A legal battle has emerged over a surrogate's decision to carry a baby diagnosed with hypoplastic left heart syndrome (HLHS), a serious congenital heart defect, after the biological parents requested an abortion. The surrogate, McKenna West, refused the termination request approximately 20 weeks into her pregnancy, leading to a dispute involving the parents, officials in three states, and raising questions about parental rights and the implications of surrogacy agreements.
The baby, Gabriel, was diagnosed with HLHS, a condition where the left side of the heart is underdeveloped, affecting the left ventricle, valves, and aorta. This critical part of the heart is responsible for pumping oxygenated blood from the lungs to the rest of the body. HLHS affects about 1 in 3,846 infants born in the United States annually.
West stated her belief that "every life matters" and that Gabriel should have a chance to live. Following her refusal to terminate the pregnancy, West traveled to Texas, seeking protection, according to the Texas Attorney General's office. The biological parents, Nausheen Gilkar and Omar Ahmed of California, have since taken custody of Gabriel, but West intends to continue seeking custody.
Symptoms and Treatment of HLHS
Babies born with HLHS can exhibit symptoms such as difficulty breathing and feeding, weak pulses, and cyanosis—a bluish tint to the lips, skin, and nails due to insufficient oxygen in the blood. Without medical intervention, infants with HLHS are at risk of heart failure and death within weeks of birth.
Diagnosis can occur before birth through ultrasounds or echocardiograms, or after birth based on observed symptoms. The condition is fatal if untreated. However, with appropriate medical intervention, approximately 72% of children survive to age five, and about 90% of those survivors reach adulthood. The oldest known survivors are in their 30s. Survivors require lifelong medical care, as their hearts do not function like a typical two-ventricle heart, and some may eventually need a heart transplant.
Treatment for HLHS typically involves a series of three surgeries performed shortly after birth. The first is the Norwood procedure, which repurposes the right ventricle to pump blood to the body. This is followed by the Glenn procedure between four to six months of age, which directs blood from the upper body to the lungs for oxygen. The final surgery, the Fontan procedure, is usually performed between ages two and three, rerouting blood from the lower body to the lungs.
In rare instances, prenatal treatment is possible, but it is a complex procedure requiring significant coordination between medical specialists. The case has brought to the forefront the ethical considerations surrounding surrogacy, fetal diagnosis, and reproductive rights within the existing legal frameworks.