The World Population Day which falls on Saturday (July 11), takes a special focus on safeguarding the sexual, reproductive health and rights of women and girls in the backdrop of the COVID pandemic.
Integral to the women’s rights and health is the theme of menstruation. Managing menstruation hygienically and with dignity is not only an integral path of good sanitation and hygiene, but is also necessary for improved human development outcomes.
Economics plays an important role in how families deal with menstruation. In poor households, families do not have adequate resources to buy things and store them for future use. This affects purchase behaviour. Adolescent girls have to visit a shop every time they have to buy a sanitary napkin. Several of them are shy to walk up to a shop and ask for it, especially if the person dispensing it is a male. In some poor households, girls alternate between using two absorbents. When they have money, they use the napkin – one type of absorbent; otherwise, they use cloth. Cloth has an advantage: it can be re-used whereas napkins cannot be. When re-used, the girls wash the cloth, dry and stash it at some corner of the house. Sometimes an NGO or an anganwadi worker visits the school and advises adolescent girls to wash the cloth and maintain cleanliness. However, not all of them re-use the cloth.
Economics aside, social norms guide menstrual behaviour throughout a woman’s adult life. The onset of menarche is an occasion for celebration in South India, especially among certain castes and communities. Called Ritusuddhi or Ritu Kala Samskara, the ritual marks the coming of age for girls. She wears a sari for the occasion and receives gifts from family and friends. There is an air of festivity around the event.
In Assam, the annual menstruation course of the goddess Kamkhya is a big event and thousands of devotees worship at the Kamkhya temple. In Japan, the family celebrates the event by eating red coloured rice and beans. The manifest purpose of menarche is joyous celebration of the event. However, its latent purpose is equally important. The celebration announces that the girl has come of age. Such an open, social event is an indication of how some cultures and societies view menstruation.
Despite such celebrations, social norms affect women’s behaviour around menstruation. In fact, the norms around menstruation seem to stretch along two axes: purity-pollution and consumption of food.
Since large parts of India consider menstruation impure, the normative practice is that menstruating girls should eschew touching some objects and keep distance from others, even her husband. Menstruating women and girls do not touch puja items, plants, even young children for fear that they would fall sick. Touching any of the puja items would defile the sacredness of worship. Hence, as the practice goes, menstruating girls do not participate in festivals and visit temples. Similarly, because the cow is revered as mother any of her products such as milk, urine or dung is ‘sacred’ and cannot be touched during menstruation. Moreover, menstruating women cannot water the plants because doing so would result in withering of leaves. They cannot farm the land because doing so would destroy crops.
Social norms extend to what women should eat or not eat during menstruation. Women avoid consuming ‘hot’ food (usually tea or sour or pungent ones such as pickle, tamarind or spicy food) as these are supposed to aggravate bodily heat and lead to excessive bleeding. Touching the pickle can make it rancid. They also believe that eating papaya and bottle gourd would induce heavy bleeding during menstruation. Instead, women are encouraged to consume ghee, pulses, fruits, egg, etc.
Ayurveda practitioners offer a more elaborate explanation about why women avoid hot food during menstruation: “Plant-derived food is also kapha in nature, full of youth giving energy that nourishes the body; menstrual blood is dominated by Pitta and Vata, which fosters the cleansing of the spirit. It is most unwise to introduce the rising, energizing nature of our food into our blood, or to mix the downward flowing, cleansing energy of blood into our sustenance, either by preparing food during menstruation, or by slaughtering animals and eating them.”
Seclusion or separation is another important aspect of menstruation. Judy Grahn’s seminal work on menstrual seclusion rites discusses separation at length. Her Metaformic theory posits that menstrual seclusion restrains women in three ways: they should not see light, touch water, or touch the earth. Societies have evolved different ways of practicing such ritualistic behaviour. In Nepal, Hindu women are confined to menstrual huts as part of a social custom called, Chhaupadi. In Japan, women cannot be sushi chefs because menstruation supposedly affects their sense of taste. In UK, a large number of women face what is called period shaming. In large parts of India, menstruating girls sit aside and sleep separately in a corner for five days. The more conservative the household, the more likely it would follow traditional menstrual practices.
Norms also influence how used absorbents will be disposed. Some dig a hole and bury the cloth; some throw it in the garbage or near a bush and some walk into the jungle to throw it away. In fact, girls in parts of eastern India believe that they will not conceive if they burn the used absorbent. Others believe that burning would make subsequent periods difficult. Burning of used absorbents is a common practice in other parts of the country.
Girls tend to avoid school during menstruation, mainly because of practical reasons. Some do not feel well and some avoid because they have to walk to school. Others fear that bloodstains would be visible and wish to avoid the embarrassment. Some households do not allow girls to perform heavy work because it may result in excessive bleeding. At other places, girls are required to cut some roof top materials (Chhat ki adhai) just before the period starts so that the cycle is limited to 2-3 days. If they do not do so, girls believe, the cycle would last longer. Restrictions on hair wash differ as girls in Bihar and Madhya Pradesh wash their hair once their menstruation stops while girls in Andhra Pradesh take ‘head bath’ on the first, third and fifth day of menstruation.
In health communication, taboo refers to topics that are shrouded in secrecy or are not discussed openly. But adolescent girls often get to learn about it from their peers, elder sister, school teacher, close female relative, media and sometimes mother. Male members of the household tend to maintain an enigmatic silence about it. Studies have shown that adolescent boys know even less about it. Talking about menstruation in the family is the first step to changing social norms and unhealthy practices around the subject.