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.
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.
She spoke of the requests that a surrogate can make when being matched with intended parents. 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. She now works as a surrogate engagement coordinator at ConceiveAbilities.
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