After more than a year of headlines documenting the real-time exodus of mothers from the labor force (open in new tab) and the continuing state of crisis in maternal health and mortality (open in new tab), Pandemic is a long overdue conversation about the systemic inequities in American motherhood was forced to.

A series of federal policies could begin to mend this rift: on August 24, Congress approved a $3.5 trillion budget proposal (opens in new tab). The budget proposal will likely include the centerpiece of President Biden's "American Families Plan" (open in new tab), which includes an expanded child tax credit, paid family and medical leave, and early education funding. Other reforms include the "Marshall Plan for Moms" (open in new tab), which reflects the demands of the national movement (open in new tab) to put mothers at the center of economic recovery; the "Black Maternal Health Act of 2021" to address alarming racial and ethnic disparities in maternal health outcomes (open in new open in new tab), and the "Assistance Through Loss Act" (open in new tab) to establish paid leave for workers experiencing difficulties related to pregnancy loss, surrogacy, infertility treatment, and adoption.

While advancing proposals to enhance and secure the well-being of mothers, we must not neglect another silent influence on maternal and women's health: physiological poverty, which, despite global attention (opens in new tab), is one of America's hidden inequities (in new tab opens in new tab).

The effects of menstrual inequity run deep: according to a 2019 study (opens in new tab), nearly half (46%) of low-income women in St. Louis had to choose between buying food or spending money on menstrual products. Those experiencing housing insecurity (open in new tab) reported isolation and even illness and infection caused by using tampons and napkins longer than recommended. Sometimes they have to improvise with discarded paper bags or newspapers.

For teens (opens in new tab), the lack of access to support and products (especially for transgender teens who are already facing an unprecedented number of legal attacks (opens in new tab)) can lead to poor health, lost class time (opens in new tab) and even lead to disciplinary intervention (opens in new tab). The pandemic has exacerbated the problem. Many people are no longer able to obtain sanitary products (opens in new tab) from public facilities they once relied on. According to another survey, one in ten college students nationwide (opens in new tab) have been unable to purchase menstrual products in the past year.

Policy leaders are beginning to respond: in the 2021 state legislatures, California (opens in new tab), Colorado (opens in new tab), Georgia (opens in new tab), Oregon (opens in new tab), Washington (opens in new tab) passed laws and fiscal budget extensions that guarantee free tampons and napkins in middle schools and universities. Earlier this summer, Louisiana, Maine, and Vermont (opens in new tab) eliminated sales taxes on sanitary products (commonly known as "tampon taxes"). For example, the Coronavirus Aid, Relief and Economic Security (CARES) Act (opens in new tab), a tweak to the federal tax code, allows tampons, pads, cups, and sanitary underwear to be purchased with pretax dollars through employee health savings or flexible spending accounts This means that

However, the distinct needs of low-income mothers, who often must not only manage their own periods but also those of their caregivers, are overlooked. Female-led households (open in new tab) are the primary participants in many of our nation's most important social safety net programs. They are among the 42 million recipients (open in new tab) of the Supplemental Nutrition Assistance Program (SNAP), formerly known as the Food Stamp Program. Soon-to-be mothers and new mothers and their children are also the only recipients of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), which provides supplemental food packages and other essential health resources to nearly 8 million people.

Shockingly, neither program allows for the purchase of sanitary products. To add insult to injury, the federal government has placed tampons and sanitary napkins in the same "contraband" category as dog food, cigarettes, and alcoholic beverages.

The World Health Organization defines maternal health (opens in new tab) as "a woman's health during pregnancy, childbirth, and the postpartum period." For new mothers, the need for menstrual products is most acute in the immediate postpartum period; pads that absorb menstrual blood after birth, which can last up to six weeks, are a necessity for the physical and emotional well-being of new mothers. And of course, regular menstrual cycles resume once breastfeeding is stopped, and even sooner if the baby is fed milk.

Those who rely on food stamps also face significant pressures regarding access to menstruation and financial affordability. Cost-effective grocery shopping requires balancing nutritional needs with a tight budget. Menstruation plays into this equation, and people often have to choose between having enough menstrual supplies or putting enough food on the table; the financial burden increases when SNAP recipients have more than one person with menstruation in the household, such as a mother with teenage children or a grandmother leading a multigenerational household .

Given that SNAP and WIC reforms will have a significant impact on the mothers who need it most, now is the time to sue for these unjust exemptions and set a precedent at the federal level. When Congress drafts reconciliation legislation, lawmakers should take access to menstruation into account whenever possible. And when discussing other legislative proposals affecting mothers, access to menstruation should be a priority from the outset.

Last month, the Biden administration called for an unprecedented expansion of SNAP (open in new tab). Monthly benefits would be raised by an average of $36, the largest increase in the program's history, and would go into effect in October. This is a great start, but allowing people to purchase sanitary products through food stamps and WIC would be a simple and humane addition. Furthermore, since everything purchased with federal benefits is already exempt from state sales tax by law, this change will effectively eliminate the "tampon tax" for those with lower incomes, no matter where they live.

A pandemic will not stop menstruation. As the President and members of Congress have pledged to ease the burden on struggling mothers, the cost of menstruation cannot be left out of the discussion.