How Pregnancy May Affect Your Wishes

There is one limited situation in which your specific directions about health care might be challenged or ignored: if you are pregnant. Many states' laws say that doctors may not withdraw or withhold life support from a pregnant person—or that such treatment may not be withheld if the fetus can be brought to term.

These state restrictions have rankled many supporters of women's rights and are legally suspect under U.S. Supreme Court rulings that the Constitution protects women's right to choose whether or not to bear children.

For this reason, if you might become pregnant, this program asks you to say whether you want your health care directions to be:

  • given no effect if you are pregnant, or
  • carried out as written.

If you specify that your health care directives be given no effect, your health care providers will have the discretion to decide what care is appropriate. They are most likely to administer whatever life-prolonging procedures are available—particularly if the fetus is at least four or five months old and potentially viable and unharmed.

If you choose that your health care directions be carried out as written if you are pregnant, beware that you may meet some resistance from the medical establishment. This is particularly true if you have directed that life-prolonging treatment, food and water or palliative care should be withheld. And you are more apt to run into resistance the more advanced your pregnancy becomes. If you are into the second trimester—fourth through sixth months—doctors are likely to administer all medical care they deem necessary to keep you and the fetus alive.

By the third trimester, it may be practically impossible to overcome a state's proscription against withholding life-prolonging medical care.

If you have strong feelings about overcoming your state's strictures—that is, you live in a state that renders your directive completely ineffective if you are pregnant, but you wish to have it enforced—it is important for you to discuss your wishes and alert your health care agent to lobby on your behalf. It would also be wise to write a brief explanation of your thoughts on this specific issue in the "other wishes" section of your health care directive.

State Laws on Pregnancy and Health Care Directives

No Effect: The law in your state does not allow your document directing health care to take effect when you are pregnant.

To Term: The law in your state will not allow your document directing health care to take effect if you are pregnant and your doctors believe the fetus could be brought to term while you are receiving life-sustaining treatment.

No Statute: Your state does not have any law about prohibiting withdrawal of life support if you are pregnant.

Alabama

No Effect

Alaska

To Term

Arizona

You may state whether or not you want your health care directions to be carried out if you are pregnant and it is possible for the fetus to develop to the point of live birth.

Arkansas

To Term

California

No Statute

Colorado

To Term

Connecticut

You may indicate whether or not you want your health care directions to be carried out in the event of your pregnancy.

Delaware

To Term

District of Columbia

No Statute

Florida

Life-prolonging procedures will be provided unless you have expressly stated that your health care surrogate may authorize that life-prolonging procedures may be withheld if you are pregnant, or if your health care surrogate obtains court approval for withholding life-prolonging procedures.

Georgia

Life-sustaining procedures will be provided unless the fetus could not develop to the point of live birth and you expressly state that you want your health care instructions carried out.

Hawaii

No Statute

Idaho

No Effect

Illinois

To Term

Indiana

No Effect

Iowa

To Term

Kansas

No Effect

Kentucky

No Effect

Maine

No Statute

Maryland

You may indicate whether or not you want your health care directions carried out in the event of your pregnancy.

Massachusetts

No Statute

Michigan

If you are pregnant, your health care representative cannot make any medical decision to withhold or withdraw treatment that would result in your death.

Minnesota

You may indicate whether or not you want your health care directives to be carried out in the event of your pregnancy.

Mississippi

No Statute

Missouri

No Effect

Montana

To Term

Nebraska

To Term

Nevada

To Term

New Hampshire

Life-sustaining treatment will be provided unless your health care providers conclude that such treatment will not permit the fetus to develop to the point of live birth, or that such treatment will cause you physical harm or prolong severe pain that cannot be alleviated by medication.

New Jersey

You may indicate whether or not you want your health care directions to be carried out in the event of pregnancy.

New Mexico

No Statute

New York

No Statute

North Carolina

No Statute

North Dakota

Life-sustaining procedures will be provided unless those procedures will not permit the fetus to develop to the point of live birth, or your doctor concludes that prolonging your life would cause you physical harm or severe pain or would prolong severe pain that cannot be alleviated by medication.

Ohio

To Term

Oklahoma

You may indicate whether or not you want your health care directions carried out in the event of pregnancy.

Oregon

No Statute

Pennsylvania

Life-sustaining procedures will be provided unless your doctors conclude that the fetus could not develop to the point of live birth with continued application of those life-sustaining procedures, or prolonging your life would be physically harmful to you or cause you pain that could not be alleviated by medication.

Rhode Island

To Term

South Carolina

No Effect

South Dakota

Life-sustaining procedures will be provided unless your doctors conclude that the fetus could not develop to the point of live birth with continued application of those life-sustaining procedures, or that prolonging your life would cause you physical harm or prolong severe pain that cannot be alleviated by medication.

Tennessee

No Statute

Texas

No Effect

Utah

No Effect

Vermont

You may indicate whether or not you want your health care directions carried out in the event of pregnancy.

Virginia

You may provide additional or modified health care instructions that will apply only if you are pregnant when your document takes effect.

Washington

No Effect

West Virginia

No Statute

Wisconsin

No Effect

Wyoming

No Statute