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Opinion: New Missouri Department of Correction Policy and 2021 Legislation Leads to Improved Health for Incarcerated Women

In the past six years, U.S. state and federal prison systems—historically focused on men—have started paying more attention to the long-ignored hygiene needs of incarcerated women. In 2017, the Federal Bureau of Prisons released guidelines requiring all its women’s prisons to offer varieties of pads and tampons free of charge. In 2018, President Donald Trump signed the federal First Step Act codifying these guidelines into law.

In September 2018, Missouri Appleseed, a nonprofit focused on criminal justice and public health issues, received funding from the Missouri Foundation for Health to study incarcerated women’s access to feminine hygiene in Missouri. At that time, Missouri Department of Corrections (DOC) provided women with pads manufactured by a prison supply company. Women in Missouri prison who wanted tampons or other pads had to buy them. Notably, the women made $7.50 or $8.50 a month at their prison jobs on average, while a box of canteen tampons cost $5.63 and a box of canteen pads cost $5.38—a huge portion of their monthly salaries. Missouri Appleseed worked with DOC to do survey research on feminine hygiene practices in its women’s prisons. The research results were concerning. 50.0% of respondents who used the free pads reported needing to change them every 30 minutes or more frequently. 80.3% of respondents who still got their periods reported using homemade tampons to manage their hygiene, and 22.5% reported having had a vaginal infection in the last 6 months.

After receiving the survey results, DOC and Missouri Appleseed began work with the Missouri state legislature to appropriate funds to improve feminine hygiene in its women’s prisons. In May 2019—due to the support of State Rep. Cody Smith, Sen. Lincoln Hough, Sen. Mary Elizabeth Coleman, Sen. Tracy McCreery, Sen. Curtis Trent, and State Rep. Bruce DeGroot—the legislature passed an appropriations bill to purchase tampons as well as pads for Missouri’s two women’s prisons. In 2021, State Rep. Bruce DeGroot sponsored a bill requiring Missouri jails as well as prisons to distribute free tampons and pads to the women they incarcerate. When Rep. DeGroot’s bill passed, Missouri became one of only a handful of states that requires free feminine hygiene products be provided to women in both jails and prisons.

In April 2023, after DOC had been distributing free tampons as well as pads for several years, Missouri Appleseed again worked with them to research the state of feminine hygiene in Missouri’s women’s prisons. The surveys suggested that real progress had been made. Only 10.3% of menstruating respondents had used homemade tampons since DOC started supplying free tampons—down from 80.3 % in 2018. Only 10.3% reported having had a vaginal infection in the past 6 months while in prison—down from 22.5% in 2018. While questions about the absorbency of the products remain, the results show dramatic improvements.

By requiring jails and prisons to provide free feminine hygiene products and appropriating the necessary funds, the Missouri legislature has dramatically reduced homemade tampon use and self-reported vaginal infection rates in Missouri’s prisons—a win for public health and human dignity in our state. This win shows that local research and the bipartisan efforts of our state government can make a real, measurable difference. As the 2023 legislative session comes to a close, Missouri Appleseed is hopeful the Missouri General Assembly will continue to put party affiliation and personalities aside to pass additional legislation that will improve the health of Missourians.