The Nurse Kept Alive Only Because She Was Pregnant and the Others: The Perverse (and Lethal) Effects of Anti-Abortion Laws

Adriana Smith , a 30-year-old nurse from Atlanta and mother of a 7-year-old boy, went to the hospital on February 9 for treatment of a severe headache, without receiving any specific treatment. On February 19, she was found unconscious by her partner and admitted to Emory University Hospital Midtown, where a CT scan showed the presence of blood clots in her brain. That same day, Adriana Smith was declared brain dead - an irreversible condition after which death is usually declared. Yet until today, the woman has been kept alive with artificial medical support. The reason? At the time of brain death, the 30-year-old was nine weeks pregnant . And the anti-abortion law of the state of Georgia - which prohibits the termination of pregnancy once a fetal heartbeat can be detected - requires the hospital to keep Smith artificially alive until it is relatively safe to proceed with a premature birth. Smith's family has stated that they have no choice in what treatments for their daughter or whether to continue her pregnancy to term. The nurse's mother described frequent visits to her daughter in the hospital as "torturous." The family was not informed whether the child could suffer serious illnesses or disabilities if the pregnancy is carried to term.

Abortion law in Georgia

Georgia has one of the most restrictive abortion laws in the United States, which went into effect in 2022, when the U.S. Supreme Court overturned a ruling that guaranteed abortion rights nationwide. The Living Infants Fairness and Equality (LIFE) Act prohibits abortions after the sixth week — a time when most women don’t even know they’re pregnant. The law, passed in 2019, was struck down as unconstitutional and stayed in 2022, but was reinstated by the Georgia Supreme Court in 2022, stayed again in 2024 following a judge’s ruling, and then reinstated by the Supreme Court that year.

The case of Adriana Smith, which has become a symbol of the most dramatic distortions of anti-abortion laws, is not an exception . In recent years, in various parts of the world, restrictive policies in the field of reproductive health have had devastating effects not only on the freedom of choice, but also on the health and life of women.

The case of Izabela Sajbor in Poland

In Poland, in 2021, the death of Izabela Sajbor , a 30-year-old woman who was 22 weeks pregnant , sparked outrage and protests across the country. Admitted to Pszczyna hospital due to a leak in amniotic fluid, Izabela was denied any curative medical intervention because the fetus still showed signs of life. Doctors chose to wait until the heartbeat stopped spontaneously, for fear of violating the abortion law in force since January of that year, which prohibits voluntary termination even in the presence of serious fetal malformations. Izabela died of sepsis a few hours later.

The law in question – passed after a ruling by Poland’s Constitutional Court in 2020 – eliminated almost all previously existing exceptions to legal abortion, leaving it possible only in cases of rape, incest or serious danger to the mother’s life.

Izabela's story sparked strong protests in Poland and had an echo at European level: the European Parliament adopted a resolution of condemnation in which it expressed "solidarity and support for Polish women" and called on the EU institutions to act against the anti-abortion drift of the Warsaw government. But the problem is not only Polish: it is evidence of how, even in the heart of Europe, the right to reproductive health is still fragile, exposed to ideological and religious attacks.

El Salvador: One of the World's Most Restrictive Anti-Abortion Laws

In El Salvador, one of the countries with the most restrictive abortion laws in the world, the termination of pregnancy is prohibited in all circumstances , including in cases of rape, incest, or danger to the mother's life. The ban on terminating a pregnancy also extends to cases of girls who have survived sexual violence. And it also provides penalties for termination of pregnancy due to natural causes . This legislation has led to the criminalization of women who have suffered obstetric emergencies, such as miscarriages or premature births.

A case in point in the Latin American country is that of Beatriz (her last name was not made public), a 21-year-old woman with lupus and kidney failure , who was denied a therapeutic abortion despite the fact that her fetus was anencephalic—that is, it was developing without a skull or brain. The young woman was forced to go through a lengthy legal process, only to give birth by cesarean section three months later, a much more invasive operation than doctors had initially recommended. Her son lived for only five hours after the operation. Beatriz died in October 2017 following health complications from a car accident. Her body was unable to cope with the rehospitalization. The Inter-American Court of Human Rights recently condemned El Salvador for obstetric violence and human rights violations in her case.

Africa: Between Restrictive Laws and Clandestine Abortions

In many African countries, restrictive abortion laws force women to resort to clandestine and dangerous practices. In Senegal , abortion is completely banned except when the woman's life is in danger, and even then it is made nearly impossible , since it requires the approval of three different doctors. According to the Guttmacher Institute, approximately 51,500 clandestine abortions occurred in 2012, with 63% performed by unqualified people, leading to serious complications for many women. In Uganda , although the Penal Code provides that abortion is only legal to save the woman's life, the 2006 National Guidelines on Sexual and Reproductive Health expand access to include cases of fetal abnormality, rape, incest, HIV infection, or cervical cancer. Legislative ambiguity and fear of legal repercussions push many doctors to refuse the intervention, forcing women to seek solutions that are unsafe for their health.

The Italian case: the problem of conscientious objection

In Italy, voluntary interruption of pregnancy (IVG) is regulated by law 194 of 1978 , which guarantees the right to abortion within the first 90 days of gestation and, in specific cases, even later. However, effective access to this right is often hindered by the high number of doctors who avail themselves of conscientious objection , provided for by article 9 of the same law.

According to the Ministry of Health's Annual Report on the implementation of Law 194, in 2022, 60.5% of gynecologists declared themselves conscientious objectors, a slight decrease compared to 63.6% the previous year. The percentages vary significantly between regions: peaks are recorded in Molise (90.9%) and Sicily (81.5%), while the lowest percentages are found in Valle d'Aosta (25.0%) and the Autonomous Province of Trento (31.8%). This situation has led to cases in which entire hospitals do not have non-objecting doctors, making access to abortion in some facilities virtually impossible.

Law 194 requires public health facilities to ensure effective access to abortion, even in the presence of conscientious objector personnel. However, the lack of available personnel and the absence of effective measures to guarantee this right raise concerns about the effective application of the law and fair access to abortion services throughout the country.