Surrogacy has recently come under national scrutiny following the announcement that Lena Dunham is using a surrogate to start a family, as well as the legal dispute involving McKenna West, a gestational surrogate who fled to Texas to avoid an abortion requested by the child’s biological parents. The Guardian spoke with surrogates across the US, including Liggia Spicer, a 34-year-old from upstate New York, who first considered surrogacy after a friend's experience with infertility. Spicer researched extensively before deciding to become a surrogate, eventually working with ConceiveAbilities, an agency that matched her with a couple after a thorough screening process including background checks, financial checks, psychological evaluations, and a review of her previous labor and delivery history. Most surrogacy programs require prior childbirth experience. ConceiveAbilities provided Spicer with an attorney to help draft a surrogacy contract, which outlines the rights of the surrogate and intended parents, insurance coverage, payment of medical bills, liability for complications, and the intended parents’ presence during medical visits and at delivery. West’s case has raised questions about the bodily autonomy of surrogates, as she violated her contract by refusing an abortion after the fetus was found 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, which would grant her a say in the child’s medical treatment. The US Supreme Court has declined to intervene in the case. Spicer stated that surrogates often perform actions they might not do in their own pregnancies but emphasized that the child is not theirs. “As long as what we’re being asked is safe to do,” she said. Kristy Miller, a 38-year-old two-time surrogate from Indianapolis, also worked with ConceiveAbilities. She emphasized the importance of a trusting relationship with intended parents and did not want to feel micromanaged. Critics of surrogacy argue that the process commodifies women’s bodies. 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 written extensively about her fertility issues in her 2026 book, Famesick, including an Ehlers-Danlos syndrome diagnosis, nearly two decades of advanced endometriosis, and a total hysterectomy at 31. Spicer emphasized the importance of bodily autonomy, stating that she wanted to get pregnant to help another family. 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. She acknowledged concerns about reproductive exploitation but argued that opponents of commercial surrogacy may not be fully informed about the process. 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 her ninth pregnancy overall. Her first experience as a surrogate was in 2018 for a same-sex male couple in Italy. She has worked both independently and with agencies, giving birth to children who live in Paris and Mexico, among other cities. Alston said she has formed close bonds with the intended parents she has worked with and frequently receives pictures and videos of the children she carried. She said that helping people have children they otherwise couldn’t have is what keeps her going. Alston, who now works for a surrogacy agency she previously used, said that interacting with intended parents reminds her why she has chosen to be a surrogate multiple times. Multiple surrogates said the biggest misconception is that surrogates get attached to the baby they are carrying and may refuse to give the child up after delivery. Miller stated that she has never known a surrogate who felt like “mom” to the baby they were carrying. Spicer emphasized the need for levity throughout the experience, advising potential surrogates to have a sense of humor and take things in stride.