Commercial surrogacy has grown like a wildfire in the United States – and just like an uncontrolled flame in a forest, it has blown past any meaningful barriers. And more and more, it has raised serious ethical questions around discriminatory induced abortions. Beginning roughly in the late 1970s, legal surrogacy in the U.S. now accounts for approximately 40% of all gestational surrogacies worldwide. Commercial surrogacy, where money is exchanged to “rent the womb” of a woman, is legal in only a few countries worldwide, including the US. The recent story of gestational surrogate McKenna West and Gabriel, the baby she carried, is another heartbreaking example of why regulation of this industry is urgently needed.
This highly publicized case has been scrutinized by the nation, prompting AAPLOG and the American College of Pediatricians (ACPeds) to jointly call for Gabriel and all preborn children to be protected from discriminatory induced abortion and to receive appropriate medical care, regardless of diagnosis or circumstance.
Here’s what happened, according to a recent New York Post op-ed by West:
In 2025, as a single mom living in Alaska, West agreed to be a surrogate for a California couple. Her goal was to help people who wanted children get to live that dream. However, when she was approximately 20 weeks pregnant, the contracting couple decided they didn’t want their son anymore. They ordered West to have an induced abortion.
Why the change in heart? There was something wrong with their son’s – a routine ultrasound had found that he had hypoplastic left heart syndrome. As a cardiac nurse herself, West knew this was “serious but treatable,” with the prescribed care being staged reconstruction surgeries, beginning soon after birth. West wrote, “This medical treatment gives children a high chance of going on to live full lives.” Yet, the couple she was carrying for didn’t want to go through with it. Instead, they wanted to end Gabriel’s life. McKenna was told she had to undergo a risky late second trimester abortion.
When West told the couple she wouldn’t end the baby’s life, her payments were cut off, and both their lawyer and hers sent her threatening letters (which concluded in filed claims amounting to at least $100,000 because West didn’t abort the baby). She ended up covering the rest of the pregnancy-related expenses herself and making a plan to save the baby.
West found a hospital in Texas with “excellent surgical outcomes, including a 100% survival rate for the Norwood procedure” (the first stage of surgical reconstruction). The contracting couple, however, wanted her to deliver in California – with zero commitment to actually have the necessary surgery done – at a hospital with a less desirable track record.
West once again took the hard road and moved to Texas, where the baby boy would have his best chance at survival. He was born on August 12 and taken care of immediately. She heartbreakingly wrote, “I haven’t been allowed to hold this precious baby boy I carried and protected throughout my pregnancy. The only glimpse I got of him was during a very short 60 seconds while his umbilical cord was still connected.” West was informed he received his first surgery. She’s unsure what will happen to him next.
The legal battle to ensure he receives proper, life-affirming care continues.
Dr. Christina Francis, CEO of AAPLOG, stated, “AAPLOG remains committed to life-affirming healthcare in all circumstances for all patients, whether it’s a biological mother, surrogate, or preborn child. This case highlights the need to keep the well-being of children at the center of decisions involving reproductive technologies and to ensure that every child receives the protection and medical care he or she deserves. When the child’s care is removed, the carrying mother’s health and safety is also placed in jeopardy. In this case, West was asked to undergo a risky late abortion that would have placed her in unnecessary danger. Life-affirming care is always the most ethical strategy.
“AAPLOG’s grateful to the Texas courts for agreeing, ruling in favor of life-saving care for this child. A preborn child’s health should never be at the whim of adults who decide whether they receive care or die by induced abortion. AAPLOG will continue to affirm the inherent dignity of every human life.”
