Nurse Surrogate Declined Termination and Gave Birth in Texas. Now 3 States Weigh In

Image source: New York Post

Somewhere in a Dallas NICU, a nurse is charting on a days-old boy with a critically underdeveloped left heart, a court order shaping his care, and a three-state parentage fight attached to his name. Both of his names.

The baby’s gestational carrier is a nurse herself. McKenna West is a 28-year-old Alaska cardiac nurse and single mother of two who agreed to carry a baby for a Los Angeles couple and, after a severe heart diagnosis at 20 weeks, refused what she describes as the couple’s push to end the pregnancy. She traveled to Texas, where her lawyers argue state law recognizes the woman who gives birth as the mother, and delivered a boy on Wednesday, August 12th, at a Dallas-area hospital.

The newborn, called Gabriel by West and her supporters and Rumi by his biological parents, was born with hypoplastic left heart syndrome (HLHS) and is now in the neonatal intensive care unit (NICU). Before his first surgery, his care was already shaped by a court order, a court-appointed guardian, and litigation that has unfolded across three states.

The intended parents, Nausheen Gilkar and Omar Ahmed of Los Angeles, say in court filings that West broke the surrogacy agreement. West says she was pressured toward abortion for weeks. Each side disputes the other’s account, and nothing has been proven in court.

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Court documents reviewed by The Associated Press show West entered the agreement with Gilkar and Ahmed through the agency Worldwide Surrogacy Specialists in August 2025; she later became pregnant through IVF. At the routine 20-week anatomy scan, the care team found hypoplastic left heart syndrome, a defect in which the left side of the heart is too small and underdeveloped so it is unable to pump blood adequately throughout the body. 

The contract allowed the intended parents to choose termination if a fetal anomaly was found. West said no and went to Texas. She is represented by the Alliance Defending Freedom, whose senior counsel Erik Baptist said in a statement that it is “an honor and privilege to represent McKenna in her courageous stand for Baby Gabriel’s life.”

Texas Attorney General Ken Paxton intervened in the Dallas County parentage case and put the two Dallas hospitals involved on notice that they were expected to treat the baby. On Tuesday, August 11th, a Dallas district court issued an emergency order requiring “medically indicated stabilizing and life-sustaining care” at birth, barring the child from leaving Texas, and appointing a guardian ad litem. Paxton said the court “made the right decision in immediately acting to protect baby Gabriel’s life.”

In California, the couple obtained a restraining order barring West from acting as the child’s parent or medical decision-maker, and a court in California found she has no custody rights under the agreement. They are also suing her, seeking roughly $250,000 tied to the surrogacy payments and alleged damages. West previously sought sole custody in Alaska and petitioned a Dallas court for custody two days before giving birth.

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The Diagnosis, and a Federal Letter to Two Dallas Hospitals

Hypoplastic left heart syndrome affects about 1 in 3,846 births, roughly 925 U.S. babies a year. Survival usually depends on three staged surgeries, starting with the Norwood procedure in the first days or weeks of life, or potentially a heart transplant. Every nurse who has floated to the cardiac NICU knows what that pathway asks of an infant and a family. It is no easy feat. 

On August 13th, Fox News reported that the HHS Office for Civil Rights sent a letter to Children’s Medical Center of Dallas and UT Southwestern Medical Center outlining their obligations under federal disability civil rights law. Per that reporting, the letter says treatment cannot be withheld based on a judgment that a disabled life has less value, urges the hospitals to have an infant care review committee weigh any move to withhold or withdraw medically indicated care, and says life-sustaining treatment should continue in the meantime.

By Thursday, the baby was in the intended parents’ physical custody while receiving care, West was barred from contact with him, and a court had granted the couple full medical decision-making authority ahead of the August 25th hearing. The couple’s attorney, Lee Budner, said his clients are “continuing to place their baby’s health and well-being first” and are “devastated to see their family tragedy transformed into political theater.” West’s attorney, Lincoln Davis Wilson, said she will keep pursuing custody.

Strip away the politics and the emotion, and this is a documentation and escalation problem landing on a bedside team.

There is a Dallas NICU staff caring for an infant whose parentage has been litigated in three states, who has a court-appointed guardian ad litem, and whose treatment and transfer are constrained by a Texas court order. The intended parents currently hold physical custody and are with the infant as he receives care. But with this many courts involved, the practical move is to escalate any consent question to the attending, risk management, legal, and ethics, and to document who signed what and under which order. Verbal assurances at the bedside are not documentation, and in a case with this many lawyers, they are not protection either.

Federal disability law and the CAPTA “Baby Doe” framework place limits on discriminatory or medically unjustified withholding of treatment from infants with disabilities, while preserving reasonable medical judgment about futility and certain end-of-life circumstances. Federal rules encourage, but do not require, hospitals to maintain infant care review committees. A nurse concerned about a treatment decision follows the institutional path: attending, chain of command, ethics, risk management, and legal counsel.

Regardless, nurses should be hyper-aware of the patient’s orders and document promptly and accurately. Keeping the medical team in the loop is important and speaking to your manager can also help in uncomfortable situations to ensure things are being followed properly. 

Then there is the part of the story about nurses like West. She has said in interviews that she became a surrogate to earn extra income for her family without taking time away from her kids. Surrogacy agreements contain termination and anomaly clauses, parentage law varies sharply by state, and a contract signed in one state may not be recognized where you deliver. Any nurses considering surrogacy should seek independent legal review before signing, and go in knowing that if a dispute turns public, the professional and reputational exposure is real no matter who is right.

A Dallas County hearing on parentage and medical decision-making is set for Tuesday, August 25th. The NICU team will be at the bedside either way.

Nurse.org will continue updating this article as the case proceeds.

🤔 You’re the charge nurse when an infant’s parentage has been litigated in three states and a court order governs his care. What’s your first move before the next consent form gets signed?