A Look at Indigenous Women’s Reproductive Rights Access

It was 2017 and Eva Marie Carney was fed up. As an elected legislator for the Citizen Potawatomi Nation she was somewhat familiar with the reproductive healthcare gap within Indigenous communities, but it wasn’t until she read an article about the Pine Ridge Reservation in South Dakota and how period poverty causes its students to miss school, that she decided to take direct action.

“I thought that this was something that only happened far away – in resource-poor countries…it woke up the feminist and activist in me,” Carney wrote in a recent blog post for the Alliance for Period supplies. “It was clear these students needed help. I decided to help them, and I suspected they were not the only Indigenous students needing help.”

As a response, Carney began sending menstrual supplies to one school in South Dakota, then started The Kwek Society in order to further support period care. She also began working with a primarily Navajo population public school district in New Mexico, distributing period supplies to students (Indigenous and otherwise) in 13 different schools.

Fast forward to 2025, and The Kwek Society now supports the period care needs of Indigenous students and their peers in 230 schools across 20 states. Some of these supplies include handmade “moon time” bags filled with pads and liners. (The Indigenous term is used to describe the menstrual cycle, which waxes and wanes like the moon’s phases.) The students also receive Auntie bags (named after “aunties,” people who care for you) sized to hold a whole cycle’s worth of pads.

“The Auntie Bags look a lot like a dish bag, a cloth bag that you take to a powwow to hold your dishes and serving utensils. You’re able to wash them and don’t have to use consumable supplies,” Carney says. “We think that our Auntie bags may be comfortable and maybe familiar to at least some of the students we support.” A huge part of The Kwek Society’s work is not just bridging the access gap of menstrual supplies, but also providing educational resources on its website and de-stigmatizing shame around periods in general, while also addressing the poverty gap.

For more context, in some places, like certain areas of Navajo Nation in Arizona, New Mexico, and Utah 30 percent of the population has limited water access and some families may not have in-home washing machines. As such, washing undergarments during menstrual weeks can use up critical water supply, explains Shanna Yazzie, Manager of Safety & Compliance for DigDeep’s Navajo Water Project. “Many young women are not taught adequate menstrual hygiene education, which, combined with a lack of pads and tampons can result in leaking, particularly during heavy flow days.” Some of them then end up staying home, due to both a lack of confidence and adequate resources, Yazzie notes, adding that this happened to her when she was younger.

While Yazzie and Carney are quick to note that period poverty spans all races and cultural groups, the Indigenous community in the US is often underfunded and forgotten. And this doesn’t solely apply to period care. Birth control, including emergency contraception, remains widely inaccessible and abortion care is a major challenge on many reservations.

So, What’s Behind the Reproductive Healthcare Gap?

For starters, the Indian Health Services (IHS), the federally-funded health service that all Indigenous people have a right to, is critically underfunded, and reproductive health concerns are tossed by the wayside and ignored by the federal government.

What’s more, the majority (89 percent, according to 2020 Forward Together data) of Indigenous people believe they should have the right to seek reproductive healthcare without government interference. But as it stands, even getting the morning after pill through IHS can be impossible. And forget accessing abortion in many abortion ban states with high Indigenous populations, like Arizona and Oklahoma (with more bans potentially on the way under the Trump administration).

On top of that, according to the American Journal of Public Health, Native American women also face disproportionate rates of sexual assault and unintended pregnancy, making emergency contraception availability and access even more important. But in the Forward Together survey, Indigenous respondents indicated that the major barriers to accessing reproductive healthcare are transportation and cost; these are also factors in ongoing period poverty.

The TLDR: The well-being of Native Americans is not prioritized in the US. And to get the reproductive health resources they need, it’s often up to Indigenous people to organize on a community level.

The Importance of Community-Led Organizations

Rachel Lorenzo, co-founder and executive director of the Indigenous Women Rising, knows what it means to help close the accessibility gap firsthand, especially when it comes to birth control and emergency contraception which wasn’t accessible in all federally-funded IHS clinics until 2015, she tells PS — and that was only thanks to Indigenous-led advocacy.

On top of that, other tribally-run or funded clinics don’t have the same requirement to carry Plan B. Even IHS clinics seem to have issues with stocking, “low demand,” and not enough providers to educate patients on the use of emergency contraception, explains Lorenzo.

That’s why she became involved with reproductive justice activism in 2014 and developed the New Mexico-based, Indigenous-led reproductive, contraceptive, and abortion advocacy organization, Indigenous Women Rising.

Indigenous Women Rising has multiple funds that serve only Indigenous people with critical support that they often are not able to get elsewhere, across the reproductive spectrum. The Rain Fund program assists with abortion access, while the Emergence Fund fosters support with culturally sensitive birth care from Indigenous doulas and midwives and lactation specialists. A third, newer program, called the MoonPie fund, provides primarily menstrual products and even helps bridge the gap with contraception access.

Monthly contraception is not much easier to access, either — especially due to geographic challenges on tribal land. “There are very long distances between homes and clinics, hospitals, and stores,” Yazzie says about the Navajo Nation, adding that there are also cultural barriers to contraception. Birth control accessibility has improved in many parts of the country (thanks to the introduction of over-the-counter options like Opill), but remains stigmatized. It’s locked up in a box in many commercial settings that Indigenous people have access to even if they’re able to afford it, adds Lorenzo.

The disparities are only magnified when you look at abortion care — something Indigenous people have never had fair access to, especially considering that the Hyde Amendment, passed in 1977, doesn’t allow federal funds to go toward abortion. As such, IHS clinics cannot fund abortion and many people who need one are obligated to come up with the money themselves.

That’s where Indigenous Women Rising steps in, again, supporting these individuals via their Rain Fund. The organization has done so since 2014, long before Roe v. Wade was overturned. “Roe v. Wade was not even the bare minimum. It didn’t serve Native folks,” says Lorenzo. But community-led organizations have continued to try and close the gaps in access.

It Shouldn’t Be All Up to Them.

While improvement to access can come in many forms, especially those that are community led, there are undeniable large-scale changes that need to be made in order to create a safer, reproductive health landscape.

For starters, period products should be as commonplace as toilet paper and soap in all public school restrooms. (Free period supplies are legally required in school bathrooms in 28 states and Washington D.C., as of today.) Carney also calls for more period destigmatization among Indigenous menstruators. Many Indigenous communities do celebrate the fact that a young person just got their period, she notes. However, this destigmatization needs to happen on a larger scale; menstruating is often still stigmatized in schools and workplaces.

Federal funding also needs to be prioritized. Even beyond US politics, Lorenzo notes that there are already so many issues tribal governments face (water and healthcare access, infrastructure, elder care, and cultural preservation, to name a few), that sexual and reproductive health concerns tend to fall by the wayside. There needs to be better federal funding, especially through IHS, so that tribes are not forced to face so many issues with significantly less funding than other government entities.

And finally, birth control must be more widely available. Something as simple as changing where birth control is kept (think: condoms or over-the-counter pills placed behind a counter or in a lock box), creates unnecessary barriers — and that’s after what’s often a long drive to many convenience stores or big box retailers on certain tribal lands.

So what can we do to make help enact change?

Mara Santilli is a PS contributor, freelance writer, and editor specializing in reproductive health, wellness, politics, and the intersection between them, whose print and digital work has appeared in Marie Claire, Glamour, Women’s Health, SELF, Cosmopolitan, and more.