Essential reading. I learned so much about this topic that I didn’t know. Well-written and intelligent, but accessible. Also, engaging. This is a must-read for anyone interested in the intersections of misogyny, motherhood, and capitalism.

Thanks to NetGalley and the publisher for the ARC.

Fascinating subject. While I had obviously known the broad strokes of the breast milk market, egg donation/freezing, and surrogacy, I never thought about the intricate details. This book answered questions I never knew I had. Such as, what are the laws concerning these issues in different countries? How does breast milk donation differ globally? What happens to surrogates when war breaks out? Can parents or surrogates change their minds after the fact? What are the legal protections for surrogates? What happens if pregnancy complications renders the surrogate infertile? So many questions came to my mind (and were answered) while I was reading.

The author writes in such a way that you are never bored. The material isn’t presented in a dry way, and is often linked back to her own experiences with motherhood. This gives a comparison between personal and business. While the labor (no pun intended) are often the same, the motivations and emotions involved are very different. It’s nice to get this perspective, especially if you have not experienced it for yourself. The research was very thorough and I really appreciated the author going undercover as a potential client to uncover details that would otherwise be unknown. Very enlightening read.

Fantastic book that actually tries to think through the ethical dilemmas involved in commercializing aspects of the pregnant body and experience with supporting evidence. I admired that it doesn’t shy away from questions that should be asked but because of their nature can’t be definitively answered. It made me think as much as it informed me. Some haunting anecdotes that I’m still thinking about days later.

Please Itemize Your Uterus: Alev Scott’s Very Uncomfortable Tour of the Reproductive Marketplace
“Cash Cow” finds milk by the ounce, eggs by the retrieval, pregnancy by the contract – and women repeatedly proving harder to price than the paperwork suggests.
By Demetris Papadimitropoulos | October 14th, 2026

Dollars and body parts share a ledger in Alev Scott’s “Cash Cow.” Before Milk, Eggs and Placenta, physiological facts sit beside prices in the same typographic key: calories beside customer cost, egg counts beside donor compensation, placental dimensions beside surrogacy fees. The arrangement is funny for about half a second. Then its violence becomes clear. Scott is tracking markets around the maternal body, but the book’s sharper move is to make us briefly read that body as a market would – output, inventory, risk, return – and then keep returning the person the numbers have edited out.

Early in the book, the argument begins with surplus rather than scarcity. Newly postpartum and producing more milk than her daughter needs, Scott discovers that donating it to a hospital requires screening, patience and infrastructure, while selling it online to strangers is almost frictionless. Men approach her for bodybuilding, digestive problems and erotic use. From there the inquiry widens through milk banks and pharmaceutical companies, egg donation and freezing, IVF clinics and financing, surrogacy contracts and cross-border agencies. A peculiar corner of the internet becomes something larger and less peculiar: one person urgently wants what another body can provide, and a market appears in the interval.

Milk, eggs and placenta are not three filing cabinets for Scott’s reporting. They mark degrees of detachability. Milk leaves the body and replenishes. Eggs leave the body but are finite, freighted with inheritance and increasingly searchable as consumer choice. Gestation cannot be bottled, banked or couriered through an airport; what changes hands is months of somebody else’s bodily time, medical risk and loss of control. Scott says the architecture was inspired by Christien Meindertsma’s “PIG 05049,” a catalogue of uses made of a single pig. “Cash Cow” borrows that inventory logic, then keeps having to put the human being back. The sequence also escalates what money is being asked to price: a substance, a reproductive possibility, then another person’s sustained bodily exposure. That progression is why the device does more than organize chapters.

Even before Scott finds a formal market, she has learned to think in units. During early motherhood she pumps obsessively and labels freezer bags “150ml, 15 February, 6 p.m.,” building what she calls a “physicalised diary of maternal anxiety.” She weighs her daughter and reads ounces and grams as if enough measurement might protect them both from uncertainty. This is one of the book’s smartest early checks on its own premise. Capitalism does not invent Scott’s wish to quantify motherhood. It finds the wish already there, fed by love, fear and the humiliating fact that bodies do not guarantee outcomes, then offers increasingly elaborate ways to make uncertainty look countable.

The sentences rarely advertise themselves; Scott prefers to let an object do the arguing first. Her default sentence is medium-length and conversational, quickened by questions, jokes and abrupt recalibrations. A scene begins in curiosity, edges toward absurdity, widens through research, then meets a person who spoils the provisional answer. That rhythm gives policy-heavy material unusual propulsion. It can also become visible as a method: by the fourth or fifth encounter in which a grotesque-looking transaction becomes harder to condemn once the woman performing it speaks, the reversal is no longer quite a surprise. Still, Scott has an excellent eye for things whose moral temperature changes as we look – freezer bags, donor profiles, cryogenic tanks, contract clauses.

Rather than treating euphemism as verbal padding, Scott follows it like money. At the Canadian NorthernStar milk bank, a director insists that women paid for milk are not donors but suppliers. Egg providers are “compensated”; surrogates receive “expenses” or reimbursement; clinics call people patients while selling packages, add-ons and guarantees. These are not innocent synonyms. They are little customs offices, allowing commerce to cross into generosity, medicine or motherhood without declaring everything in the suitcase. Scott’s subject is often less the price itself than the noun that makes the price socially tolerable.

If Scott starts a scene smiling, she often makes sure the smile has nowhere comfortable to land. At Dublin’s Future Fertility Show, Scott walks among IVF clinics, sperm banks, embryo couriers and improbable wellness offerings with the delighted alarm of a reporter who knows the room is giving her material. The scene looks built for satire until she notices couples sitting together but not touching and calls the event a “convention of grief.” The phrase does not cancel the joke. It tells us who is paying for it. Hope is being sold in a room full of people for whom hope has stopped feeling optional.

Part of Scott’s authority comes from refusing the reporter’s clean white coat. She poses as an infertile customer, browses donor catalogues, invents a younger donor persona and submits herself to the market’s gaze. One small moment tells us more than the undercover theatrics: offered a cheap AMH test that would quantify her own ovarian reserve, she balks. She already has children and does not need the number, yet she fears being graded by it. The investigator becomes her own case study. A system built to measure reproductive possibility does not have to persuade her that the number matters; she has arrived with the anxiety preinstalled.

As donor shopping becomes more explicit, choice hardens into price. One Northern Cypriot coordinator tells Scott that blond, blue-eyed donors cost more because they have a more model-like appearance. At a university hospital, another staff member explains that compensation rises with the number of eggs retrieved: more eggs, more money. The first statement prices desirability; the second prices biological yield. Neither requires a trumpet blast of outrage. Their flatness is the revelation. Very old hierarchies reappear with freshly itemized invoices.

Perhaps no scene earns more argumentative mileage than Stephenie’s. An Idaho commercial surrogate, she has carried an extraordinary number of children for other people. After one birth, an intended father treats her badly and declares theirs “a business transaction,” using payment to cancel gratitude. When the couple asks her to carry again, Stephenie repeats the phrase and raises her fee by ten thousand dollars. The words do not change. The speaker does. In his mouth, commerce strips her of relationship; in hers, it becomes leverage. A sentence meant to put her in her place becomes the tool with which she prices the insult.

A price, in Scott’s reporting, behaves less like a moral verdict than a reagent: it exposes what was already in the mixture. Payment can turn a body into a service platform, but it can also acknowledge work that sentimental language has expected women to perform for love. A commercial surrogate may have lawyers, escrow and bargaining power; an altruistic surrogate may receive no wage yet inherit a burden of gratitude and continued intimacy. Money can corrupt an exchange. Its absence can hide one. Scott is most persuasive when she refuses to rescue the reader from having to hold both possibilities.

During “Blighted Eggs,” one overworked noun changes jobs. For dozens of pages, egg has meant file, freezing, yield, donor, retrieval, price, transport. Then Scott looks at her daughter and imagines the eggs already inside her, nested across generations, the egg that became the child once carried inside Scott while Scott herself was inside her mother. Soon she experiences a missed miscarriage and hears the clinical phrase “blighted egg.” Commodity becomes inheritance, possibility, pregnancy, loss. The word has not changed. Scott makes the used-up word hurt.

In the same passage, she admits something less flattering and therefore more useful: the miscarriage makes her angrier at predatory fertility practices than she had been when the suffering belonged to other women. During surgery she thinks of patients pumped with hormones and sold “a little percentage of hope.” The phrase is polished enough to make me wary of it, but the confession around it is not. Empathy has arrived through resemblance. Scott’s body becomes an investigative instrument, and the instrument exposes its own calibration problem. Personal experience deepens the inquiry while showing how much easier another person’s pain can be to feel once it looks like ours.

Money reaches its bleakest precision in the surrogacy contracts. Scott finds agreements that assign modest sums to the loss of reproductive organs and prorate compensation after stillbirth down to daily amounts. The obscenity is not simply that a uterus acquires a price. It is that the price is exact enough to simulate adequacy. A contract can protect a worker by making obligations enforceable while announcing, in the same clause, how little its arithmetic can comprehend the loss it has priced. Here precision is not knowledge. It is bureaucracy faced with an injury for which money is both necessary and absurd.

If all this arithmetic merely showed that pricing bodies dehumanizes women, the book would shrink into its own title. Scott keeps meeting women who spoil that conclusion. Stephenie says she would not surrogate for free. Other carriers describe payment as recognition of labor. Some intended parents prefer compensation because an unpaid gift can create an almost unpayable emotional debt. Conversely, Scott meets altruistic surrogates who reject wages because payment would make them feel owned. These accounts do not abolish class inequality or bodily risk. They do make paternalism harder. Any defense of autonomy worth much has to leave room for women to choose arrangements a critic may still find unsettling.

The hardest evidentiary gap opens where that principle becomes hardest to test. In Northern Cyprus, Scott can reach agencies, lawyers, clinics and intended parents far more easily than the Central Asian women whose relative poverty and migration status make exploitation most plausible. A Georgian surrogate named Natalya declines to meet her. Later, Scott refuses an invitation to approach an Uzbek woman immediately after childbirth, recognizing that an uninvited visit would reproduce the extraction she is investigating. She flies home admitting that she has established the scope for exploitation rather than the firsthand evidence required to describe its interior life confidently.

Refusing that hospital-room interview is both the right decision and a cost to the book. Scott should not turn a recovering woman into journalistic raw material because her narrative needs a stronger scene. But the resulting asymmetry matters. Comparatively empowered American surrogates become textured people with motives, jokes and contradictions; poorer women in opaque cross-border systems appear more often through brokers, documents, prices and silence. “Cash Cow” therefore knows more securely how exploitation can be structured than how the least powerful participants themselves understand the bargains being made around their bodies.

Outside the book, Anna Collinson’s BBC Radio 4 “File on 4 Investigates” documentary “Sunshine and Secrets: The Hidden Side of IVF” gives that restraint retrospective weight. After the British publication of “Cash Cow,” Collinson followed families who believed Northern Cypriot clinics had supplied different donors from those they had selected; an accredited genetic test provided very strong support that two children who were expected to share a donor were unrelated. The programme did not prove Scott’s every suspicion, still less wrongdoing across an entire fertility sector. It did show that provenance in such a market is not a fussy consumer concern. Scott had reason to doubt, and mostly stopped where her evidence stopped.

Precisely because those grey-market chapters are so vivid, they should not be allowed to stand for fertility medicine everywhere. In March 2026, the Human Fertilisation and Embryology Authority told Parliament that British fertility care poses unusual consumer-protection problems because most patients pay for treatment themselves and clinics compete in a commercial market; it also reported no evidence that vulnerable women were being systematically encouraged to donate or freeze eggs within the regulated UK system. That contrast improves Scott’s argument rather than softening it. Regulation, jurisdiction and bargaining power matter more than the mere fact that money has entered the room.

One rhythm eventually begins to show through the reporting: another bizarre transaction, another recoil, another person whose testimony makes the recoil look too easy. Milk, eggs and gestation are different enough to justify the recurrence, but not every example advances the argument equally. Scott’s analogies can overpressurize a scene too: clinics become casinos, donor networks edge toward pimping, bodies become agricultural yield. Usually the comparison exposes an economic structure. Occasionally it supplies the moral atmosphere a beat before the reporting has earned it. Those are real deductions from an otherwise unusually nimble piece of narrative journalism.

Under the invoices, dependency keeps reappearing. A premature baby needs milk it cannot produce; an intended parent needs an egg another body can relinquish; a pregnancy may require somebody else to carry it; a child, once born, needs hours no parent possesses in infinite supply. Markets can coordinate those needs, widen access and sometimes rescue people from biological bad luck. They also know exactly where desperation weakens bargaining power. Scott’s deepest insight is not that dependency destroys autonomy. It is that autonomy becomes most expensive precisely where nobody is self-sufficient.

Late in the epilogue, Scott considers artificial wombs, synthetic embryos and other technologies that might seem to solve the maternal body by engineering around it. She doubts they will end the markets she has described, because the desire for biological connection, pregnancy and parenthood is not merely a technical problem awaiting a technical fix. Then she abandons futurism for her own household. While she writes, a younger woman is being paid to care for her children. Scott has purchased time in order to write about the purchase of women’s time.

Only then does “Baby,” the heading after Milk, Eggs and Placenta, reveal its formal joke. The baby is not the final product of the reproductive economy but the beginning of new labor, new dependencies and new bargains over attention. Scott’s closing question about whether she is consumer or consumed works because the book has spent so long separating buyers from sellers before allowing the categories to leak into one another. My rating is 87/100, translating under the Goodreads quarter-star rubric to 4.50/5: a book whose structural intelligence and moral restlessness outweigh its repetition, analogical overreach and uneven access.

Scott’s title ends up both accurate and insufficient. It promises women milked, harvested and rented for profit, and finds enough to justify the provocation. The more difficult discovery is that calling reproductive labor priceless can be another way of declining to value it, while pricing that labor can recognize work and expose the worker to purchase in the same motion. Scott never gets the ledger to balance. Better that she does not. After milk, eggs, gestation and care have been counted, something remains stubbornly off the books: somebody’s body, somebody’s time, somebody’s hope, still refusing the neat little box where the price ought to go.

The origin of this book is the author’s own pregnancy. As a new mother, she stumbled into a world that she (and most other people I suspect) did not know about, and turned her skills as a journalist on it.

The topic is marketing bodies, which sounds both more and less dire than what goes on in the book. It could be a look at fertility and childbirth in general, but it has a materialist focus – what the process actually is for these things.

It reveals the unexpected, and is willing to be uncomfortable in not knowing all the answers even with it providing a lot more facts. The weakness is that some of these areas are too complex for the treatment they get, largely because the law and practice around them varies so much.

The author wants to provide a personal tone. I like this in the abstract because it makes a lot of sense in the context – personalizing the depersonalized through the author’s own participation. But the author’s voice is not consistent. She is not bound to be, of course, with the previous paragraph in mind, but there are the occasional section where her commentary falls flat.

Still, it ends up as a strong recommend based on it disclosing the uncomfortable and beginning an examination.

My thanks to the author, Alev Scott, for writing the book, and to the publisher, Harper 360, for making the ARC available to me.