone to fight the proposed “Big Beautiful Bill” the Republicans are trying to force through. It cuts Medicaid and food assistance programs, both of which are necessary to protect disabled and low income babies that this same government are forcing be born.

It just recently passed a key committee in a late night vote on Sunday May 18th, but we can still fight it.

Medicaid currently provides care to a third of disabled children and 7 out of 10 poor disabled children.

It is the height of cruelty to slash the program while at the same time forcing women to give birth to babies they don’t want, can’t afford and/or can’t care for.

Call your elected officials. Demand they vote ‘No’ on cuts to Medicaid and food assistance. While you’re talking to them, make sure they know you also oppose abortion bans and forced birth policies.

I know it can feel dire right now, but we need to remember that we all have a voice. We all have power. When we use our voice, it can make a difference.

In addition to calling and emailing elected officials, tell your stories. I know it’s scary and not everyone has the privilege of a platform, but if you’re able, speak up. Tell the world about what medical misogyny or misogynoir has done to you. What challenges you’ve faced accessing reproductive healthcare. What an abortion ban would do to you and your loved ones.

Finally, amplify the stories of those who are most marginalized. They can struggle to get their stories told. Share them, support them and hold space for them. Hold space for Adriana’s family, and for all the other women who have died, been traumatized or disabled by medical misogyny and cruel forced birth policies.

We are stronger together.

If you want to learn more about the medical ethics of Adriana Smith’s case, I strongly recommend this video by

Alyssa Burgart, MD, MA

Do you have a story you want to tell about pregnancy, reproductive rights, abortion or medical misogyny?

Have you experienced trauma due to lack of autonomy in reproductive health?

Please comment below and let’s support one another as we fight for true equal rights.

1. Infant mortality stats can be found here: https://www.ossoff.senate.gov/press-releases/cdc-reports-georgia-infant-mortality-increase-among-worst-in-country-sen-ossoff-sounds-alarm/#:~:text=%E2%80%9CIn%20Georgia%2C%20892%20infants%20died,than%20the%20year%20before%20nationwide.