Katherine J. Parkin’s The Abortion Market tells the story of abortion access in the decade before Roe v. Wade as a consumer experience to illustrate the scale of demand and the persistence of inequality in access. The most striking aspect of Parkin’s account of the pre-Roe care landscape is how legalization transformed abortion access while leaving many underlying problems in place. Access during this time of legalization developed gradually as a market response to new rights. By examining abortion as a marketplace, Parkin shifts attention away from formal rights and toward the material conditions that determine access. What emerges is an explanation of a system in which legality expands access conditions, while cost continues to determine who receives care.
Abortion is a market formed by restriction. Legal restrictions and bans constrain abortion access by producing scarcity, raising prices, and creating opportunities for profiteering. Drawing on archival records, advertisements, and personal accounts, Parkin reconstructs a network of providers, brokers, and consumers operating in a system bounded by stigma, urgency, and limited information. Trust is at a premium as women arrive alone in unfamiliar places, carrying a concerning amount of cash, with little assurance that a doctor can see them. Parkin details the economic realities of abortion care with new historical cost calculations and payment strategies that reflect financial and logistical burdens beyond medical billing. In the early 1960s, abortion routinely cost the equivalent of thousands of dollars today, and millions of women found a way to pay.
Parkin shows how inequality is reproduced when abortion options are limited. Those with resources can afford expediency and privacy, while those without face constrained options, increased risk, and greater exposure to exploitation. The abortion market from 1962 to 1972 operated as a stratified system in which access was mediated by the ability to pay. These inequities have persisted over time, and current abortion bans have intensified these market conditions, with economic barriers intensifying in the post-Dobbs landscape.
Crucially, these inequalities are rooted in the forces behind legalization. Parkin traces how a mix of wealth and ideology shaped abortion access, linking population growth fears to American eugenics efforts funded by wealthy patrons. Well-funded “population crisis” groups, including Planned Parenthood, helped shift the abortion debate while also funding access and legal reform efforts cited in Roe. Parkin offers a critical analysis of movement history through financing that highlights how abortion access has been shaped by political and economic interests that prioritize control over bodily autonomy.
The role of monied interests continues as Parkin introduces her core concept of abortion entrepreneurs. These are providers seeking a high-demand, high-paying specialty and middlemen who brokered access to care and information. While feminist organizations and campus groups attempted to scale and sustain freedom of information and affordability, abortion access was largely organized through a patchwork of private networks that charged for entry into care.
Legalization expanded access while also reconfiguring these conditions, as clinic and hospital systems created new opportunities for profit while lowering some costs through competition and volume. The abortion travel business flourished alongside these changes, linking patients to providers through word-of-mouth and paid referral networks. Even as costs were lower in public hospitals, patients often encountered more stigmatizing and bureaucratic conditions. Brokers justified their fees by connecting women directly with providers and bypassing hospital review processes. For these women, money could restore a measure of control in an otherwise constrained system.
These intermediaries prospered in a context where information was scarce, time-sensitive, and often censored. This information environment is at play today. Although technologies have changed, the demand for reliable abortion information persists. Access continues to depend on navigating fragmented systems mediated by organizations rather than public entities. Today, these conditions produce fertile ground for abortion misinformation, as gaps are filled by bad actors who distort, delay, or obstruct access to care. Parkin’s brings us back to a time when church groups helped facilitate abortions, challenging assumptions about normative religious political behavior.
Parkins offers a new perspective by decentering law as the primary analytic frame to understand abortion access. Parkin’s research suggests that legalization does not change underlying inequalities that structure the abortion market. This insight is salient in a post-Dobbs landscape where long-distance travel, informal networks, and access disparities persist. Medication abortion has altered the terrain in ways our grandmothers hoped for when they boarded flights on a weekend trip for a “dusting and cleaning” (as one woman told her friend to keep her D&C secret). Parkin’s research raises the questions about who is profiting from abortion today and how to prevent predatory practices. What is clear from our past is that post-Dobbs democratic backsliding compounds the loss of rights with a reemerging marketplace that limits who can end a pregnancy.
The Abortion Market is a rigorous and timely contribution that expands familiar narratives about abortion before Roe. By centering the consumer economics of care, Parkin shows that abortion access has long been structured by inequality. If reproductive autonomy is to be realized, abortion access must be removed from market logics.
