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By Sam Stroozas, Minnesota Public Radio News

Richfield High School student Chimdalu Dibua was late to class five times recently in one day. That’s unusual for her, but the circumstances were out of her control. Five friends had texted needing a tampon or pad and she had to help them out.

Long known in her group as someone who carries extra period supplies, Dibua, 18, didn’t think she’d be needed that way anymore after the Legislature last year ordered Minnesota schools to stock period products at no cost to students in all bathrooms for grades 4-12.

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She and other teens had pressed lawmakers for years to address a problem they saw as a public health issue. The new law seemed like the answer. Lawmakers even OK’d funding — $2 per pupil to keep the products stocked. Problem solved, right?

Not quite. Students who helped get the law passed say some schools have come up short since it took effect Feb 1. Some schools have products while others don’t, they say, while some schools stock products that are cheaply made, extending the problems for students struggling with periods and classwork.

They feel stuck in a policy limbo — lawmakers see the job as done, yet there doesn’t seem to be an effective way to hold schools accountable for how they implement the law.

“When we stopped having conversations, that’s when a lot of the issues arose,” said Maarit Mattson, a 15-year-old student at Mankato East High School who’s worked for several years to get free supplies in school and end what she and others describe as “period poverty.”

“We lost that piece of what we really needed and what we wanted to work on and how it was going to be implemented,” she said.

‘What are they actually doing?’

Maarit and others describe early confusion and miscommunication around the law’s first few months that have led to problems trying to make it work at the school level.

At Mankato East, she said, thin pads similar to panty liners were available initially. Tampons provided at the start didn’t expand well and then were removed from lavatories after administration expressed concern about toxic shock syndrome, she added.

Toxic shock syndrome is a rare, life-threatening complication of certain types of bacterial infections, according to Mayo Clinic. It shot to national attention in the late 1970s. However, changes in tampon manufacturing have significantly reduced its occurrence, according to John Hopkins Medicine. In Minnesota, there were 197 confirmed cases in 1981 with 13 deaths. In 2017, the most recent numbers provided by the Minnesota Department of Health, there were 13 cases with one death.

The legislation for the bill says schools must provide pads, tampons or other menstrual products, but the word “or” has led to some confusion, said Tara Cliff, supervisor of health services for East Carver County Schools.

“I don’t believe it has been communicated. It defines menstrual products as tampons, pads or other similar products but it does not dictate that we need to have both,” said Cliff, who as president of the School Nurse Association of Minnesota has been watching how the law is being implemented across the state’s school districts.

“You probably have as many different rollouts across the state as you have districts,” Cliff said.

In a list of common questions and answers around the law, the Minnesota Department of Education said districts must “offer both tampons and pads; however, product stocking should follow student use. Some schools may need to stock many tampons, while others may not. Students can always self-determine what products are right for them, considering the activities that they are in, their own culture and values, and their personal experiences.”

In some districts, the rollout’s been tasked to the facilities department rather than the health or nursing staff.

Kara Cowell, an advocate of the products-in-schools policy who went to St. Cloud State University, helped monitor a similar rollout this spring at the college level. While the higher education version had far less legislative debate than the one for grades 4-12 the frustration around implementation is similar, she said.

“The bill was the floor, not the ceiling. We have to go from there,” Cowell said. “It’s great we’re passing all these bills, but what are they actually doing if no one’s following up on them?”

According to the Alliance for Period Products, 27 states have passed legislation requiring schools to have no-cost period products. Minnesota’s neighbors do not have mandates. Illinois passed legislation in 2020 requiring products, but the state is not providing funding. Four years later, she says compliance is still difficult, said Illinois state Rep. Katie Stuart, D-Collinsville.

Minnesota’s law was driven in part by students and their advocates who’d detailed the indignities of struggling with periods at school without the products they need or the means to buy them — more than just a hassle.

Change comes slowly, though. Deb Miedema, 50, an advocate for free menstrual products in schools, recalled when she was younger having to use napkins from gas stations as a makeshift pad. She did not know period products were an option, and even so, her family could not afford them.

“When you’re sitting there wondering if you’re going to have an accident it’s really hard to do calculus. It’s painfully disruptive honestly,” she said. ”Having those products in the bathroom would have made a world of a difference to me as a kid … I can’t even tell you how much.”

‘Be quiet. Let’s listen. Let’s pay attention’

Advocates say one of the last discussed reasons the new law and its proper implementation is so important is that it can help keep students in school and reduce absenteeism, but only if the right products are available when they’re needed.

“We want to keep girls and anybody who can menstruate in school, we know that is a barrier. We know that period poverty is more likely to affect kids of color,” said Dr. Katy Miller, director of adolescent medicine at Children’s Minnesota. “We know that many teens feel uncomfortable asking for period products.”

About half of her patients say they only use tampons, and the other half, only pads. The first year someone gets their period, cycles can be irregular. For schools stocking products she emphasized that variety and choice is key. “Not every product is going to work for every person,” she said.

At Richfield High, Chimdalu Dibua’s still carrying extra products for friends just in case, but she’s also worked to make things better for everyone who needs them. She got a $250 grant from the Hershey Co. to help buy period products. It helped change the conversation in the school and the district around periods, including lesson plans and talking points that focused on menstruation as normal.

“I started with a disclaimer,” said Ibelizet Dominguez, the district’s health resource center coordinator. “‘I know this can be uncomfortable, but I encourage you all to listen and learn.’”

And students did. There were posters and videos explaining how to use products, dispose of them and how to find more. Overall, the rollout has been positive. Dominguez says that once students understood that period products were going to be a normal part of daily life in Richfield, they moved on.

“Even the boys, they were all like ‘Be quiet. Let’s listen. Let’s pay attention, I don’t know anything about periods.’ And they listened. That just speaks to the importance of education around this topic,” she said.

Classrooms at Richfield High can sign up to become a “red heart location” meaning they have a small poster on the door letting students know this is a spot they can pick up products. Higher quality products with a variety of sizes that were donated by community members are available in the classrooms, health center, food shelf and take home kits.

The women’s and gender-neutral bathrooms are stocked with products purchased by the state bill, although like Maarit’s school, they are bought in bulk and there is only one size for pads and tampons, and the tampons have cardboard applicators.

Dibua, though, said it was important to her that there were multiple access points to get products. She thought back to all the times her friends asked her for products and worried about peers that did not feel comfortable asking someone.

“Most people get their products by friendship, or they have to ask,” she said. “For people who may not have a close circle of people that they know, it might be very awkward for them.”

As the school year comes to a close at Mankato East, Maarit said tampons are back in restrooms, as confirmed by school administration, and the school agreed to partner with Aunt Flow, a nonprofit that provides schools or businesses with period products, which was her original plan before the Minnesota law passed.

In her ideal world, Maarit says there would be a variety of products, different sizes and high quality. She sees the rollout at her school as likely mirroring much of Minnesota.

“We’ve come a long way. We’ve had a lot of important conversations and we’ve made a lot of progress,” she said. “But I think that the $2 budget makes it really tight for schools. I think it is obviously the minimum. If that is what’s able to be financed by the state, I am happy that we’ve gotten to a place where that is financed and where that is a priority but it is not the best option.”