The US Supreme Court has rejected the emergency custody request from McKenna West, the surrogate who refused to terminate a pregnancy after the baby was diagnosed with a serious heart defect, leaving a California court ruling recognising the biological parents as the child's legal parents firmly in place.

Justice Elena Kagan declined West's appeal on Tuesday September 22, opting to rule on the matter herself rather than referring it to the full court for a vote. The decision gave no reason for the rejection.

The case began when a 20-week scan revealed that the baby West was carrying had hypoplastic left heart syndrome, a rare congenital condition in which the left side of the heart is severely underdeveloped and unable to pump blood to the body properly, requiring several surgeries shortly after birth. Biological parents Omar Ahmed and Nausheen Gilkar asked West to terminate the pregnancy under the terms of the surrogacy agreement. West refused, travelling from Alaska to Texas, where most abortions are banned, and carrying the baby to term.

The baby, born on August 12 in Dallas, is called Rumi by his biological parents and Gabriel by West. Following the birth, a California court granted parental rights to Ahmed and Gilkar, and a Texas court also ruled against West's bid for custody. A separate court order banned West from seeing the child shortly after the birth. The baby underwent heart surgery after a court ordered that he receive medical treatment.

West had asked the Supreme Court to halt the California ruling and grant her custody or conservatorship, arguing that she feared the biological parents would not provide the treatment she believed the baby needed. Her lawyers warned that if the appeal was denied, she would receive no further information about the child she had carried for 37 weeks. They also argued that the baby could be placed in hospice care if moved to California, and pointed to Texas law granting parental rights to the birth mother of a child.

The biological parents rejected West's characterisation of their intentions entirely. Gilkar testified in court that West had travelled to Texas without informing them and had blocked their access to medical information. She described the couple's son as "our child" and "the love of our lives," and told the court directly: "She's making us run from doctor to doctor, state to state with our baby. She's trying to take him."

With the Supreme Court's rejection of the emergency stay, Ahmed and Gilkar remain the child's recognised legal parents. The case has involved courts in California, Texas and now the nation's highest court, and has drawn widespread attention for the questions it raises about surrogacy agreements, parental rights and the limits of a surrogate's legal standing after birth.