In a Texas hospital this week, doctors performed a complex, high-risk, open-heart surgery on a 6-day-old boy born with hypoplastic left heart syndrome, a rare congenital condition that rendered part of his heart underdeveloped.

Omar Ahmed and Nausheen Gilkar waited in the hospital as the newborn, whom they named Rumi, underwent the first of three surgeries babies with the condition need very early in life, their lawyer told CNN.

When the California couple contracted last August via a surrogacy agency with McKenna West, a nurse from Alaska, to carry their child, few could have guessed the decision would land them in a Texas hospital room as a multistate, nationally publicized legal battle played out over who the baby’s rightful parents are.

Anti-abortion activists – who pointedly have bypassed the baby’s given name, calling him Gabriel – have seized on the case to bolster their arguments about fetal personhood, feeding a small but rising movement against surrogacy in the US. And as the newborn recuperates from surgery, the high-stakes legal battle centered around abortion, surrogacy and parental rights appears far from over.

Surrogacy arrangements often include a contract. The one between Ahmed, Gilkar and West outlined stipulations, including a clause saying the intended parents could ask in writing to terminate the pregnancy if a doctor found a fetal abnormality – and West would honor their request, according to the agreement, which the couple attached to an August 10 court filing in Dallas County, Texas.