I think that its ironic that her mother is always wanting Anna for medical procedures but on page 90 her mother says "Anna, right now, you are the last person whose input i need or want." When it comes down to Anna wanting to say what she thinks about those procedures her mother does not want to here it. After the court session, Anna's mom is very rude to Anna.
I feel like Anna's mother only cares about Anna when Kate needs something. In between Kate's surgeries, her mother does not want anything to do with her. As i said, its only when Kate needs something that her mother will give her the time of day.
On page 99, it goes into detail on how Sara, Anna's mom, felt about when she got pregnant for Anna. She says "It's a girl!" to all the ladies in the salon but as she says it she was really thinking "I know everything about this baby, from her sex to the very placement of her chromosomes, including the ones that make her a perfect match for Kate."
The fact that Sara does not say that out loud proves that she knows it is wrong. She knows its not right just to have a baby for Kate's sake. She even said on page 100 "I have thought of this daughter only in terms of what she will be able to do for the daughter I already have. I haven't even admitted it to Brian". She refers to Anna as "This daughter". She said her goal for Anna was too save her sisters life.
If I were put into Sara's position I'm not quite sure what i would have done. Everyone can have an opinion but no one will truly know what they would have done until they are put into that situation. Which no one should have to be put in.