On Tuesday, groups around the globe marked Menstrual Hygiene Day, an annual effort that arose in recent years to raise awareness about the ways in which stigma and lack of access to adequate sanitary products affect girls and women around the world.
A recent UNICEF study found that one in three women in South Asia had no knowledge of what menstruation was before their first period, and 48 percent of girls in Iran thought menstruation was a disease. Another study by the World Health Organization found that one in 10 African girls do not attend school when they are menstruating.
But lack of access to adequate menstrual care doesn’t just affect women in developing countries. It’s also an issue for those living in the U.S., where a recent survey published in Obstetrics & Gynecology found that nearly two-thirds of low-income women could not afford to purchase both food and menstrual hygiene products in the same month.
These challenges have spurred more conversations about what activist Jennifer Weiss-Wolf calls “menstrual equity” in recent years, as lawmakers and organizations have considered how to make basic sanitary products more accessible and affordable to women across the board.
From U.S. prisons to rural communities in India, here are four ways groups are working to make feminine hygiene care better for all.
One woman pushed to make sanitary products free in all California county jails
While women in the U.S. account for around 30 percent of the world’s incarcerated population and are the fastest-growing prison population in the country, they face particular challenges in American facilities. Many states continue to shackle incarcerated pregnant women during childbirth, and female inmates have long reported that sanitary products in U.S. jails are expensive and difficult to access.
This started to change back in 2017, when the Bureau of Prisons issued a memo directing federal prisons to start issuing free sanitary products to inmates. Progress on the state level, however, has been slower. California lawyer Paula Canny filed a class-action lawsuit last December after a public records request revealed that a number of local jails in her state were charging women for tampons and pads above the market rate.
“The cost of a tampon in San Mateo County jail was $6.99 for 10,” said Canny, who started looking into the issue when a client who was at risk for suicide told her that she was having to deal with her period without any access to tampons. In April, the state of California said it would require county jails to make tampons, pads, or panty liners available to women free of charge.
Canny told the PBS NewsHour that the experience in San Mateo has prompted her to think a lot more about how the issue plays out in local jails, which are often run by male sheriffs. “It’s gotten me thinking a lot about how much period shame everybody has, she said. “It was hard to get people to talk about it.”
After spurring the law change in California, Canny has filed public records requests to investigate the issue in Hawaii local prisons, and plans to look into Oregon jails as well.
State lawmakers are working to eliminate the “tampon tax”
In many U.S. states, a state sales tax adds to the cost of menstrual hygiene products. But in recent years, more legislatures have moved to eliminate it. The most recent state to do so was Nevada, which previously did not exempt menstrual products from its 6.85 percent tax. Voters approved a measure to nix the tax back in November, making Nevada the 10th U.S. state to do so.
“Feminine hygiene products are primarily bought for women and the sales tax on what are medically necessary devices disproportionately affects women,” state senator Yvanna Cancela told Marketplace at the time. She added that removing a “gender tax” from Nevada’s tax code would mark an important step “in moving towards equality.”
Other states that have done away with taxes on menstrual hygiene products include Connecticut, Illinois and Maryland. Back in 2016, the lawyer who challenged New York’s tampon tax posited that, “tampons and pads would have been tax-exempt from the very beginning if men had to use them every month.” The state voted to eliminate it in July of that year.
A group of California students sent machines to India so that women can make biodegradable pads
In many parts of the world menstruation remains taboo, making it more complicated, and even dangerous, for women to care for themselves.
In India this past January, two women set off a series of country-wide protests after entering Sabarimala temple, which bans females of menstrual age from entering. And in February, a Nepali woman died when a fire broke out in a menstrual hut where she was staying during her period, according to a tradition that considers menstruation impure.
The reasons that menstruation remains stigmatized in different parts of the world are varied and complicated, often deeply ingrained in various cultural practices and societal traditions. But there has been an uptick in initiatives to reduce stigma surrounding periods and make sanitary products more accessible in these countries in recent years.
One such initiative, The Pad Project, donates machines to help women in India make affordable, biodegradable pads by themselves. The California-based project was started by high school students in North Hollywood, and was the subject of an Oscar-winning documentary, “Period: End of Sentence.”
“There’s this giant elephant in the room,” the film’s director told the New Yorker about the stigma they were trying to combat. “Mothers are not talking about it to their daughters, wives are not talking to their husbands, so no one is really very knowledgeable or educated about what this thing is that happens to women’s bodies every month.”
Uganda-based AfriPads follows a similar model, working with local women to manufacture and sell reusable sanitary pads.
More companies are offering more environmentally friendly products, or helping helping women in need
Like other everyday disposable products, sanitary pads and tampons take a toll on the environment: It is estimated that around 2 million disposable pads and tampons are dumped into landfills every month.
In recent years, feminine hygiene companies have started responding to customer demands for more sustainable, environmentally friendly products. This month, Procter & Gamble rolled out Tampax PURE, a line of tampons made from organic cotton, with no added dyes or chemicals. Other companies such as Natracare and Seventh Generation have long offered similar products, and a 2017 market report suggests they’ve become popular among consumers.
Reusable products have also garnered consumer interest, with more women turning to menstrual cups such as DivaCup and underwear such as Thinx.
A number of companies have pursued sustainable products with a dual purpose, such as the environmentally friendly LunaPads, which uses customer funds to send reusable pads to students in Africa through the One4Her campaign. Cora, which makes tampons, pads and menstrual cups, says every purchase ensures a girl in need gets pads and health education. The sustainable tampon brand Ilo donates 50 percent of its profits to Homeless Period Ireland, which donates sanitary products to women who need them.
“It’s really important that the company gives back to the community,” the company’s founder Jette Verdi told the website Her.ie.
Correction: This article has been updated to reflect that the UNICEF report focused on South Asia, and that Tampax PURE tampons are not biodegradeable.