The Missouri Department of Corrections (MDOC) offers free, yet nonabsorbent, sanitary napkins to incarcerated menstruating individuals, while adequate alternatives must be purchased. HB 318 specifies the Department of Corrections must ensure that feminine hygiene products, that conform to applicable industry standards, are available for free while they are confined in any of the Department's correctional centers. Additionally, every sheriff and jailer who holds a person in custody must ensure that tampons and sanitary napkins are available for free and in a quantity that is appropriate for the health care needs of the person.
Missouri has the one of the fastest growing female prison populations in the United States. Between 2007 and 2016, Missouri’s female prison population increased by 33 percent.1 In 2017, the incarcerated female population was 81% White, 15% African American, and 87.2% were between the ages of 18-45 years old.1 Between 2000 and 2019, the national rate of African American female imprisonment has decreased by 60%, however, the rate is still 1.7 times higher than White females; consequently, there is a strong likelihood of being disproportionately affected by reduced access to appropriate feminine hygiene products while incarcerated.2
The majority of incarcerated individuals come from lower-income backgrounds, with national reports estimating 72% of women are living in poverty prior to being arrested.3 Missouri inmates
make a base pay of 33 cents per hour (37 cents per hour if they have a high school diploma) or $7.50 to $8.50 per month.4 These funds can help pay for services such as phone access, snack products, medical visits, and healthcare items. The MDOC offers free sanitary napkins to incarcerated individuals who menstruate, however, these products do not meet the industry standard for absorbency; industry standard /absorbent alternatives are available for purchase. In Missouri commissaries or canteens, industry tested feminine hygiene products cost approximately $6.00 for 18 pads or 20 tampons. For reference, a box of 36 Tampax Tampons can cost approximately $7.00 in retail stores and to accommodate most menstrual cycles, a minimum of 21 tampons or pads are needed. The cost of these products in canteens means approximately 70-80% of an incarcerated individual’s monthly wage may be used to buy feminine hygiene products each month. This may require forgoing medical care or a phone call to family in order to purchase feminine hygiene products and places a significant financial burden on incarcerated females.
Many incarcerated females have had difficulty accessing adequate menstrual products which can lead to physical and mental health effects. The Missouri Appleseed, a non-profit committed to providing all Missourians an opportunity to live healthy, dignified, and productive lives, surveyed 90 incarcerated women about feminine hygiene in the prisons and unmet hygiene needs.5 Of the 87.3% of respondents using the free pads from MDOC, 50% reported having to change them more frequently due to inadequate absorbency.5 Due to accessibility to adequate products, 80.3% of respondents created homemade tampons.5 This led to an increased incidence of reported infections (1 in 4 women), however, respondents continued to use homemade products due to inadequate alternatives.5 Poor feminine hygiene is associated with increased reproductive and urinary tract infections and ultimately, increased healthcare costs.6 Additionally, poor feminine hygiene increases workplace safety risks as bloodborne pathogens can be transmitted through menses.7,8
In 2016, New York passed the first legislation that required correctional facilities (in addition to schools and shelters) to provide free feminine hygiene products. In 2018, the FIRST STEP act was passed which mandated federal correction centers to provide feminine hygiene products at no cost to incarcerated females.9,10 In federal correctional facilities, feminine hygiene products were available for purchase in the commissary or canteen at inflated prices (two tampons could cost $5.55). In accordance, some states passed legislation that required or ensured adequate access to menstrual products in state correctional facilities; as of 2020, 13 states (AL, CA, CO, CT, FL, KY, LA, MD, NY, TN, TX, VA) and Washington, D.C. have legislation requiring free access to such products in state prisons and correctional facilities. The product brands used in these facilities are undisclosed, however, reports from varying states suggest that the feminine hygiene products that are provided for free are less absorbent than the industry standard products which were only available for purchase in the canteen. There are no available reports of fiscal impacts from states that have provided free feminine hygiene products in prisons.