Two-Thirds Of Low-Income Women In 1 Major City Can't Always Afford Tampons And Pads

They sometimes use their kids' diapers and even go to the ER for period products, says a new study.
Lili K. via Getty Images

A startling number of low-income women in America cannot afford period products — so they’re using rags, paper towels or even diapers in order not to bleed through their clothing every month.

Nearly two-thirds of low-income women in the St. Louis area reported that they were unable to afford pads, tampons or other menstrual hygiene products within the last year, according to a new study published in the journal Obstetrics and Gynecology this week.

And though the study was relatively small, the numbers are likely similar elsewhere in the country, said study author Anne Sebert Kuhlmann.

“This is an issue that has received an increasing amount of attention, particularly in developing countries. But when we looked at what was known and documented in more developed countries like the United States, there wasn’t much,” explained Kuhlmann, director of the master of public health program at St. Louis University.

“The magnitude was definitely a surprise,” she told HuffPost. “We hypothesized that we’d document some need. But the fact that nearly two-thirds of the women had been in that situation — that magnitude really surprised us.”

To better gauge how many women are affected by what is sometimes called “period poverty,” the researchers used three different sources of information: They surveyed more than 180 women who were recruited at community organizations that serve low-income individuals; they conducted three smaller focus groups; and they surveyed 18 local community organizations directly, to get their take on the scope of unmet menstrual hygiene needs.

In addition to the two-thirds of women who said they had been unable to afford pads or tampons at least once in the last year, roughly 1 in 5 said they had been in that situation every single month.

“We had women tell us that they had gone to the emergency room for the sole purpose of getting a pad and the mesh postpartum underwear they provide, because they didn't have underwear and they didn't have period products.”

- Anne Sebert Kuhlmann, director of the master of public health program at St. Louis University

Without pads and tampons, women said they had to use rags, toilet paper or their children’s diapers. Others said they ducked into public restrooms in order to take paper towels.

“We had women tell us that they had gone to the emergency room for the sole purpose of getting a pad and the mesh postpartum underwear they provide, because they didn’t have underwear and they didn’t have period products — and they had nowhere else to go,” Kuhlmann said. “If you think about that as a use of our emergency departments in our major metropolitan areas ... we can do better for women.”

In most of the U.S., tampons and pads are subject to sales tax because they’re not classified as products that fill a basic, essential need. Only a handful of states have abolished the so-called “tampon tax.”

Food assistance funding like the Supplemental Nutrition Assistance Program (SNAP) cannot be used for menstrual products, nor can Medicaid.

Women’s advocates say there is a pressing need to make menstrual hygiene products more accessible to all women, regardless of their economic situation.

“If a girl is in the classroom and gets her period unexpectedly, and she doesn’t have a period product on her — and she can’t afford one — she might go to the restroom to check. But if there’s no period product there, she might not feel comfortable going to the office and ask for one,” said Nadya Okamoto, founder of the nonprofit PERIOD, which delivers menstrual health products to women in need and calls for repeal of tampon taxes.

“So she’ll put a wad of toilet paper in and go back to the classroom,” Okamoto continued. “But then she might be distracted and worried about bleeding through her clothes, or what the smell is like, or she might be uncomfortable. In that timespan, the fact that she had that burden because she couldn’t access period products — even small moments like that are unfair. That could be 10 to 15 minutes of her being disrupted in class and missing her curriculum. That makes a difference.”

In the absence of national programs to help women afford pads, tampons and menstrual cups, nonprofits and community health centers have tried to step in.

Kuhlmann noted that the new study would have to be replicated elsewhere in order to come up with national estimates for the problem, but she said there’s no reason to believe that other major U.S. metropolitan areas do not have similar levels of need.

“Most women can identify with having to ‘make do.’ You know, you’re caught off guard, you’re out in public and your period starts — you make do with some toilet paper or you borrow from a friend,” Kuhlmann said. “But to have to do that every month, and to have to do that when you may have only one pair of underwear yourself — that affects your dignity and your sense of self and your sense of being able to care for yourself.”

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