
As high-profile cases spark public discussion on bodily autonomy and ethics, gestational carriers discuss the realities of the industry.
Surrogates across the US are speaking out on the complexities of commercial surrogacy following high-profile cases involving Lena Dunham and McKenna West, addressing concerns regarding bodily autonomy, compensation, and emotional detachment.
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Surrogacy has gained public attention due to high-profile celebrity announcements and a legal dispute involving a surrogate who fled Texas to avoid a requested abortion.
Surrogacy has been thrust into the national spotlight in recent weeks, with both the announcement of Lena Dunham using a surrogate to start a family and the ongoing legal battle surrounding McKenna West, a gestational surrogate who fled to Texas to avoid having an abortion that was requested by the child’s biological parents.
With a renewed public interest on commercial, or compensated, surrogacy, the Guardian spoke with surrogates across the US who shared their experiences and how they feel about surrogacy being part of a global, public conversation.
Liggia Spicer, a 34-year-old woman based in upstate New York, first considered getting involved with surrogacy work after hearing about a mutual friend who was looking into using a surrogate after battling cancer and undergoing a hysterectomy.
“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 ended up working with an agency, ConceiveAbilities, where she was matched with a couple after what she described as a “vigorous” screening process that included a background check, financial check, psychological screen and a review of previous labor and delivery history. Most surrogacy programs require that a woman has given birth previously before becoming a surrogate.
ConceiveAbilities provided her with an attorney to assist with the creation of a surrogacy contract, an agreement that comes to pass before an embryo transfer and details the rights of the surrogate and the intended parents. It also addresses insurance, payment of medical bills, liability for medical complications and the intended parents’ presence during doctor’s visits and at delivery.
Notably, West’s case has brought up questions of how much bodily autonomy carriers are afforded in surrogacy. West violated her surrogacy contract by refusing to get an abortion after the fetus she was carrying was discovered to have a congenital heart defect. She later fled to Texas, where abortion is banned, and gave birth to the child. West has sought conservatorship over the child as well, which would give her a say in the child’s medical treatment. The US supreme court has declined to intervene in the case.
“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. “As long as what we’re being asked is safe to do.”
Kristy Miller, a 38-year-old, two-time surrogate based in Indianapolis, also worked with ConceiveAbilities. She spoke of the requests that a surrogate can make when being matched with intended parents.
“I remember feeling very strongly that I wanted there to be a trusting relationship [with the intended parents],” she said. “I didn’t want to feel micromanaged. I didn’t want someone to be kind of dictating what I ate every day, or how I took care of myself.”
Critics of surrogacy also argue that the process treats women’s bodies as a commodity.
Under Vogue’s Instagram post announcing Dunham’s essay about her surrogate journey, one commenter wrote: “Let’s not normalize buying humans.” Another said: “The concept of rich people renting poor people’s wombs will never not be strange.”
Dunham has spoken publicly about her fertility issues for years and writes about them at length in her 2026 book, Famesick. Her struggles have included an Ehlers-Danlos syndrome diagnosis, nearly two decades of advanced endometriosis and a total hysterectomy at 31 years old.
Spicer said: “It’s important that everyone should decide what happens to their body, and I wanted to get pregnant to help another family.
“That’s my decision,” she added. She now works as a surrogate engagement coordinator at ConceiveAbilities.
Christine S, a 38-year-old former gestational surrogate in New York state, carried and gave birth to a child for a same-sex male couple in 2025 with New York Surrogacy Center. Christine, who declined to share her last name for privacy reasons, said she understands concerns about reproductive exploitation, but believes that opponents of commercial surrogacy haven’t been informed enough on the intricacies of the process in the US.
“I think it’s just [that] they don’t understand enough about it,” she said. “Because there are situations where there are women that are held against their will to breed, right? Like that is a legit concern. But I volunteered. I didn’t do this against my will.
“And the journey of working with someone to be a surrogate, not only is it costly, but I also feel like [intended parents are] offering somebody an opportunity too. I had a job for a temporary amount of time, and it was a high-risk job, but it was also a high reward.”
Christine received $45,000 for carrying the child, in addition to coverage for her medical and legal fees. Spicer was paid $67,000, which was broken down and paid out over the course of the pregnancy.
Kimber Alston, a 36-year-old gestational surrogate based in Texas, is pregnant with her fifth surrogate child, and in the middle of her ninth pregnancy overall. Her first experience as a surrogate was in 2018 for a same-sex male couple in Italy. Since then, she has embarked on surrogate journeys both independently and with agencies, and given birth to children who live in Paris and Mexico, among other cities around the world.
She said she has formed close bonds with the intended parents she’s worked with, and frequently receives pictures and videos of the children she carried.
“What keeps me going is being able to help people have something that they couldn’t have otherwise,” she said. Alston, who also now works for a surrogacy agency she previously used, said that interacting with intended parents reminds her why has chosen to be a surrogate multiple times.
“I watch these couples every day come in and tell their stories; I’m in these match calls and watching them cry and not be able to have a child of their own,” she said. “I’m like: ‘If I could do it just one more time, I might as well just do it.’”
Multiple surrogates said the biggest misconception they see is the notion that surrogates get attached to the baby they are carrying, and may refuse to give the child up after delivery.
“I have never known a surrogate who felt like ‘mom’ to the baby [they were] carrying,” said Miller. “I think it’s hard for people to wrap their head around that unless they are truly considering [surrogacy].”
Spicer emphasized the need for levity throughout the experience.
“Honestly, I tell a lot of girls who want to be surrogates: ‘You have to have a sense of humor. You have to just take things on the chin and laugh it off,’” she said. “You could tell them until you’re blue in the face: ‘I’m not attached to this baby,’ and they still just don’t understand.”

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