Justice Elena Kagan turned away a surrogate's emergency request to block a California custody order, leaving a newborn with a severe heart defect at the center of a fight over surrogacy, abortion and parental rights.
The Supreme Court declined Tuesday to intervene in a surrogacy dispute that has become a national flashpoint, rejecting an emergency appeal from a surrogate who wants a continued role in the care of the newborn she carried. Justice Elena Kagan, who handles emergency applications arising from California, turned away the request, leaving in place a California court order that grants parental authority over the baby solely to his genetic parents.
At the center of the case is a boy born Aug. 12 in Dallas with hypoplastic left heart syndrome, a severe congenital defect that leaves the left side of the heart underdeveloped. His surrogate calls him Gabriel. The California couple who contracted with her, Nausheen Gilkar and Omar Ahmed, call him Rumi. Both sides say the child should receive life-saving medical care, yet they remain locked in a legal fight over who decides what that care looks like.
The dispute began with a scan. A 20-week ultrasound revealed the fetus had a serious heart condition, and the biological parents told the surrogate, McKenna West, an Alaska nurse, that they wanted to end the pregnancy. West refused. She traveled from Alaska to Texas, where abortion is largely prohibited, and delivered the baby in Dallas on Aug. 12.
Texas Attorney General Ken Paxton intervened before the birth. A Dallas County judge responded with an emergency order directing hospitals to provide medically necessary care and barring the baby from being moved out of Texas while the case played out. After delivery, the biological parents won a court order in California awarding them parental authority, and that ruling took effect once the child was born.
West argues the dispute belongs in Alaska, not California, under the terms of the surrogacy agreement she signed. She has been fighting the California order since it was issued, and her emergency application to the Supreme Court was her most urgent attempt yet to keep a voice in the baby's medical decisions.
In her emergency filing, West said she should be allowed to remain involved "through this critical time in his young life." Her attorneys warned that the baby could be transferred from a Texas hospital to hospice care in California "despite his treatable condition," and argued that without swift intervention the parents could halt life-saving treatment without her knowledge.
Lawyers for Ahmed and Gilkar rejected that framing. They told the court they are "providing the precise medical care for their child" that West also says she wants, and they insisted that a right to life is not at issue in the case. Pausing the California ruling, they argued, "would serve only to cause chaos and confusion" over which party is authorized to make medical decisions.
That is the crux of the disagreement: not whether the boy should be treated, but which adult holds the legal authority to direct his care, and in which state that authority is settled.
Hypoplastic left heart syndrome is rare and life-threatening. Roughly 925 babies in the United States are born with it each year, or about one in 3,846. Newborns diagnosed with the condition typically need a series of surgeries to reroute blood flow so the right side of the heart can handle work normally done by the left.
The first of those operations, the Norwood procedure, is usually performed shortly after birth. Court filings in late August described serious complications afterward: the baby was reported to be in critical condition and needed to be reintubated as doctors monitored him closely.
The child has remained under medical care in Texas throughout the litigation. His condition has added urgency to a case that otherwise would have moved through the courts at a far slower pace.
Surrogacy contracts can address what happens when prenatal testing uncovers a serious abnormality, but those clauses do not clearly give intended parents the power to compel a surrogate to terminate a pregnancy. West's case has exposed how unsettled that question remains, especially when the people involved live in different states with sharply different laws.
It also lands in the middle of a wider national argument over abortion law, one that continues to move through state legislatures, including the push in Massachusetts to remove all abortion time limits. Texas has staked out the opposite position, and Paxton's early intervention signaled that the state would treat the unborn child as a person with rights the courts must protect.
The jurisdictional puzzle is just as significant. A pregnancy that began under a California contract, was carried by a woman from Alaska, and ended in a Texas delivery produced competing court orders from two states. That overlap, not the clinical facts alone, is what left the Supreme Court as the last stop for an emergency request. Kagan's action keeps the California ruling in force.
West's legal team can still pursue a full appeal, and her attorneys have argued that Alaska courts should have heard the dispute from the start. The parents asked a court to postpone a scheduled hearing on the temporary custody order because of the baby's medical condition, a request that underscores how quickly the situation can change.
For now, the child remains in Texas, treatment decisions rest with his genetic parents under the California ruling, and the broader questions the case raised about surrogacy contracts, abortion, and which state's courts get to decide remain unresolved.
The next developments to watch are whether West refiles in Alaska, whether the California case advances toward a permanent custody ruling, and whether Texas continues to assert an interest in a child born inside its borders.
Justice Elena Kagan turned away a surrogate's emergency request to block a California custody order, leaving a newborn with a severe heart defect at the center of a fight over surrogacy, abortion and parental rights.
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