#UMNMCH student Kara Cowell (she/her/hers, MPH 2026) wrote this reflection on how her work co-leading the Minnesota Menstrual Equity Toolkit Project has connected her previous policy and health research work to public health practice. Through her leadership across organizations including the Minnesota Menstrual Equity Coalition, PERIOD, Honest Sex Ed Minnesota, and the Women’s Foundation of Minnesota, Kara shares how transforming grassroots advocacy into an equity informed, accessible toolkit can advance menstrual and reproductive health outcomes across Minnesota.
Why I Chose Maternal and Child Health (MCH)
When I started college as a student interested in healthcare and social justice work, I never imagined I would end up in public health (partially because I didn’t know it existed). Throughout my undergraduate career, I found that the science-intensive curriculum failed to recognize the ways in which the research that informs our education can be biased and exclusionary. During this time, I worked at the SCSU Women’s Center where my job centered on menstrual equity and reproductive health education, with a greater aim to advance gender equity. I attended a Women’s Center guest speaker event in 2022 where MCH Program alumni and Center faculty member Dr. J’Mag Karbeah came to present about Black Maternal Mortality Disparities. Overtime I realized that this direction felt like the right career path to combine interests and strengths. While I will always love clinical healthcare and scientific research, my various backgrounds have led me to question the intersectional public health factors influencing health outcomes for women and queer folxs. Maternal and Child Public Health allows me to focus on the populations and specific issues of menstruation and reproductive health services.
My Previous Work & How I Got Involved
I’ve held numerous roles relating to menstrual equity and reproductive health that informed the work of the Minnesota Menstrual Equity Toolkit project. Early on in my menstrual equity journey as a high school student, I organized access to free menstrual products. While that passion for access has remained consistent, I learned over time that we simultaneously needed policy interventions to program sustainability, as well as how menstrual health education must be tied into other reproductive health conversations. While organizing for menstrual product access in college, I worked with the Minnesota Menstrual Equity Coalition to testify on and pass both the higher education menstrual product requirement (Minn. Stat. 135A.1365) and the K-12 public schools menstrual product requirements (Minn. Stat. 121A.212). As I finished my undergraduate degree working on implementation for the higher education statute, I knew that there was more work to still be done to support menstrual products in schools. The Minnesota Menstrual Equity Coalition paused its meetings after the legislation was passed, but in the spring and summer of 2024, I worked to reconvene this coalition of organizations and individuals that care about access to menstrual products. This coalition identified that the two key next steps for menstrual equity strides in Minnesota were: 1) needing to organize additional data collection about implementation status of menstrual products in K-12 schools, and 2) the need to build supportive resources for schools as they work to implement products.
The Minnesota Menstrual Equity Toolkit Project
The need for access to data and resources was something I was actively thinking about as I began my program at the school of public health. Upon meeting Mary Kenny (another MCH student) who had complimentary skills to my own, it made sense for us to pitch the Minnesota Menstrual Equity Toolkit Project to organizations within the coalition as our Applied Experience (APEX) project. The Women’s Foundation of Minnesota became our formal preceptor and deployment in order to be able to start work on this project. We were grateful that, as we worked to create this project, the Center for Leadership Education in Maternal & Child Public Health staff and MCH Program faculty saw the importance in what we were trying to organize. They helped us further build our partnership with the Women’s Foundation of Minnesota into a deployment that was intentionally catered to our skills and goals. My deployment was as the Menstrual Equity Toolkit Research and Advocacy Coordinator, to specifically call out how I would be applying my health research and policy skills to support the toolkit project work. Having this deployment gave us the time, funding, and formal job description to support the energy we put into this project. Faculty and Staff from the Center continued to provide consultation and support throughout the project process, playing a key role in our success getting the resources launched. The Minnesota Menstrual Equity Toolkit project ended up consisting of 4 components:Statewide Needs Assessment, Qualitative School Interviews, Community Partner Meetings, and ultimately resulted in the creation of the Minnesota Menstrual Products in Schools Toolkit.
Impact on MCH Populations
Menstruation is a topic that touches everyone and every component of MCH work in some way. We used the L.I.F.E. (Leadership, Interdisciplinary, Family-centered, and Equity) framework and MCH competencies throughout the Minnesota Menstrual Equity Toolkit project. As a co-led project designed by Mary and I, with self directed progress, deadlines, and meetings with our supervisor, we demonstrated strong leadership, communication, and negotiation skills when we disagreed on approaches or priorities. This project is also rooted in the application and implementation of policy given we worked to evaluate and support an existing but new state statute. Interprofessional team building was crucial to the success of this project, because without numerous partnerships we could not have made such comprehensive products. Between collaboration with teachers, medical professionals, community organizations, I constantly had to leverage my biomedical science and policy backgrounds or consult with Mary’s education and nonprofits background to have the most productive conversations. We consider so many different people, groups, and organizations to have been on our team throughout this project, and it is because of all of these perspectives that we were able to navigate the multiple intersecting communities and systems within Minnesota school settings. Finally, we are so proud that we specially focused on cultural competence and highlighting community perspectives from diverse groups across our state in building our toolkit. Menstrual product guidance in other states has not addressed the social and cultural context of menstruation so it was really important that we do the research, community consulting, and inclusion of specific topic materials within our toolkit products and translated parent resources. Overall, menstrual health conversations and menstrual equity work is deeply rooted in MCH competencies, populations, and skills which I was grateful to apply in practice.
What Surprised Me
Throughout this project I was surprised by a few different things. The first was that the main focus of a lot of menstrual equity work has simply been on increasing access to menstrual products through legislation, but that this really is not enough. We heard from schools over and over again that access to products only really “sticks” and helps people who menstruate feel supported when they have education along with it. I was also less surprised but encouraged by the overwhelming excitement and support from people when we talked about this project. So many people menstruate and have experiences that they want to talk about, and are excited for space to do that, both within the school context but also more broadly. It also continues to surprise me though that so little conversation is being had about menstruation in the context of reproductive health, especially when we know it is connected to many conditions and indicators for one’s overall health.
What I Want Future MCH Students to Know
I want future MCH students to know that, while our project was unique in a lot of ways, doing it required us to be brave in telling organizations and people what we saw as a need and how we thought we could fill that gap with this work. This experience and deployment was shaped by the ability to ask lots of questions, even when they were intimidating and could not have happened without the outstanding support of everyone on our team. I also want future MCH students to tune into policy change and how their role in MCH will likely in some way be tied to laws, so it is crucial to invest the time in gaining the skills of how to watch, advocate, and interact with policy from multiple angles.
BIO
Kara Cowell is a second-year MCH MPH student. Prior to graduate school, she earned a bachelor’s degree in Biomedical Sciences from St. Cloud State University.
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