A deeply personal disagreement between a surrogate and the couple who planned to raise her unborn child has become a complicated legal battle spanning three U.S. states.
McKenna West, an Alaska nurse who was serving as a surrogate, refused to terminate the pregnancy after doctors discovered that the baby had hypoplastic left heart syndrome, a serious heart defect that affects the development of the left side of the heart.
The diagnosis came at about 20 weeks of pregnancy. According to court filings, the intended parents, California residents Nausheen Gilkar and Omar Ahmed, wanted the pregnancy terminated. West disagreed and eventually traveled to Texas, where she could access specialists capable of treating the condition and where abortion is heavily restricted.
The baby was born Aug. 12 in Dallas and is now receiving specialized medical treatment. The child has become the focus of a dispute over who has the legal authority to make decisions about his care.
West has referred to the baby as Gabriel. The intended parents have said they chose the name Rumi.
The case has drawn attention partly because it exposes a difficult gap in U.S. surrogacy law. Surrogacy agreements are generally intended to settle parental rights and responsibilities before a pregnancy begins, but unexpected medical problems can create situations that are much harder to resolve.
West says she could not agree to an abortion and believed the baby should have the opportunity to receive treatment. Her lawyers have argued that a surrogacy contract cannot force a woman to undergo a medical procedure against her wishes.
The intended parents see the situation differently. Their attorney, Lee Budner, has said their priority is the health of their son and that they want to make medical decisions as his parents.
“Our clients’ only focus at this time is ensuring that their baby receives the medical care that he vitally needs,” Budner said.
Texas Attorney General Ken Paxton also became involved before the birth, seeking to ensure that the baby would receive medically necessary treatment. “Baby Gabriel deserves a chance at life,” Paxton said.
After the birth, a Texas court authorized Gilkar and Ahmed to make medical decisions for the child, according to court documents. The parents are now with the baby as he receives treatment in Dallas.
The dispute has not ended there. Gilkar and Ahmed have sued West, alleging that she violated the terms of their surrogacy agreement by refusing to follow their wishes after the baby’s diagnosis. West’s legal team has pushed back, arguing that she should not be forced to terminate a pregnancy against her will and seeking recognition of her rights under Texas law.
The case is particularly complicated because the parties are connected to different states with different approaches to surrogacy and reproductive law. West lives in Alaska, the intended parents live in California, and the baby was born in Texas. Courts in all three states have become involved in different aspects of the dispute.
Hypoplastic left heart syndrome is a serious condition, but it is not necessarily fatal. Babies born with the defect typically require multiple surgeries and long term medical care. The first procedure is generally performed shortly after birth.
The disagreement reflects a broader issue that has followed the growth of assisted reproduction for decades: What happens when the person carrying a pregnancy and the intended parents no longer agree about what should happen to the child?
Surrogacy has become increasingly common in the United States, but there is no single nationwide legal framework governing every aspect of the process. States have developed their own rules concerning contracts, parental rights and the legal status of children born through assisted reproduction.
Those differences can become especially important when a pregnancy takes an unexpected turn.
For West, the dispute is about her right to make decisions about her own pregnancy and her belief that the baby deserves medical treatment. For Gilkar and Ahmed, it is about their rights as the child’s parents and their ability to determine what they believe is best for their son.
At the center of the argument is a newborn who now needs complex medical care.
As the legal proceedings continue, the case could have implications beyond the people involved. It may force courts to take a closer look at how surrogacy contracts should handle medical emergencies and where the rights of intended parents end and a surrogate’s control over her own body begins.
The next major court hearing is scheduled for Aug. 25. Until then, the baby’s medical treatment continues while the adults involved wait for the courts to determine what happens next.
