The headlines sound like they belong in separate news stories.
In Texas, McKenna West is approximately 35 weeks pregnant with a child who is not biologically hers. According to court filings, the intended parents, a California couple, wanted the pregnancy terminated after the baby was diagnosed with Hypoplastic Left Heart Syndrome, a serious congenital heart defect. McKenna refused.
She later relocated to Texas so she could deliver near a hospital with specialized experience treating babies with that condition. The legal dispute now stretches across state lines, raising questions about jurisdiction, contracts, parental rights, and bodily autonomy.
In Ontario, another surrogate is being sued after refusing to terminate a pregnancy following a prenatal diagnosis that included a cleft lip and possible cleft palate. Additional testing later reportedly suggested the baby was far healthier than initially feared, but by then, the relationship between the surrogate and the intended parents had already broken down, and the lawsuit was underway.
Years earlier, the world watched the heartbreaking story of Baby Gammy in Thailand. A surrogate gave birth to twins. The intended parents took home the healthy baby, while the twin born with Down syndrome remained in Thailand with the surrogate who had carried him.
Many aspects of that case were debated publicly, but one image has never left me. I cannot imagine telling one twin later in life, “You have a sibling who grew up in another country because your lives took different paths before you were even born.”
These are very different cases, but together they force us to confront questions our laws are only beginning to answer.
How many areas of law collide in these disputes? Contract law. Family law. Medical ethics. Disability rights. Constitutional questions about bodily autonomy. Interstate and international jurisdiction.
None of these questions fit together neatly because technology has moved faster than the legal and ethical framework surrounding it.
Who has authority while a child is still in the womb?
The genetic parents?
The woman carrying the child?
The doctor?
The contract signed months earlier?
And perhaps the most uncomfortable question of all: What is the woman carrying the baby?
Is she the mother?
An employee?
A contractor?
An incubator?
A patient?
None of those descriptions seem adequate.
I find myself deeply impressed by women like McKenna West and the Ontario surrogate. Standing by their convictions has likely come at an enormous personal and financial cost. Whether someone agrees with every decision they made or not, they were willing to bear that cost because they believed the child they were carrying deserved protection.
As I have thought about these stories, I keep coming back to one question I simply cannot answer.
I understand that pregnancy is unpredictable. I understand that prenatal diagnoses can be devastating. I understand that parents receiving heartbreaking news may wrestle with impossible decisions.
But what I struggle to understand is wanting a child so desperately that you pursue fertility treatments, hire a surrogate, invest enormous emotional and financial resources into bringing that child into the world, and then, when the child is not exactly as you imagined, decide that the answer is to end that child’s life.
I cannot reconcile those two ideas.
Children are not custom orders.
They are not products assembled to specification.
They are not something we return because the final result wasn’t exactly what we expected.
Having a baby is not Costco.
It is not Walmart.
It is not a Play-Doh sculpture that can simply be rolled into a ball and started over.
To be clear, many families turn to surrogacy because they have exhausted every other option. Infertility is real. Some women cannot safely carry a pregnancy. Same-sex couples have embraced surrogacy as a way to build families. Those realities deserve compassion.
But like many technologies, what begins as an extraordinary solution often expands beyond its original purpose.
Today, surrogacy is sometimes chosen for reasons that have little to do with medical necessity. In some circles, pregnancy itself has become something that can be outsourced because it interrupts careers, changes bodies, or simply asks too much.
That should at least cause us to pause.
We have become remarkably skilled at separating conception from sex, pregnancy from parenthood, biology from caregiving, and reproduction from relationship. Every technological advance has made another separation possible.
Perhaps the inconvenience of pregnancy is not simply an obstacle to overcome.
Perhaps it is part of the gift.
Pregnancy changes a woman’s body. It changes her priorities. It changes her schedule, her sleep, her appetite, and often her career. It asks something extraordinary of her.
Maybe there is a reason nature designed it that way.
Maybe the sacrifice itself is part of what binds a mother to her child long before she ever holds that baby in her arms.
As IVF expands, commercial surrogacy grows, prenatal genetic testing becomes more sophisticated, and technologies such as gene editing continue to advance, these conflicts are likely to become more common. The law will continue trying to answer questions that previous generations never imagined.
The question is whether it can keep up.
More importantly, are we remembering to see the two human beings at the center of these cases?
The unborn child.
And the woman whose body is sustaining that child’s life.
Neither should disappear behind contracts, court filings, or competing claims of authority.
Perhaps the greatest mistake we’ve made is believing we could separate conception from sex, pregnancy from motherhood, and children from the relationships that created them without creating entirely new moral and legal questions. Nature bound those things together. Technology gave us the ability to pull them apart.
Now, one lawsuit at a time, we are discovering why they may have belonged together in the first place.
