Georgia Advance Directive Pregnancy Clause: What Women Need to Know

Georgia has one of the most restrictive pregnancy provisions in U.S. advance directive law. Under O.C.G.A. § 31-32-9, Part Two generally has no force and effect during pregnancy unless the fetus is not viable and the declarant initials the statutory form's election in Part Two, Section (9) to have Part Two carried out.

Without meeting those statutory conditions, Part Two generally has no force and effect during pregnancy — regardless of what you told your family, your doctor, or your healthcare agent verbally.

How the Law Works

The standard Georgia Advance Directive for Health Care form lets you state treatment preferences in Part Two. You can request that life support be withdrawn when two physicians determine that you're in a terminal condition, persistent vegetative state, or end-stage condition. But the statutory pregnancy override changes the calculation.

If you are pregnant at the time a life-sustaining treatment decision arises:

1. Your healthcare agent's authority is limited. During pregnancy, Part Two generally has no force and effect unless the fetus is not viable and you initial the form's election in Part Two, Section (9) to have Part Two carried out.
2. The exception is narrow. The fetus must be non-viable, and the statutory election must be initialed; a custom instruction cannot bypass those requirements.
3. The statutory form includes the election. Review Part Two, Section (9), and follow its initialing instruction if you want Part Two to be carried out if the statutory non-viability condition is met.

Why This Matters

Brain death, catastrophic injury, and permanent vegetative states can happen to anyone at any age. For women of childbearing age in Georgia, the intersection of these events with pregnancy creates a situation where:

• Your family may be legally unable to honor your end-of-life wishes
• Physicians and hospitals, facing liability concerns, will default to maintaining life support
• Court intervention may be required to resolve the conflict between your directive and the pregnancy provision

The cases that have drawn national attention in recent years involve exactly this conflict — families watching a brain-dead loved one kept on mechanical support because the state's pregnancy provision overrides the patient's documented wishes.

What You Can Do

If you want Part Two of your advance directive to apply during a pregnancy, use the statutory election in Part Two, Section (9). There are two practical steps:

Option 1: Complete the statutory election. Review and initial Part Two, Section (9) so Part Two can be carried out if the fetus is non-viable.

Option 2: Discuss the limits with your agent and physician. Make sure they understand the non-viability condition and the initialing requirement, as well as what level of intervention you would want in the interim.

The statutory election and non-viability condition control. Verbal instructions or a separate custom clause cannot override the statutory restriction.

The Practical Steps

1. Review the statutory form carefully. Complete the election in Part Two, Section (9), following its initialing instruction and non-viability condition.
2. Discuss this with your healthcare agent. They need to understand both your wishes and the legal limitations they may face.
3. Keep a copy with your OB-GYN if you're currently pregnant or planning to become pregnant.
4. Review after major life changes. Your feelings about this provision may evolve with pregnancies, miscarriages, or changes in family planning.

The Georgia Advance Directive & Living Will Kit covers the pregnancy election in detail and provides guidance on documenting pregnancy-related preferences within Georgia's legal framework.

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