McKenna West entered surrogacy believing she was doing something generous. A single mother from Alaska, she hoped to help an infertile couple have a child while earning money to support her own family. She was matched with a California couple and became pregnant through IVF.

Then came the 20-week ultrasound.

Doctors diagnosed the baby boy with hypoplastic left heart syndrome, a serious congenital heart condition that would need to be treated surgically. The diagnosis changed everything.

The genetic parents invoked an abortion provision in the surrogacy contract and demanded that McKenna abort their son at 24 weeks, which would mean a horrific second-trimester abortion. If she refused, she could face more than $100,000 in financial liability.

At 24 weeks, a preborn baby is remarkably developed and can survive outside the womb even earlier. The most common abortion procedure at this stage is dilation and evacuation (D&E), which involves dilating the cervix before forceps are used to reach into the womb, grasp a limb or part of the living child, and remove the body by dismemberment. In some cases, a lethal injection may be administered by piercing the baby’s chest and triggering a heart attack with a drug such as digoxin. These procedures are sobering and painful realities.

So, McKenna refused. That decision is why this child is alive today.

McKenna went to Texas seeking a hospital known for the life-saving surgeries he would need after birth because of his condition. The legal battle continued over his medical treatment, custody, and McKenna’s ability to remain in his life. Texas Attorney General Ken Paxton intervened in the dispute over the baby’s care, and a court appointed a guardian to protect his medical interests.

The courts have since ruled that the genetic parents have legal custody of the child. On September 22, 2026, the U.S. Supreme Court refused to intervene: Justice Elena Kagan denied McKenna’s emergency request to halt the California court order recognizing the intended parents as the child’s legal parents. The brief denial left that order in place. The highest court in the land declined even to pause the arrangement that severs a newborn from the woman who carried and defended him. Today, the genetic parents have complete control over the baby’s care.

McKenna was separated from the child she had carried and protected when others wanted his life ended.

This heartbreaking separation of mother and child exposes the deep injustice of commodification, which is at the heart of commercial surrogacy. The deliberate severance of the profound bond between a child and the mother who carried him treats both as parties in a contract rather than as human beings.

And the legal pressure has not ended. McKenna is now being sued by the genetic parents, who are seeking substantial damages from the woman whose refusal to abort made it possible for this child to be alive at all.

Her story is heartbreaking on its own. It also exposes something much larger.

Surrogacy asks the law to turn some of the most intimate human relationships imaginable into matters of contract. Before a child is born, agreements can attempt to determine who controls decisions during pregnancy, what happens if the child has a disability, what medical procedures the woman carrying him may be expected to undergo, and who will have custody of the child after birth.

The abortion clause in McKenna’s contract shows how dangerous that can become.

A woman should never face financial ruin because she refuses to undergo an abortion. No contract should give another person the power to demand the death of the child she is carrying or punish her financially for saying no.

Commercial surrogacy places money and contractual obligations around pregnancy and even the life of a living human child. The adults negotiate the terms. The child cannot. He has no voice in the agreement governing his conception, gestation, custody, or relationship with the woman whose body sustained him for nine months.

Contracts cannot anticipate what happens when a child does not meet the expectations of the adults who commissioned the arrangement. What if the baby is “imperfect” in the eyes of the buying parents?

In McKenna’s case, a medical diagnosis was all it took. The genetic parents wanted an abortion. McKenna did not. A contractual arrangement that was supposed to govern the commercial transaction surrounding a pregnancy suddenly became a weapon that could be used to try to force a woman to end the life of the child growing inside her.

She chose the child instead.

Whatever one believes about the complicated custody questions that followed, one fact is impossible to ignore: this child is alive today because McKenna refused to abort him.

That should force a more serious reckoning with surrogacy.

Pregnancy is not a service that can be purchased, and a child is not a product whose terms can be negotiated before birth. When money, parental rights, medical decisions, and expectations about the characteristics of a child are bound together in a contract, the dignity of both women and children is unacceptably compromised.

Abortion-demand clauses in surrogacy contracts should be banned. Thankfully, there is already legislation in Congress that would do just that. Courts should also recognize the humanity and rights of every mother and preborn child. In America, the child must come first.

McKenna’s case has shown exactly where such clauses can lead. The child she carried is alive today because she refused to obey one.

Please pray for McKenna and for the genetic parents in this story. I pray that McKenna will one day have the opportunity to meet the child she carried for nine months and fought to save, and that his parents will continue pursuing the medical care he needs to thrive. I pray, too, that no family facing a difficult prenatal diagnosis is made to believe that abortion is the only answer. A child’s right to life does not depend on a diagnosis, a prognosis, or the circumstances of his conception.

Whatever broader debate America continues to have about surrogacy, this should be the starting point: abortion can never be a contractual obligation, and refusing to kill a child should never be treated as a breach of contract.

***

Lila Rose is a writer, speaker and activist. She is the founder and president of Live Action, a human rights nonprofit with the largest digital footprint for the global pro-life movement.

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