A Review of FLOW: A Cultural History of Menstruation

Bianca I. Laureano

The authors of FLOW: A Cultural History of Menstruation recognize the need for different approaches to discussing Femcare, but don't go far enough in using those approaches themselves. 

Growing up with hippie parents I was exposed to books such as Our Bodies, Ourselves and The Joy of Sex at a very young age. I’d like to think that my parents owning these books helped shape the sex-positive ideologies I embrace today. When my homegirl Nilki contacted me about an upcoming book focusing on U.S. women’s bodies, menstruation, marketing, and myths I was instantly sold and eager to read the book. FLOW: A Cultural History of Menstruation arrived at my home for review and I was instantly impressed.

A hardcover sturdy book with a pin-up image on the cover appealed to the femme in me. The pages are glossy and bright and almost every page had an image of some sort to break up the text on the page. My initial thought was that the book was accessible, which is always pleasant for books of this sort. At the same time, when I read the title I had some assumptions. As a child of immigrants, and a woman of color, the term “cultural” triggers many images/ideas for me. Basically, I expected to see myself represented at some point in the text. As an interdisciplinary professor, I know the term “culture” and “cultural” have various definitions, yet I still immediately think in an inclusive way with the term.

I noticed that with the exception of one image on page 96, that all of the images in the book were of racially White women and written in English. A majority of the images are of marketing ads geared towards women regarding tampons, sanitary napkins, and “cleansing” products. I found, and still find it, extremely odd that images in the early 80s to the present were not included to represent women of Color. After all Serena Williams is the latest spokesperson for Tampons®, and there is what I would consider a “racially ambiguous” woman on the Moon Cup advertisements. Neither of these are included.

I often joke that my time in graduate school made me too critical of research and theories, as that is how we are trained when engaging with various texts. Yet, I’ve tried to get out of that graduate school mode and understand that not every book can do every thing. Sometimes this is difficult to remember, especially when there are huge gaps in a narrative. Yet, we still live in a society where creating a text that is supposed to be inclusive of all women really isn’t and this is a problem. One of the ways I’ve appreciated some authors approach this issue is to say explicitly in their introduction what their text does, who it includes, how they know their scope is limited. I often admire when authors are aware of how this can help prepare readers for their text.

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One of the many soapboxes I have is that the bodies of women of Color are not valued in the same way the bodies of other women are in this country. The text clearly showed how color-free and exclusive early marketing was for menstrual products. I wondered how the “flow” out of the bodies of women of Color were stigmatized, celebrated, seen as a rite of passage and those perspectives were not present in the text. Actually, I can recall two specific instances when they were presented, but they were done so in a way that “Othered” them/us. The examples were of women outside the US, especially in Africa, and how “primitive” the experiences of young women can be challenging in such “oppressive” environments.

This continues when the authors, Elissa Stein and Susan Kim, mention international women of Color in examples as they discuss their text. For example, in their interview on The View Susan Kim discusses various terms and phrases people have used to reference and name their menstrual cycle. See a short clip below here.

Watching this short clip made me very uncomfortable (and not because I’m menstruating and can’t joke about some things). There’s also something about these examples in the clip that strike me as a form of name-calling that is inappropriate and perpetuates stereotypes. “Walking like an Egyptian,” was that really necessary? And to evoke that Egyptian people walk differently just makes me want to give them a reading list of texts by Nawal El Saadawwi. Was I surprised to hear this from the authors after reading the book? Not really, especially when there are sentences such as these in the text:

“…unless you belong to some kind of cult, chances are you are not bearing and breast-feeding babies every second of your entire reproductive life” (page XXII).

“(And we’re sorry no matter what any 15 yo tells you, vulgarity alone does not count as honest discourse)” (page 2).

“In a small study of women in New York City, 61 percent said they had had a period when they weren’t expecting it…and we bet the others were lying” (page 188).

As someone who has a belief system that is not part of an organized religion, which has been called a “cult” this wording really turned me off because it was extremely offensive. It clearly isolates women who do not fall into a specific value and/or belief system, women outside the US, women with a different perspective on their spiritual connection with various deities/spaces/texts/etc. The statement about youth and vulgarity really irks me. As one of my favorite bloggers, cripchick, once said (and I’m paraphrasing): “language is one of the only things youth have” to express themselves and we, as adults, often take that away from them.

Now, I know that my opinion and cripchick’s may be unpopular, however I find that things such as graffiti writing, use of slang, and fashion are forms of media that youth create. They are media makers and when we attempt to censor them it’s not the most effective way to build and gain their trust. It also reeks of class and age discrimination. On the age tip, there were also quotes by women discussing their experiences with their cycles, and the youngest was 37 years old. I wondered why women younger than 37 were not quoted in the text. Were we even included?

To be clear I’m not advocating that youth are not introduced to and learn the scientific or what others may call “proper” terminology for our body parts and genitals. I think this is important, I just don’t think because a young person is more comfortable code switching that they are not capable of being engaged in “honest discourse.” Positive youth development is essential. So is affirming identities. Language has power and I’m not comfortable debunking the power in the language young people use to express themselves.

Then the idea that the authors will “bet” that some women in a small study were lying if they did not remember or recall experiencing an unexpected period; defeats the entire purpose of the book which I read as: trust women. There is also the issue that “women” only refers to cisgender women. There is no discussion of trans communities. At all. In the discussion regarding how menstruation is constructed in US society, there is nothing regarding how transgender men may experience their menstrual cycle, and this may not always be something that is celebrated. At the same time, there is no discussion about how conversations and values of menstruation exclude transgender women. How does menstruation confirm rigid ideas of gender and gender identity? I thought this type of discussion could have fit nicely in the list of questions the authors identify on page XXIII. Even to simply ask the questions is a sign that they recognize the term “woman” and “women” are often used in an exclusive context.

Finally, the book is an interesting, yet color-free and limited history of menstruation in the U.S. I was intrigued by chapter two “Where Are We Today” with discussions of menstruation and connections to current and future birth control methods. People of Color are mentioned in chapter seven which focuses on religion. Unfortunately, almost all of the examples from a religious space are negative. “Scent of A Woman” is the title for chapter nine and the advertisements focusing on scent and menstruation are overwhelmingly heterosexist. Almost all of them discuss pleasing a husband, which I found very interesting and troubling. Chapter 10 has the most discussion of rites of passages among women outside the U.S. and specifically in Africa and the Philippines, yet these examples are one’s I learned about over 15 years ago when I took an introduction to Anthropology course.

The list of resources and bibliography at the end of the text was not what I expected and were a pleasant surprise. There were limited citations on some of the research that was presented (except for the Kinsey Reports and such) and a majority of the citations were online. I see the author’s inclusion of these resources as useful and important from a historical perspective. They are also great examples on how to reference a website, which surprisingly not too many students know how to do these days. I’m saddened that there was no reference to some of the amazing forms of art that have been created regarding menstruation, contributions to popular culture if you will. Sandra Cisneros’ poem “Down There” in her book Loose Women Poems comes to mind, Ani DeFranco’s song “Blood In The Boardroom.” I agree with Cisneros, “I find the subject charming,” and hope that there is a second part to this text that will be more inclusive to the “culture” aspects the authors implied in the book.

At the end of the day, I expected to see myself in this text, have my experiences affirmed, and my community represented. This did not occur, however, to be fair this rarely occurs in books that come out in the field of sexuality and reproductive health unless the text is specifically devoted to communities of Color. As they said in their text “Femcare has been so long monopolized by manufacturing, medicine, advertising, and religion that any fresh, individual voices seem like cool water in a blazing desert” (p. 251). That’s right, fresh, individual voices. Klein and Kim started the work and there is still a lot more to complete.

Roundups Politics

Campaign Week in Review: Republican National Convention Edition

Ally Boguhn

The Trump family's RNC claims about crime and the presidential candidate's record on gender equality have kept fact-checkers busy.

Republicans came together in Cleveland this week to nominate Donald Trump at the Republican National Convention (RNC), generating days of cringe-inducing falsehoods and misleading statements on crime, the nominee’s positions on gender equality, and LGBTQ people.

Trump’s Acceptance Speech Blasted for Making False Claims on Crime

Trump accepted the Republican nomination in a Thursday night speech at the RNC that drew harsh criticism for many of its misleading and outright false talking points.

Numerous fact-checkers took Trump to task, calling out many of his claims for being “wrong,” and “inflated or misleading.”

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 Among the most hotly contested of Trump’s claims was the assertion that crime has exploded across the country.

“Decades of progress made in bringing down crime are now being reversed by this administration’s rollback of criminal enforcement,” Trump claimed, according to his prepared remarks, which were leaked ahead of his address. “Homicides last year increased by 17 percent in America’s 50 largest cities. That’s the largest increase in 25 years. In our nation’s capital, killings have risen by 50 percent. They are up nearly 60 percent in nearby Baltimore.”

Crime rates overall have been steadily declining for years.

“In 2015, there was an uptick in homicides in 36 of the 50 largest cities compared to the previous years. The rate did, indeed, increase nearly 17 percent, and it was the worst annual change since 1990. The homicide rate was up 54.3 percent in Washington, and 58.5 percent in Baltimore,” explained Washington Post fact checkers Glenn Kessler and Michelle Ye Hee Lee. “But in the first months of 2016, homicide trends were about evenly split in the major cities. Out of 63 agencies reporting to the Major Cities Chiefs Association, 32 cities saw a decrease in homicides in first quarter 2016 and 31 saw an increase.”

Ames Grawert, a counsel in the Brennan Center’s Justice Program, said in a statement posted to the organization’s website that 2016 statistics aren’t sufficient in declaring crime rate trends. 

“Overall, crime rates remain at historic lows. Fear-inducing soundbites are counterproductive, and distract from nuanced, data-driven, and solution-oriented conversations on how to build a smarter criminal justice system in America,” Grawert said. “It’s true that some cities saw an increase in murder rates last year, and that can’t be ignored, but it’s too early to say if that’s part of a national trend.” 

When Paul Manafort, Trump’s campaign chairman, was confronted with the common Republican falsehoods on crime during a Thursday interview with CNN’s Jake Tapper, he claimed that the FBI’s statistics were not to be trusted given that the organization recently advised against charges in connection with Hillary Clinton’s use of a private email server during her tenure as secretary of state.

“According to FBI statistics, crime rates have been going down for decades,” Tapper told Manafort. “How can Republicans make the argument that it’s somehow more dangerous today when the facts don’t back that up?”

“People don’t feel safe in their neighborhoods,” said Manafort, going on to claim that “the FBI is certainly suspect these days after what they did with Hillary Clinton.”

There was at least one notable figure who wholeheartedly embraced Trump’s fearmongering: former KKK Grand Wizard David Duke. “Great Trump Speech,” tweeted Duke on Thursday evening. “Couldn’t have said it better!”

Ben Carson Claims Transgender People Are Proof of “How Absurd We Have Become”

Former Republican presidential candidate Ben Carson criticized the existence of transgender people while speaking at the Florida delegation breakfast on Tuesday in Cleveland.  

“You know, we look at this whole transgender thing, I’ve got to tell you: For thousands of years, mankind has known what a man is and what a woman is. And now, all of a sudden we don’t know anymore,” said Carson, a retired neurosurgeon. “Now, is that the height of absurdity? Because today you feel like a woman, even though everything about you genetically says that you’re a man or vice versa?”

“Wouldn’t that be the same as if you woke up tomorrow morning after seeing a movie about Afghanistan or reading some books and said, ‘You know what? I’m Afghanistan. Look, I know I don’t look that way. My ancestors came from Sweden, or something, I don’t know. But I really am. And if you say I’m not, you’re a racist,’” Carson said. “This is how absurd we have become.”

When confronted with his comments during an interview with Yahoo News’ Katie Couric, Carson doubled down on his claims.“There are biological markers that tell us whether we are a male or a female,” said Carson. “And just because you wake up one day and you say, ‘I think I’m the other one,’ that doesn’t change it. Just, a leopard can’t change its spots.”

“It’s not as if they woke up one day and decided, ‘I’m going to be a male or I’m going to be a female,’” Couric countered, pointing out that transgender people do not suddenly choose to change their gender identities on a whim.

Carson made several similar comments last year while on the campaign trail.

In December, Carson criticized the suggested that allowing transgender people into the military amounted to using the armed services “as a laboratory for social experimentation.”

Carson once suggested that allowing transgender people to use the restroom that aligned with their gender identity amounted to granting them “extra rights.”

Ivanka Trump Claims Her Father Supports Equal Pay, Access to Child Care

Ivanka Trump, the nominee’s daughter, made a pitch during her speech Thursday night at the RNC for why women voters should support her father.

“There have always been men of all background and ethnicities on my father’s job sites. And long before it was commonplace, you also saw women,” Ivanka Trump said. “At my father’s company, there are more female than male executives. Women are paid equally for the work that we do and when a woman becomes a mother, she is supported, not shut out.” 

“As president, my father will change the labor laws that were put into place at a time when women were not a significant portion of the workforce. And he will focus on making quality child care affordable and accessible for all,” she continued before pivoting to address the gender wage gap. 

“Policies that allow women with children to thrive should not be novelties; they should be the norm. Politicians talk about wage equality, but my father has made it a practice at his company throughout his entire career.”

However, Trump’s stated positions on the gender wage gap, pregnancy and mothers in the workplace, and child care don’t quite add up to the picture the Trumps tried to paint at the RNC.

In 2004, Trump called pregnancy an “inconvenience” for employers. When a lawyer asked for a break during a deposition in 2011 to pump breast milk, Trump reportedly called her “disgusting.”

According to a June analysis conducted by the Boston Globe, the Trump campaign found that men who worked on Trump’s campaign “made nearly $6,100, or about 35 percent more [than women during the April payroll]. The disparity is slightly greater than the gender pay gap nationally.”

A former organizer for Trump also filed a discrimination complaint in January, alleging that she was paid less than her male counterparts.

When Trump was questioned about equal pay during a campaign stop last October, he did not outline his support for policies to address the issue. Instead, Trump suggested that, “You’re gonna make the same if you do as good a job.” Though he had previously stated that men and women who do the same job should be paid the same during an August 2015 interview on MSNBC, he also cautioned that determining whether people were doing the same jobs was “tricky.”

Trump has been all but completely silent on child care so far on the campaign trail. In contrast, Clinton released an agenda in May to address the soaring costs of child care in the United States.

Ivanka’s claims were not the only attempt that night by Trump’s inner circle to explain why women voters should turn to the Republican ticket. During an interview with MSNBC’s Chris Matthews, Manafort said that women would vote for the Republican nominee because they “can’t afford their lives anymore.”

“Many women in this country feel they can’t afford their lives, their husbands can’t afford to be paying for the family bills,” claimed Manafort. “Hillary Clinton is guilty of being part of the establishment that created that problem. They’re going to hear the message. And as they hear the message, that’s how we are going to appeal to them.”

What Else We’re Reading

Vox’s Dara Lind explained how “Trump’s RNC speech turned his white supporters’ fear into a weapon.”

Now that Mike Pence is the Republican nominee for vice president, Indiana Republicans have faced “an intense, chaotic, awkward week of brazen lobbying at the breakfast buffet, in the hallways and on the elevators” at the convention as they grapple with who will run to replace the state’s governor, according to the New York Times.

“This is a party and a power structure that feels threatened with extinction, willing to do anything for survival,” wrote Rebecca Traister on Trump and the RNC for New York Magazine. “They may not love Trump, but he is leading them precisely because he embodies their grotesque dreams of the restoration of white, patriarchal power.”

Though Trump spent much of the primary season denouncing big money in politics, while at the RNC, he courted billionaires in hopes of having them donate to supporting super PACs.

Michael Kranish reported for the Washington Post that of the 2,472 delegates at the RNC, it is estimated that only 18 were Black.

Cosmopolitan highlighted nine of the most sexist things that could be found at the convention.

Rep. Steve King (R-IA) asked, “Where are these contributions that have been made” by people of color to civilization?

Analysis Law and Policy

Indiana Court of Appeals Tosses Patel Feticide Conviction, Still Defers to Junk Science

Jessica Mason Pieklo

The Indiana Court of Appeals ruled patients cannot be prosecuted for self-inducing an abortion under the feticide statute, but left open the possibility other criminal charges could apply.

The Indiana Court of Appeals on Friday vacated the feticide conviction of Purvi Patel, an Indiana woman who faced 20 years in prison for what state attorneys argued was a self-induced abortion. The good news is the court decided Patel and others in the state could not be charged and convicted for feticide after experiencing failed pregnancies. The bad news is that the court still deferred to junk science at trial that claimed Patel’s fetus was on the cusp of viability and had taken a breath outside the womb, and largely upheld Patel’s conviction of felony neglect of a dependent. This leaves the door open for similar prosecutions in the state in the future.

As Rewire previously reported, “In July 2013 … Purvi Patel sought treatment at a hospital emergency room for heavy vaginal bleeding, telling doctors she’d had a miscarriage. That set off a chain of events, which eventually led to a jury convicting Patel of one count of feticide and one count of felony neglect of a dependent in February 2015.”

To charge Patel with feticide under Indiana’s law, the state at trial was required to prove she “knowingly or intentionally” terminated her pregnancy “with an intention other than to produce a live birth or to remove a dead fetus.”

According to the Indiana Court of Appeals, attorneys for the State of Indiana failed to show the legislature had originally passed the feticide statute with the intention of criminally charging patients like Patel for terminating their own pregnancies. Patel’s case, the court said, marked an “abrupt departure” from the normal course of prosecutions under the statute.

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“This is the first case that we are aware of in which the State has used the feticide statute to prosecute a pregnant woman (or anyone else) for performing an illegal abortion, as that term is commonly understood,” the decision reads. “[T]he wording of the statute as a whole indicate[s] that the legislature intended for any criminal liability to be imposed on medical personnel, not on women who perform their own abortions,” the court continued.

“[W]e conclude that the legislature never intended the feticide statute to apply to pregnant women in the first place,” it said.

This is an important holding, because Patel was not actually the first woman Indiana prosecutors tried to jail for a failed pregnancy outcome. In 2011, state prosecutors brought an attempted feticide charge against Bei Bei Shuai, a pregnant Chinese woman suffering from depression who tried to commit suicide. She survived, but the fetus did not.

Shuai was held in prison for a year until a plea agreement was reached in her case.

The Indiana Court of Appeals did not throw out Patel’s conviction entirely, though. Instead, it vacated Patel’s second charge of Class A felony conviction of neglect of a dependent, ruling Patel should have been charged and convicted of a lower Class D felony. The court remanded the case back to the trial court with instructions to enter judgment against Patel for conviction of a Class D felony neglect of a dependent, and to re-sentence Patel accordingly to that drop in classification.

A Class D felony conviction in Indiana carries with it a sentence of six months to three years.

To support Patel’s second charge of felony neglect at trial, prosecutors needed to show that Patel took abortifacients; that she delivered a viable fetus; that said viable fetus was, in fact, born alive; and that Patel abandoned the fetus. According to the Indiana Court of Appeals, the state got close, but not all the way, to meeting this burden.

According to the Indiana Court of Appeals, the state had presented enough evidence to establish “that the baby took at least one breath and that its heart was beating after delivery and continued to beat until all of its blood had drained out of its body.”

Therefore, the Court of Appeals concluded, it was reasonable for the jury to infer that Patel knowingly neglected the fetus after delivery by failing to provide medical care after its birth. The remaining question, according to the court, was what degree of a felony Patel should have been charged with and convicted of.

That is where the State of Indiana fell short on its neglect of a dependent conviction, the court said. Attorneys had failed to sufficiently show that any medical care Patel could have provided would have resulted in the fetus surviving after birth. Without that evidence, the Indiana Court of Appeals concluded, state attorneys could not support a Class A conviction. The evidence they presented, though, could support a Class D felony conviction, the court said.

In other words, the Indiana Court of Appeals told prosecutors in the state, make sure your medical experts offer more specific testimony next time you bring a charge like the one at issue in Patel’s case.

The decision is a mixed win for reproductive rights and justice advocates. The ruling from the court that the feticide statute cannot be used to prosecute patients for terminating their own pregnancy is an important victory, especially in a state that has sought not just to curb access to abortion, but to eradicate family planning and reproductive health services almost entirely. Friday’s decision made it clear to prosecutors that they cannot rely on the state’s feticide statute to punish patients who turn to desperate measures to end their pregnancies. This is a critical pushback against the full-scale erosion of reproductive rights and autonomy in the state.

But the fact remains that at both trial and appeal, the court and jury largely accepted the conclusions of the state’s medical experts that Patel delivered a live baby that, at least for a moment, was capable of survival outside the womb. And that is troubling. The state’s experts offered these conclusions, despite existing contradictions on key points of evidence such as the gestational age of the fetus—and thus if it was viable—and whether or not the fetus displayed evidence of life when it was born.

Patel’s attorneys tried, unsuccessfully, to rebut those conclusions. For example, the state’s medical expert used the “lung float test,” also known as the hydrostatic test, to conclude Patel’s fetus had taken a breath outside the womb. The test, developed in the 17th century, posits that if a fetus’ lungs are removed and placed in a container of liquid and the lungs float, it means the fetus drew at least one breath of air before dying. If the lungs sink, the theory holds, the fetus did not take a breath.

Not surprisingly, medical forensics has advanced since the 17th century, and medical researchers widely question the hydrostatic test’s reliability. Yet this is the only medical evidence the state presented of live birth.

Ultimately, the fact that the jury decided to accept the conclusions of the state’s experts over Patel’s is itself not shocking. Weighing the evidence and coming to a conclusion of guilt or innocence based on that evidence is what juries do. But it does suggest that when women of color are dragged before a court for a failed pregnancy, they will rarely, if ever, get the benefit of the doubt.

The jurors could have just as easily believed the evidence put forward by Patel’s attorneys that gestational age, and thus viability, was in doubt, but they didn’t. The jurors could have just as easily concluded the state’s medical testimony that the fetus took “at least one breath” was not sufficient to support convicting Patel of a felony and sending her to prison for 20 years. But they didn’t.

Why was the State of Indiana so intent on criminally prosecuting Patel, despite the many glaring weaknesses in the case against her? Why were the jurors so willing to take the State of Indiana’s word over Patel’s when presented with those weaknesses? And why did it take them less than five hours to convict her?

Patel was ordered in March to serve 20 years in prison for her conviction. Friday’s decision upends that; Patel now faces a sentence of six months to three years. She’s been in jail serving her 20 year sentence since February 2015 while her appeal moved forward. If there’s real justice in this case, Patel will be released immediately.