Cash Cow: A Radio 4 Book of the Week

by Alev Scott

'Captivating, mind-boggling and deeply disturbing' – Maureen Freely

'Humane, thoughtful and urgent — this book will make you think, make you laugh, make you cry, but also make you burn with rage' – Dr Mary Wellesley

A thought-provoking deep dive into the global fertility industry and the commodification of the maternal body

Should surrogacy be a paid service, an altruistic act – or even legal at all?

Is it right that you can pay more for ‘VIP’ egg donors – and to view their photos?

How much, if anything, should breastmilk cost – and who should be allowed to buy it?

The global fertility industry is rapidly growing, hugely profitable and morally complex. This an industry where one person’s biological bad luck can be another person’s financial gain. From egg freezing to black-market breastmilk, the maternal body has never been more commodified, yet the ethical, emotional and economic implications are rarely considered.

Through a combination of undercover reporting and detailed first-hand accounts – including a surrogate of 12 children, an international embryo courier and a man who buys breastmilk for his IBS – Alev Scott exposes how the IVF, surrogacy and milk industries operate around the world and who is profiting. In doing so, she considers the blurred line between exploitation and empowerment. Who should make money from the maternal only the women themselves, anyone or no one?

Timely, thought-provoking and compelling, Cash Cow is an unmissable investigation into how desire, desperation and commerce intersect, and the impact the fertility industry has on individuals.

Genres: Nonfiction, Feminism, Audiobook, History, Economics, Science

306 pages, Kindle Edition

First published January 1, 2026

About the author

Alev Scott (born 1987) is a British-Turkish author, journalist, and cultural commentator. She is best known for her explorations of Turkish identity, Ottoman history, and modern sociopolitical issues in the Mediterranean and Middle East.

Reviews

[Yana Sybiga · Rating 5 out of 5]

A well researched, well rounded journalistic report on the state of the female fertility industry in the world today. The book deals with subjects like egg freezing, breast milk, IVF and surrogate births — explaining every industry in detail, talking about costs, main players, legality and morality of every part of the process to make a child. I really appreciated the author’s willingness to ask questions and not pass any judgments on any participants of the process. The book helped me make my mind up about what I personally think about some of these issues (like — is surrogacy ethical? Should it be allowed?) and whether I would ever consider them for myself. The title is so clever as well.. „Cash cow” as in — everybody makes profit from you as a female. Obviously sickening and disturbing that women are always the ones who go into potentially exploitative industries to make money using their bodies. Female bodies are valuable enough to be paid for, but not valuable enough to be protected by better laws and regulations. Ugh. Highly recommended for both genders to read and understand the complexity of what it takes to just simply give birth and nurture a child (not even talking about raising them!!!).

[Magdalena Morris · Rating 5 out of 5]

Oh my word where do I start?! This book is shocking, eye-opening, thought-provoking, insanely well reasearched and just so full of empathy. I loved the audiobook version narrated by Alev Scott and I couldn't stop listening, even when I got to the grim parts. I definitely did get upset a few times, but there was so much in this book that I either didn't know or simply didn't ever think about - until now. I know this book, facts and stories within it, will stick with me for a while and I think it's important that people read it, whether you're a woman or a parent or not. The whole industry built around women and their reproductive system; using both women and people who are *so* desperate to have children; even just sharing breastmilk with another woman and child in need. There is so much to think about, there is so much to be aware of, and I am grateful to Alev Scott that she has brought all of this to our attention. A very important read.

[Sadhbh O'Sullivan · Rating 5 out of 5]

This was such an interesting and in depth exploration into the fertility industry and the fundamental human forces that drive it, as well as all the ways it is commercialised and commodified. Read for work.

[Tamara Wilson · Rating 5 out of 5]

So crazily unbelievably interesting.

[brogan · Rating 4 out of 5]

4.5⭐️

[Caroline Priddle · Rating 5 out of 5]

Cheated and listened to it on radio 4 but really good

[Clare Bailey · Rating 4 out of 5]

Thought provoking, open minded and uncomfortable peek into a few industries that a lot of people probably don't even know exist, let alone have ever had to think about

[rosie · Rating 4 out of 5]

loved doing such a deep dive into this industry!!!

[Krazyaboutbooks · Rating 4 out of 5]

In this book, the author investigates the 'business' of assisted insemination, pregnancy and breast feeding. she examines key pillars, namely: milk, eggs, sperm, IVF, surrogacy and ethics. This was an eye opening read, especially about the laws governing egg donation (anonymous or non-anonymous ), surrogacy and restrictions in the UK for couples seeking IVF on the NHS. The chapter on milk was quite interesting with a large market for human breastmilk (normal and black market). The chapter on surrogacy was sad but expected with some agencies/ prospective parents mistreating the surrogates and the women suffering lifelong injuries (with little compensation) from the pregnancies. However, there are positive surrogacy stories with some parents becoming lifelong friends with their surrogate. The book also discusses the ethics of sperm donors with multiple children (this is detrimental due to the possibility of their children marrying/ having kids. Which leads to an increase in the probability of genetic diseases found in the sperm donors family presenting). Overall, an interesting read that is quite relevant to the present time as more women are waiting until later life to start a family (looking for right partner, financial or academic reasons and etc., ), there will be an increase in assisted insemination but this leaves room for bad actors to take advantage of desperate people wanting a family, surrogates and egg donors. I would highly recommend.

Disclaimer: I received this book from NetGalley and HarperCollins UK, Nonfiction | HarperCollins in exchange for a free and honest review.

[Alanna Metz · Rating 5 out of 5]

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.

I was given a copy of this book in exchange for my honest review.

[Laila Hardy · Rating 4 out of 5]

I picked up this book after reading about two women who had used their own eggs and had carefully chosen one anonymous, healthy sperm donor, in order to have two babies that were related, only to find out that the second child had a different sperm donor. This may have happened in one of the clinics in Northern Cyprus that Alev herself went undercover to report on, in order to find out about this lucrative industry in IVF and sperm donors.


In a compelling narrative we discover more about this search for what many of us take for granted alongside Alev’s personal experience of donating breast milk and what lies behind its increasing commercialisation, as well as the the use of surrogacy and IVF, from personal accounts to the market driven capitalisation of this fertility business.


It is an eye opener to discover that commercial surrogacy for foreigners is legal only in the US, Ukraine, Georgia and Iran!.Parents of all sexual persuasions do pick and choose but it is still a minefield in various other countries. Alev takes us on her journey to discover where the clinics are, who profits and the happy outcomes of this trade in human life with interviews with surrogates and grateful clients, clinicians and some heartwarming stories.

[Hilary · Rating 5 out of 5]

I couldn't put this book down. Alev Scott takes you by the hand and drags you into a world you didn't know you needed to visit. But the minute you hear about her selling her breast milk to a trucker named Steve, you can't turn away as she journeys into the sometimes heartbreaking, sometimes seedy and always fascinating world of surrogacy, fertility and breast milk sales. These global industries are booming - and in unexpected places. Who knew Iran was a popular surrogacy destination? Not me. This book is beautifully written and researched but what sets it apart is the author's eye for the story. You can tell she's a first rate journalist. Some of the people she interviews come to life and stay with you. Stephanie, a woman who likes being pregnant enough to do it a dozen times, deserves her own Netflix series. With women's bodies being commodified and subjected to legal gymnastics, this is a timely book that leaves you grappling with the difficult moral and ethical terrain we, as a society, now find ourselves in. And though a non-fiction book, this is actually a great choice for a book club. So much to discuss!

[Aoife · Rating 4 out of 5]

I picked this book up as a kindle deal this month and was instantly intrigued.
I’m trying to read a bit to get prepared for the next chapter, but this was a bit of a push, but one I sped through.

Scott a mother two, looks on at her own experiences and those of her friends and family on how the female anatomy is used and abused for profit, exploitation, altruism and survival, crossing borders, cultures and moral conundrums, she opens the eyes of the uneducated and the ill informed on the price of motherhood and the choices we make and the industries that exploit.

Not too much of a heavy read, but please do watch out for triggers of child loss, infertility struggles, surrogacy etc
I learned a lot about the IVF/surrogacy industry in North Cyprus, the many uses of breast milk and the different global legislation surrounding surrogacy, so definitely worth a read.

[em · Rating 4 out of 5]

An incredibly educational and well researched book. I learned so many new things while reading this, from the world of the breast milk market, to altruistic surrogacy. Scott presents all the facts without judgment and in a very clear and concise manner. As a woman, pregnancy and childbirth is inexplicable tied into our social expectations, and this book really opened my eyes and educated me in so many ways.

Thank you to NetGalley and the publishers for kindly providing an ARC in exchange for an honest review. #CashCow #NetGalley. All opinions are my own.

[C.Z. Munu · Rating 5 out of 5]

I first came across Cash Cow: How the Maternal Body Became a Global Commodity and the Hidden Costs for Women on Instagram, and I'll admit it was the cover that initially caught my attention. I looked it up almost immediately, and I'm so glad I did.

Part memoir and part investigative journalism, Alev Scott dives into the ways women's bodies and motherhood itself have become intertwined with global industries in ways I had never really considered. As a mother, I was genuinely shocked by some of the topics explored in this book. These are aspects of pregnancy, childbirth, and the journey into motherhood that had completely escaped my awareness.

What impressed me most was how accessible the writing was. Despite tackling complex, emotional, and often uncomfortable topics, Scott presents everything in a way that's engaging and easy to digest. I found myself constantly wanting to pick it back up because every chapter introduced another perspective or issue that left me thinking.

This is one of those books that informs without feeling preachy. It asks important questions, presents well-researched information, and encourages readers to think critically about systems that many of us rarely stop to examine.

I honestly think more people should be talking about this book. Whether you're a parent, planning to become one, or simply interested in women's health and the often-overlooked realities surrounding motherhood, this is a fascinating and eye-opening read.

I highly recommend it.

[jadene · Rating 5 out of 5]

Wow. Such an interesting book about a topic that many people may not give much thought too (I personally hadn’t before reading). I loved Alev Scott’s writing style which felt informative but also conversational. The way she sprinkled in her personal anecdotes amongst the research made for a much more engaging read. I’d 100% recommend this book to a fellow reader!

[Bookwormbadger · Rating 5 out of 5]

A fascinating and compulsively readable account of the global industries related to parenthood - specifically breastmilk, egg donation and surrogacy. I found this book extremely interesting and learned loads. Very well written and thought provoking. Highly recommended.

[Gordon Adam · Rating 5 out of 5]

This is an eye-opener, even for those in the industry or struggling personally with fertility issues, and beautifully written. It conveys the tension of being in that world, and the pressure of uncovering, in investigative journalist mode, what is really going on behind the scenes.

[Jamie · Rating 4 out of 5]

A good balance to the pro-fertility/medical forward book I read before this, illustrative of the financial basis behind milk, eggs, and placenta to bring babies into the world. Of course, colored by personal anecdotes of the author

[Kimberly · Rating 5 out of 5]

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.

[heyheyhey · Rating 5 out of 5]

Fantastic book that actually tries to think through these ethical dilemmas with evidence and 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.

[Cordelia · Rating 4 out of 5]

This is so crazy, Scott brings up issues and experiences women face when it comes motherhood - some I have never even thought about as a woman who hasn't had children. Really fascinating.

[Beth Ibbotson · Rating 4 out of 5]

incredible research and journalism! and well isn’t being a woman in the modern world really so absurd and bizarre

[Hannah W · Rating 3 out of 5]

3.5 stars. The audiobook had a blooper left it, never heard that before :D

[Fleur Currie · Rating 5 out of 5]

Merged personal reflections and experiences with journalistic research to combine a nuanced, thought provoking book.

[Simon Fletcher · Rating 4 out of 5]

A fascinating, thought provoking and occasionally disturbing look at the comodification of pregnancy and motherhood.

[Teddy · Rating 5 out of 5]

okay this topic is always my favorite thing to talk about and think about and read about so of course i loved this (excellent) book very much

[Colin Thomson · Rating 5 out of 5]

Gripping, eye opening, balanced, and frank discussion and investigation into a topic is often too taboo to learn about

[Francis Pellow · Rating 4 out of 5]

radio 4 book of the week adaptation. a brief view into an unimagined world in this abridgement

[Abigail Rickard · Rating 3 out of 5]

Raised interesting questions about the female body , but didn’t quite go into enough depth to really push my understanding of the subject