By James Berreth 

Editor in Chief 

In an increasingly polarized debate over abortion, the story of McKenna West presents a question that reaches beyond politics: What do we owe a child when that child is diagnosed before birth with a serious medical condition? 

West, an Alaska nurse and surrogate mother, recently gave birth in Texas to a baby boy after refusing to terminate the pregnancy when doctors diagnosed the child with hypoplastic left heart syndrome, or HLHS. The condition is a serious congenital heart defect in which the left side of the heart is severely underdeveloped. It can require multiple surgeries and extensive medical care, but it is survivable.  

From a pro-life perspective, West’s decision represents something fundamental: a determination that a child’s medical diagnosis should not determine whether that child receives the opportunity to be born. 

The circumstances surrounding the case are unusually complicated. West was carrying the child as a gestational surrogate for Nausheen Gilkar and Omar Ahmed, a California couple who are the child’s biological parents. According to court filings, the couple requested that the pregnancy be terminated after the diagnosis. The couple disputes West’s characterization that she was forced or coerced into having an abortion and maintains that they initially reached an agreement with West regarding the termination. 

Those competing accounts matter. It would be irresponsible to portray every allegation made by either side as an established fact. But one fact is no longer disputed: West ultimately chose not to have an abortion. She traveled from Alaska to Texas, continued the pregnancy, and gave birth to a baby boy on Aug. 12. The newborn is now receiving specialized medical care. 

For those who believe that human life deserves protection regardless of disability, illness, or prognosis, that decision carries profound significance. HLHS is unquestionably serious, and children born with the condition can face major surgeries, prolonged medical treatment, and significant lifelong health challenges.  

But acknowledging the difficulty of a medical condition is different from concluding that the person with that condition would be better off never being born. That distinction is at the heart of the pro-life position. 

A child diagnosed with a heart defect is still a child. A child diagnosed with Down syndrome is still a child. A child diagnosed with a neurological disorder is still a child, and a child whose physicians believe will have only a limited life expectancy is still a human being. 

Medicine can tell us about a person’s prognosis, but it cannot determine that person’s inherent worth. West’s decision is therefore significant because she rejected the idea that a devastating diagnosis necessarily requires the child’s life end before birth. 

Parents confronting a devastating prenatal diagnosis can face an unimaginable decision. They may be told that their child could undergo surgeries, experience pain, live with significant disabilities, or die shortly after birth. Compassion requires acknowledging the fear and grief involved. 

But instead of asking whether a child is sufficiently healthy to deserve life, society can and should ask how it can provide the medical, financial, and emotional support necessary for that child and the family caring for him or her. 

The answer to suffering should not automatically be death, and for the pro-life movement, this is where the broader debate over abortion intersects with the disability-rights movement. If society begins measuring the value of a human life by its expected health, independence, or economic cost, people with disabilities have legitimate reason to question where that principle ultimately leads. West’s decision makes the opposite statement: a difficult life is still a life worth living and protecting. 

The West case also raises questions that extend beyond abortion. Surrogacy contracts attempt to establish expectations between intended parents and the woman carrying their child. Yet pregnancy involves a human body, medical decisions, and circumstances that cannot always be anticipated when a contract is signed. 

West’s attorneys have argued that the agreement cannot compel her to undergo an abortion. Legal experts quoted in reporting have similarly distinguished between contractual obligations and the physical authority to make medical decisions during pregnancy. 

That distinction deserves careful consideration regardless of one’s position on abortion. 

A woman should not be reduced to a contractual instrument merely because she agreed to serve as a surrogate. At the same time, intended parents enter surrogacy with legitimate expectations concerning their future child and their role as parents.  

It is easy for the public debate to become focused on West, the intended parents, Texas Attorney General Ken Paxton, abortion politics, and the legal battle over parentage. But there is another person at the center of this controversy: the child. He did not choose to have HLHS. He did not choose to become the subject of a custody dispute. He did not choose the state in which he was born, nor did choose to become a national political symbol. He simply exists. 

That is perhaps the most powerful argument West’s decision presents to those who hold a pro-life philosophy. The question should not be whether this child is perfect, as no child is. The question should not be whether his life will be easy, as most lives are not. The question is whether a human being should meet a medical standard before being allowed to live. The pro-life answer is no. 

But if society were to ask women to carry pregnancies involving serious fetal diagnoses, it must also be willing to help them carry the enormous burdens that inevitably follow. 

That means supporting parents who receive devastating prenatal diagnoses and ensuring access to pediatric specialists, strengthening disability services, family leave, insurance coverage, and community support. It means helping families navigate the financial and emotional realities of raising children with significant medical needs. 

The moral argument for life becomes considerably stronger when it is accompanied by a commitment to support the people who choose it.  

Additionally, West’s decision should not be reduced to a political slogan. She made a profoundly consequential choice in circumstances involving medicine, law, surrogacy, competing parental interests, and a child with a serious heart condition. Whatever ultimately happens in court, her decision to continue the pregnancy has already forced an uncomfortable question into the national conversation, that is: 

Do we believe that every child possesses inherent value, or only those children whom we believe are likely to live healthy and uncomplicated lives? 

For those who are pro-life, the answer is clear. A diagnosis does not make a child less human. A disability does not make a life less valuable. A difficult prognosis does not eliminate a person’s dignity. And a child’s right to live should not depend upon whether that child’s life is expected to be easy. 

McKenna West chose to give this child the chance to be born, and from a pro-life perspective, that is not merely a decision about pregnancy. It is a declaration that the worth of a human life cannot be measured by the condition of the heart.