Playing God with Black lives: The preventable tragedy of Adriana Smith

Black women in America have had a complicated—and often painful—relationship with childbirth for centuries. During slavery, Black women were forced to perform intensive labor throughout their pregnancies, and their infants were 1.6 times more likely to die during their first year compared to White infants. Many early gynecological advancements like cesarean sections were made by White doctors who used Black women as test subjects, usually without pain medicine or consent. Many Black women could not even rest in peace after their death due to their cadavers being used for all kinds of degrading and dehumanizing experimentation in White medical schools. 

This year, the February death of Adriana Smith and a hospital's subsequent decision to keep her body artificially alive until her baby’s birth has newly sparked controversy, concern, and a moral dilemma for many.

As covered in local media, Smith was a 30- year-old nurse, the mother of a school-aged son, who in the eighth week of a new pregnancy began suffering headaches and went to Northside Hospital in Atlanta. Instead of performing a CT scan or keeping her overnight, doctors sent Smith home with pain medicine. The next morning, Smith's boyfriend called 911 when she awoke gasping for air. After being transported to two different hospitals, she was diagnosed with several blood clots in her brain and was later pronounced brain-dead. 

Tragedy turned into disbelief when Emory University Hospital told Smith’s next of kin that Smith would be kept on life support until her baby could be delivered. According to the hospital, the family could have no say in the decision. Smith's mother, April Newkirk, told 11Alive, “I think every woman should have the right to make their own decision… And if not, then their partner or their parents.”

Emory Hospital's demand to keep Smith alive was most likely due to the legislative changes in Georgia in 2019 after Gov. Brian Kemp signed into law the “Living Infants Fairness and Equality” (LIFE) Act, a heartbeat bill that forbids abortions after a fetal pulse is detected. This is usually seen around the sixth week of pregnancy—earlier than many women know they are with child. The law also has provisions that treat the unborn baby as a person with certain legal rights. 

However, in a statement released amid the Smith controversy, Georgia's attorney general said that the LIFE Act does not apply in her situation:

“There is nothing in the LIFE Act that requires medical professionals to keep a woman on life support after brain death. Removing life support is not an action with the purpose to terminate a pregnancy. Our prayers go out to the woman's family.”

On June 13, Smith’s lifeless body underwent a cesarean section. Her baby, who the family named “Chance,” was born prematurely, weighing just under two pounds. With the baby receiving care in the NICU, Newkirk asked for prayers for her newest grandson and started a GoFundMe.

Many Catholics and Christians are celebrating the baby's birth as a victory for the pro-life cause, focusing on the fact that Chance deserves to be alive. As a Black Catholic, I'm appalled that the freedom his family deserved to make the life-or-death choice for Smith was stolen from them. The decision to take their next of kin off life support should have belonged only to them.

They may have chosen to keep Smith on life support in order to keep the baby. But the fact that they were given no choice harkens back to centuries of racist medical malpractice against Black women, their bodies, and their children. What the hospital administrators did was try to play God, force their will on a Black family that already faced unspeakable tragedy, and medically experiment on Smith and Chance.

As I read it, the Catholic Catechism also condemns the hospital's actions to force a medical decision on Smith's family without their consent.

Research or experimentation on the human being cannot legitimate acts that are in themselves contrary to the dignity of persons and moral law. The subjects' potential consent does not justify such acts. Experimentation on human beings is not morally legitimate if it exposes the subject's life or physical and psychological integrity to disproportionate or avoidable risks. Experimentation on human beings does not conform to the dignity of the person if it takes place without the informed consent of the subject or those who legitimately speak for him.
(CCC #2295)

While the Catechism makes clear that intentional abortion is always a sin, it also underscores that, sometimes, the death of a mother cannot be prevented. There needs to be acceptance of that, especially in certain unusual medical circumstances.

Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected.
(CCC #2278)

Instead of forcing a brain-dead woman to artificially incubate an unborn child who will never have an opportunity to meet his mother, the state of Georgia should be working toward rectifying the Black maternal mortality rate. This crisis is explained in Emory University’s Rollins Magazine, from the Rollins School of Public Health.

In 2021, maternal mortality (defined as a death during pregnancy or within one year of the end of pregnancy) rose by 40 percent in the U.S., with Black women dying at more than twice the rate of white women, according to a recent Centers for Disease Control and Prevention (CDC) report.  

Georgia’s maternal mortality rate is among the worst in the country with 33.9 deaths per 100,000 live births, according to data compiled by the National Center for Health Statistics between 2018 and 2021…Similar to the rest of the country, the numbers are worse for Black women: According to the Georgia Department of Public Health’s Maternal Mortality report, for the period 2018–2020, there were 48.6 pregnancy-related deaths per 100,000 live births among non-Hispanic Black women versus 22.7 pregnancy-related deaths per 100,000 live births among non-Hispanic white women. 

Racism, structural inequality, lack of access to quality health care, and the LIFE Act—which restricts 90% of common abortions—all lead to higher incidences of Black mothers and their babies dying. A recent Commonwealth Fund report shares key findings and concludes that: 

Compared to states where abortion is accessible, states that have banned, are planning to ban, or have otherwise restricted abortion have fewer maternity care providers; more maternity care “deserts”; higher rates of maternal mortality and infant death, especially among women of color; higher overall death rates for women of reproductive age; and greater racial inequities across their health care systems. 

While I'm certainly praying that Chance, the baby of Adriana Smith and her partner, thrives in the NICU and has a wonderful life, it's time for elected leaders to stop playing politics at the expense of Black families’ lives. God willing, all Black women and their next of kin should have the freedom and empowerment to make decisions when it comes to life and death decisions in medical settings.

Alessandra Harris is a co-founder of Black Catholic Messenger, author of three novels and a non-fiction title, "In the Shadow of Freedom: The Enduring Call for Racial Justice." In addition to holding degrees in Religious Studies and Middle East Studies, she is pursuing a Graduate Certificate in Restorative Justice and Chaplaincy from Santa Clara University.

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