The surrogacy debate has surged nationally in recent weeks, fueled by actor Lena Dunham’s announcement that she used a surrogate and the ongoing court fight involving McKenna West, a gestational carrier who declined an abortion requested by the baby’s biological parents and later gave birth in Texas.
With public attention focused on commercial, or compensated, surrogacy, several U.S. carriers described how they navigated screening, contracts, compensation and the emotional landscape, and how they view the growing public conversation.
Surrogacy debate and the road to becoming a carrier
Liggia Spicer, 34, from upstate New York, began considering surrogacy after learning a friend who had cancer and a hysterectomy was exploring the option. “I probably did about two years of research before I turned to my husband and was like: ‘OK I think I want to do this,’” she said.
Spicer worked with the agency ConceiveAbilities and was matched with intended parents after what she called a vigorous screening process, including background and financial checks, a psychological evaluation and a review of prior labor and delivery history. Most programs require carriers to have given birth before.
The agency provided legal counsel to draft a contract before embryo transfer. Such agreements outline the rights of the surrogate and intended parents, and address insurance, medical billing, liability for complications and participation in appointments and delivery.
Contracts, autonomy and a closely watched legal case
West’s case has focused attention on how much bodily autonomy carriers have. According to court filings, West violated her contract by refusing an abortion after a congenital heart defect was diagnosed. She later relocated to Texas, where abortion is banned, and delivered the child. She has sought conservatorship that would allow her input in the child’s medical care. The U.S. Supreme Court declined to intervene.
“As surrogates, we do things that we may not do in our own pregnancies, but at the end of the day, it’s not our child,” Spicer said, adding that requests should be safe.
Kristy Miller, 38, a two-time surrogate in Indianapolis who also worked with ConceiveAbilities, said surrogates can state preferences when matching with intended parents. She wanted a trusting relationship without feeling micromanaged about daily choices.
Ethics, stigma and why some still choose surrogacy
Critics argue commercial surrogacy commodifies women’s bodies. Social media responses to Dunham’s announcement included comments such as “Let’s not normalize buying humans” and concerns about wealthy people “renting” the wombs of those with fewer resources. Dunham has publicly documented long-standing fertility challenges, including Ehlers-Danlos syndrome, severe endometriosis and a hysterectomy at 31.
Spicer said bodily autonomy is essential and that she chose pregnancy to help another family. She now works as a surrogate engagement coordinator at ConceiveAbilities.
Christine S, 38, a former gestational surrogate in New York who requested partial anonymity, carried for a same-sex male couple in 2025 through New York Surrogacy Center. She said worries about exploitation are understandable, but believes many opponents are unfamiliar with how U.S. surrogacy operates. “I volunteered. I didn’t do this against my will,” she said, adding that while the role is costly and high risk, it can also provide meaningful opportunity.
Christine received $45,000 for her journey, plus medical and legal costs. Spicer was paid $67,000 disbursed across the pregnancy.
Global families, ongoing relationships and motivation
Kimber Alston, 36, a Texas-based gestational carrier now pregnant with her fifth surrogate child and in her ninth pregnancy overall, began in 2018 for a same-sex couple in Italy. She has completed journeys through agencies and independently, with children now living in cities including Paris and in Mexico. She said she often stays in touch, receiving photos and videos.
“What keeps me going is being able to help people have something that they couldn’t have otherwise,” said Alston, who also works for a surrogacy agency she once used. Hearing intended parents’ stories, she said, motivates her to continue.
Attachment myths and the realities of the surrogacy debate
Several surrogates said a common misconception is that carriers become attached and may refuse to relinquish the baby. “I have never known a surrogate who felt like ‘mom’ to the baby [they were] carrying,” Miller said.
Spicer encourages would-be surrogates to bring levity to the experience. “You have to have a sense of humor,” she said. Even when carriers explain they are not attached, she added, some people still struggle to understand.
Some of these debates over autonomy, ethics and public perception echo broader disagreements about American culture that surface in features like the American Culture Quiz: Fast-food frenzy and campaign clash, even as the specifics of surrogacy remain deeply personal.
