By Columbia Mailman School of Public Health
Have you ever had to make a decision about whether to buy food or tampons? Use a sock as a pad? Or to wear tight-fitting pants to bed so your makeshift pad doesn’t move around too much and stain your sheets?
These are some of the experiences for those facing period poverty, the inability to afford menstrual products and manage menstruation effectively and comfortably. If you don’t have a period, these situations might come as a shock to you. If you do have a period, they may resonate with your own experiences. While period poverty in the United States is increasingly being seen as a problem, the day-to-day experiences of those facing period poverty are only just beginning to be researched and understood. Additionally, new research has been conducted to understand the impacts of the COVID-19 pandemic on period poverty.
It is evident that the impacts of the pandemic are gendered, with women bearing burdens like high unemployment, increased childcare and home responsibilities, and worsened mental health. For those experiencing period poverty, the lack of resources, like access to free products, is a problem that has been exacerbated by the pandemic but is by no means a new public health issue. While supports like SNAP (Supplemental Nutrition Assistance Program) and its counterpart, WIC (Women, Infants, and Children) help to support low-income women, many public assistance programs do not cover purchasing period products (more on this later).
For my summer 2021 practicum as a Columbia Public Health student, I worked with the Gender, Adolescent Transitions, and Environment (GATE) program as a Menstrual Health Research Fellow where I worked to understand how the pandemic impacted period poverty. This mixed methods study involved GATE partnering with the City University of New York, which administered a nationwide survey to assess how the pandemic was impacting many facets of people’s lives, including a few questions on menstruation. From answers to these menstruation questions, a sample of people participated in a series of qualitative interviews led by the GATE team to gain a deeper understanding of their menstruation management experiences during the pandemic.
The research team published the quantitative findings from the study, which showed the gendered implications of COVID-19, namely the effect on managing menstruation and securing menstrual products. The study highlighted:
1. the negative economic impacts that COVID-19 had on women;
2. that income loss had a high association to product insecurity;
3. how often someone changed their product;
4. the use of makeshift materials to soak up blood.
Overall, the study found that income loss was a strong predictor of product menstrual insecurity. Product insecurity is the inability to consistently afford or have access to necessary products to manage menstruation effectively. It can result in a number of physical, mental, emotional, and financial challenges that can make monthly menstruation a crisis.
During my first year at Mailman I completed a qualitative data analysis class about the process of collecting data, transcribing, coding, and finding themes and findings to report on; all skill sets which served me well for the work I did on the qualitative portion of the study. This included supporting the qualitative analysis of interviews collected with US women (ages 18-45), examining the relationship between income loss and menstrual product insecurity, and how women coped with these challenges.
Translating the skills I gained in class to a real-world example was rewarding and further emphasized the importance of understanding day-to-day experiences when problem-solving. This research has real implications for policy and program implementation that address period poverty and increase the support and resources available to people.
I feel incredibly grateful to have been able to hear people’s firsthand stories about managing their periods during a crisis. Given the stigma that menstruation still faces in our society, the openness and honesty of study participants is even more impactful, and it often reflects the experiences of many. The women interviewed were relieved to hear that others were going through the same things and they hoped that being part of this research could help shed light on the important yet overlooked issue of period poverty.
Making Progress in Ending Period Poverty
Despite the period poverty challenges found across our country, some recent progress has been made to lessen the burden. These efforts are focused in policy reform and the non-profit sectors, as illustrated by the passage of new period-friendly legislation like mandates that schools and government buildings provide free period products. More specifically, this includes Illinois’ inclusion of period products under SNAP and WIC and the historic win in Ann Arbor, Michigan that enacted the provision of free products in all public bathrooms. More cities and states are starting to pass similar legislation, with 27 states passing laws removing the tampon tax, and many others ensuring that free products be made available in federal buildings and publicly funded schools and universities.
Some initiatives are also donation-based, like the nationally operating Alliance for Period Supplies, run through the National Diaper Bank Network. In New York City, the Woman to Woman campaign provides free products and other necessities through the New York Food Bank. In addition to the legislation mentioned above, it is also important that free products are available on larger scales. Further research could help identify if product provision through donation is sustainable in reducing product insecurity. There are lessons to be learned from how the non-profit sector has mobilized to ensure their communities are provided with the necessities they need.
While I’ve had my own “oh no” period moments, I have never had to worry about affording products and for that I am grateful. Through my experience at GATE I learned that by better understanding what people go through to manage their periods with limited resources, we can aid in creating sustainable and far-reaching solutions and policies that help people manage menstruation confidently and comfortably.
I am excited that this research will contribute to the relatively new conversation about period poverty and the pandemic and that it will shed light on potential pathways to reduce the burden of period poverty for so many menstruators. No person should have to decide between food or tampons or be dependent on makeshift supplies, or feel that their period holds them back in any way.
Katie Dimond is a 2022 MPH candidate in the Heilbrunn Department of Population and Family Health and a certificate in Sexuality, Sexual, and Reproductive Health. She received her BA in Anthropology from Trinity College, where she conducted research on women’s birth experiences. Prior to Columbia Public Health, Katie worked at the Cancer Support Community where she developed psychosocial support programs for patients and families impacted by cancer.
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