Who Has the Final Say in a Surrogate Pregnancy? Inside the McKenna West Case

The birth of a baby boy with a life-threatening heart condition has sparked a complicated legal battle involving surrogacy, abortion and parental rights across three states.

Rumi was born in Dallas, Texas, on Aug. 12 with hypoplastic left heart syndrome, a rare defect that left him in need of a series of major heart surgeries. But a conflict surrounding his birth began months earlier, after his intended parents, Omar Ahmed and Nausheen Gilkar, decided to terminate the pregnancy following his diagnosis — and their surrogate, McKenna West, ultimately chose to continue it.

Now, West is seeking legal parentage and custody, while Ahmed and Gilkar maintain that they are Rumi’s legal parents.

The dispute has since drawn in Texas Attorney General Ken Paxton, anti-abortion groups, and courts in multiple states — while raising a complicated question with no easy answer: What happens when a surrogate and intended parents fundamentally disagree about a pregnancy? We asked two legal experts to weigh in.

What happened between McKenna West and the baby's intended parents?

In August 2025, West, a cardiac nurse and single mother of two, agreed to serve as a surrogate for the Los Angeles couple. Things appear to have gone relatively smoothly until about halfway through the pregnancy, when an anatomy scan revealed that the baby had hypoplastic left heart syndrome, or HLHS, a rare and potentially life-threatening heart defect.

According to court filings, Ahmed and Gilkar decided to terminate the pregnancy after consulting with doctors and researching the condition. Their attorneys called it a “difficult decision” following “heartbreaking consultations with medical providers.”

West claims the couple spent weeks pressuring her to have an abortion after she decided to continue the pregnancy. Ahmed and Gilkar deny that they tried to force her to terminate the pregnancy. Their filings acknowledge that they initially decided to terminate — and say West initially agreed — but say that after she chose to continue the pregnancy, they respected that decision and made plans for their baby’s delivery and medical care in California.

This is when things escalated: West then allegedly cut off contact and traveled from Alaska to Texas (where almost all abortions are illegal) with help from anti-abortion groups.

With legal support from the conservative Christian organization Alliance Defending Freedom, West petitioned a Dallas court for custody two days before giving birth. West gave birth to the baby boy in Texas on Aug. 12.

Texas Attorney General Paxton intervened, accusing Ahmed and Gilkar of refusing to consent to life-saving heart surgery for the baby. The couple strongly denied the allegation, saying they never intended to withhold care and had made plans for the baby’s care after birth.

A Dallas judge granted the biological parents’ request that prevents West from making any medical decision for the child and representing herself as the child’s mother.

The baby, whom Ahmed and Gilkar have named Rumi, remains in Texas with the couple while receiving treatment for HLHS. He underwent the Norwood procedure on Aug. 17, the first of three surgeries typically used to treat the condition. According to the couple’s attorney, Lee Budner, Rumi is recovering with Ahmed and Gilkar and his medical team, though his condition remains “critical and complex.” The family does not plan to provide further updates as he begins what Budner described as a long recovery.

What is hypoplastic left heart syndrome?

HLHS is a serious birth defect in which the left side of a fetus's heart doesn’t fully develop, making it difficult for the heart to pump blood to the rest of the body. The exact cause isn’t known, though genetics may play a role, according to the Mayo Clinic. It’s also extremely rare: About 925 babies in the U.S. are born with HLHS each year, according to the CDC.

Babies with the condition typically become very sick soon after birth. Symptoms can include blue or gray skin, rapid or strained breathing, poor feeding, cold hands and feet, a weak pulse, and unusual drowsiness. Without treatment, HLHS can quickly become life-threatening, and babies with the condition may die within days or weeks.

Treatment typically involves a series of three surgeries beginning shortly after birth. The Norwood procedure, which Rumi already underwent, is the first and is usually performed within the first two weeks of life, according to the CDC. A second surgery generally occurs around 4 to 6 months of age, with the third typically performed between 18 months and 3 years of age.

But those surgeries aren’t considered a cure. Children with HLHS can face lifelong heart complications and require regular care from a cardiologist. In more complex cases — or if the heart becomes too weak despite surgery — a heart transplant may eventually be necessary. Children who receive one must take anti-rejection medication for the rest of their lives.

What do surrogacy laws say?

Part of what has made this case so complicated is the patchwork of surrogacy laws in the U.S. There’s no overarching federal law — instead, states set their own rules, including whether agreements are enforceable and how intended parents establish legal parentage.

Surrogacy agreements commonly include termination clauses that spell out the circumstances under which the parties agree a pregnancy may be terminated, according to Rachel Rebouché, a law professor at the University of Texas. Those can include fetal anomalies, risks to the surrogate’s health, or other conditions specified in the contract. West’s agreement reportedly had a broad provision addressing fetal anomalies, though Rebouché said she has not seen the contract itself.

But even if a contract includes a termination clause, Rebouché says no state allows intended parents to legally force a surrogate to have an abortion against her will.

“A surrogate’s bodily autonomy cannot be contractually signed away,” she tells Katie Couric Media. “This is not just a policy argument; it is settled law.”

That doesn’t necessarily mean refusing to follow a termination provision has no consequences. Rebouché said surrogacy agreements can include financial penalties for breaching their terms, such as requiring a surrogate to repay compensation or forgo future payments.

But what makes West’s case particularly unusual is that she isn’t simply arguing that she had the right to continue the pregnancy — she’s also seeking legal parentage and custody of the child.

Susan Crockin, an attorney and legal scholar specializing in assisted reproductive technology and surrogacy law, cautions against viewing the dispute as representative of surrogacy more broadly. “It’s an aberrational case,” she tells Katie Couric Media. “Thousands upon thousands of families are built by surrogacy, by women who want to be surrogates, by families who want to have children this way, and they don’t make the news.”

But Crockin worries the case could still have broader consequences, giving anti-surrogacy advocates a platform to push state lawmakers for tighter restrictions.

Who has custody of Rumi, and what happens next?

Ahmed and Gilkar currently have custody of Rumi and authority over his medical care. A California court had already recognized them as his legal parents before his birth.

But West’s attorneys are challenging that, arguing that West “is lawfully the parent because she gave birth to this child that she carries in Texas” and therefore “should control custody as well.”

The Dallas judge reinforced Ahmed and Gilkar’s authority over Rumi’s medical care and ordered that the baby receive life-saving treatment in Texas while the dispute plays out. According to West’s attorney, the orders have also prevented her from seeing or holding the baby.

The fight isn’t over, though. The parties are due back in a Dallas County court on Aug. 25 for the next hearing in the case.