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Rags Instead of Tampons. Here’s What Period Poverty Looks Like in the U.S.


Community Health

The Women's Free Clinic in Santa Barbara provides women with basic medical services and personal care items— including pads.

Pads and tampons are a simple necessity, yet women across America are going without them. The cost of these products make them inaccessible for many low-income women struggling to make ends meet. These women often forgo menstrual hygiene products in order to afford for other basic necessities. Without tampons or pads, women resort to using rags, toilet paper, or even adult diapers. The problem has garnered national attention and stoked advocacy campaigns across the United States. While activists work to pass policies that would increase women’s access to period products, women on the margins continue to struggle with the problem on a monthly basis.

In this episode of our podcast, we explore the realities of period poverty in the United States and the movement working to end it.


AMARICA RAFANELLI, HOST: You know those tampon dispensers in public bathrooms?

They’re like vending machines, except they give out tampons, not chips.

Insert a quarter, turn the knob. Period crisis averted.

But what if you don’t have a quarter? What if you don’t have money to buy tampons at all?

Women across America face this problem on a monthly basis. The price of period products forces women to choose between basic necessities.

JORIE NILSON: They spend their money on food because that’s the basic necessity. Any money they have goes to food.

That’s Nurse Practitioner Jorie Nilson. She’s the medical director at the Women’s Free Homeless Clinic in Santa Barbara.

NILSON: They lack food. That’s the big thing. They lack food. And they’re more concerned about food than just about anything.

RAFANELLI: OK. So if it comes down to it?

NILSON: They’ll buy food over hygiene products. That’s it for sure.

The women’s clinic happens three times a month in a transition home downtown. It’s a safe space where women can shower, eat a hot meal, and relax. In addition to offering basic medical care, the clinic provides women with free hygiene supplies—including pads.

RAFANELLI Why are you providing menstrual hygiene products for these women?

NILSON: Because it’s part of basic healthcare for a woman. And we’re trying to do everything that we can to provide the biological, psychological and social aspects of what every human being needs, but within our women’s clinic population.

RAFANELLI: I decided to go to the clinic to speak with some of the women. While I was there, I met Nancy. We talked about periods over a bowl of soup.

NANCY: I used to have go behind dumpster enclosures, go behind a tree and change real fast and hope nobody sees you. Stuff like that.

RAFANELLI: So you’d have to change your tampon or pad behind a dumpster?

NANCY: Yeah. I did it a lot. Go behind a dumpster enclosure and close the gate and change. I did that a lot. It was pretty commonplace.

RAFANELLI: Nancy was homeless for 23 years. She said when she was living on the streets, she couldn’t afford tampons or pads every month.

RAFANELLI: What would you did if you couldn’t purchase them?

Stick rags up in there. Maybe find an old shirt alongside a road and stick it up in there. I’ve done that.


NANCY: Yeah, it’s rough out there. It’s rough out there sweetheart.

For Nancy, buying period products was just one worry on a list of many.

NANCY: Getting your stuff around in a shopping cart, I mean finding a safe dry place to sleep, yeah dealing with menstrual periods, if you got the flu, like, how you were going to recover and where you were going to sleep, staying warm, having enough blankets, having enough sweaters to stay warm at night. Yeah, it was a lot of things.

For women like Nancy, menstrual hygiene takes a backseat to buying food or finding shelter. When financial resources are stretched thin, tampons and pads are some of the first things to go.

But homeless women are not the only ones dealing with this problem. In Mississippi, immigrant women are up against the same struggle.

JOSE DELGADO: Following US Immigration and Enforcement Agency arrests that happened on August 7th where nearly 680 undocumented persons were taken into custody we realized that there were going to be a lot of persons, who unfortunately, were going to be in dire financial straits.

That’s Jose Delgado—the Vice President of patient services at Planned Parenthood Southeast. He helps manage the Planned Parenthood in Mississippi.

RAFANELLI: So were these women arrested and detained by ICE?

DELGADO: So most of the individuals, the 680 individuals who were detained, were mostly men. With that said, they had families and many of those were, not only their wives, if they did have wives, but their children are identifying as female. So, this was a big deal. We wanted to make sure that those individuals who previously had this financial resource that no longer existed were able to afford for some of the standard gynecological items that might help them with their day to day lives.

After the raid, Planned Parenthood requested menstrual hygiene products from Direct Relief. It was the first request of its kind. The Mississippi site had never provided their patients with tampons or pads before.

DELGADO: For our affiliate this is a first. It’s not that we didn’t think this product or being able to dispense these products were a necessity it’s more that it became more of a necessity with new obstacles. When you have individuals that are targeting particular families or persons things become a little bit more serious and particular families and persons are being targeted things become more serious and any help or support that these families can get becomes a little bit more of a priority.

RAFANELLI: In partnership with the nonprofit organization, Days for Girls, Direct Relief, sent Planned Parenthood 200 menstrual hygiene kits—each containing a reusable pad. Within 2 weeks, half of the kits had been distributed.

Without Planned Parenthood, these girls may have had to go without.

As menstruation becomes less taboo, more and more women are coming forward with their stories and attracting attention to the problem. In the first city-wide study of its kind, two-thirds of women in St. Louis, Missouri said they couldn’t afford period products at least once in the last year. More than 20% of these women said they experienced this problem on a monthly basis.

For activist, Jennifer Weiss-Wolf, these kinds of accounts are evidence of a national problem.

JENNIFER WEISS-WOLF: Anecdotally I would say there is almost overwhelming agreement that the ability to afford and manage menstruation is a challenge for people.

Weiss-Wolf has been hailed as a tampon crusader. She serves as vice president of development at the Brennan Center for Justice and is the co-founder of Period Equity—a non-profit that advocates for safe and affordable access to menstrual hygiene products.

WEISS-WOLF: This idea of period equity, it’s different than period poverty actually, and it’s not rooted in the experience of any one person, but the idea of equitable participation and engagement in civic life. Whether that is one’s education or workplace or any aspect of public life requires that we have a full understanding of menstruation. That we have the ability to manage menstruation. And I’ve taken up the issue with that perspective in mind. It’s surely about helping those that are most marginalized and most in need be able to manage menstruation fully, fairly, with dignity, and all of that. But it’s more, I think, actually driving towards that it’s a policy agenda and that it acknowledges that if half of the people that live by our laws have bodies that menstruate that acknowledging that within the framework of those laws is essential.

Period Equity is involved in several campaigns to pass policies that increase women’s access to period products. One of the organization’s main goals has been ending the tampon tax.

In 35 states, tampons, pads and menstrual cups are not exempt from sales tax. While other basic products, like toilet paper and soap, are also taxed by most states, activists argue taxing tampons—a product only half the population needs— is sex-based discrimination.

WEISS-WOLF: The tampon tax, sales tax, affects everybody. It wasn’t asking for any specific program or specific carve out, but to acknowledge that these products are a necessity and therefore deserving of this exemption. Slightly different questions if you can see what I’m getting at and it was a way to start that conversation.

In 2016, Weiss-Wolf led a class-action lawsuit to end the tampon tax in her home state of New York. The suit was successful in pressuring the governor to repeal the tax. But New York is an outlier. To date, only 5 states have passed a law ending the tampon tax.

WEISS-WOLF: The United States is just kind of scratching the surface right now. Kenya was the first nation to eliminate a national sales tax on menstrual products and did so in 2004. And has had policy ranging from menstrual product provision in schools to educational programs for the better half of the last decade.So yeah, I would say the United States is not ahead.

Thanks to activists like Weiss-Wolf, the United States is making incremental steps towards increasing women’s access to period products. This year, a bill that would make feminine hygiene products available for free in schools, shelters, and other public facilities was introduced into Congress. While other bills like it have been proposed in the past, the period equity movement has stimulated a national conversation that could give menstrual access laws unprecedented momentum.

WEISS-WOLF: Getting people to talk about menstruation, I would say, 500% improves their ability to be healthy in their menstruation. And that includes everything from helping to eradicate the shame, ensuring they are asking for what they need, in terms of information, in terms of medical support, in terms of product support. It’s a way to help live a healthier life and I don’t see why anyone would want to deny that.

RAFANELLI: While activists like Jennifer work to end the problem, women on the margins continue to deal with it on a regular basis. For many women, having a period without a tampon or pad to manage it is unimaginable. For women like Nancy, or the girls in Mississippi, it’s routine.

For Direct Relief, this is Amarica Rafanelli.

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