Menstrual norms in Nepal…. They are changing!

Recently, Nepal has received a lot of attention from the international community due to a New York Times article on Chhaupadi – the practice of isolating menstruating women and girls – and social taboos around menstruation. As part of the Fertility Awareness for Community Transformation (FACT) Project, the Institute for Reproductive Health (IRH), at Georgetown University is undertaking the Pragati intervention in Nepal. Pragati aims to increase fertility awareness and to change social norms that reflect negative attitudes about menstruation and lead to behaviors that are harmful to women. In this three-part blog series, three IRH colleagues – Ojashwi Pathak, Shwetha Srinivasan, and Sarah Thompson – explore menstruation norms through their personal experiences as women and through qualitative data analysis of such taboos in Nepali society. The authors reflect on the current state of menstruation-related norms, discuss whether these norms are changing in Nepal, and elucidate what can be done in the future by practitioners and researchers to destigmatize menstruation.

If you are tuned in to international development news, you may have already heard or read recently about Chhaupadi, the most severe of these menstrual norms, where women have to stay outside the house – in a small hut or cowshed – during their period. We have learned from qualitative research under the FACT Project that Chhaupadi is just one of many menstrual norms in Nepal.

Restrictions range from not entering the kitchen to not touching seeds, cattle or milk products during their period. Some women are restricted from touching other people or anything used by others, including latrines. As in our colleague Oja’s story, some women described being banned from participating in religious activities during menstruation. Menstruation is viewed as impure, dirty, and taboo. While the extent of these norms differ across various communities, they are rooted in the belief that menstruation results in contamination of people, food and religion, and that this will result in disaster or bad luck for the family.

Why should we care? Restriction and isolation during menstruation lead to unhealthy outcomes for women that include limited menstrual hygiene, discrimination, physical danger, and poor mental health.

Women’s perception of menstrual norms in Nepal

During interviews and focus group discussions, women shared a variety of perspectives about menstrual norms in their community. In most cases, women consider these menstrual practices to be discriminatory and unjustified. They harbor concerns about the consequences of these restrictive practices on their well-being.

“This is not a right practice but our parents are not convinced as they tell us this is our culture and tradition. We should not touch temple as god will be angry, this way they advise adolescent girls. So they discriminate [against] us.”

To our surprise, women also shared benefits they associated with the menstrual norms. For instance, some women viewed being restricted from the kitchen as a break from daily household chores. Women expressed that during their period, they feel weaker and cannot perform all their tasks. As a result, they view these norms as being meant for their safety and well-being. Many Nepali women work and run the household at the same time. One woman shared that she enjoyed having her husband cook for her while she was on her period. An unmarried women expressed her mixed feelings about these norms, saying,

“I feel unhappy when we are not allowed to do puja [prayers] and everything, but we also don’t have to do anything, so that is okay. When we are not allowed to go to temple and do puja [prayers], I feel unhappy but besides that it is fun.”  

Menstrual norms appear to be changing in Nepal. Our qualitative research suggests two main reasons for these changes.

First, menstrual norms are shifting due to larger changes in Nepali society driven by generational differences in attitudes and practices related to menstruation. Interviews with different community members revealed a shared consensus that elders – including fathers and mothers-in-law – are responsible for perpetuating and sustaining these menstrual norms.

“Once when I was having a period, my husband sat near me on the same bed. When my mother-in law saw that she complained to my father-in law. Another day she had a severe headache and had a nightmare. She [said] that this happened because I touched my husband during menstruation and our Kuldevata [family god] got angry. My father-in law scolded me saying ‘Can’t you stay away; without touching even in these days?’”

Most women and men suggested that younger generations do not believe in or support these menstrual norms and anticipate that such restrictive menstrual norms will decrease or disappear over time.

Second, community-based interventions like the Pragati games are helping to debunk existing myths and misconceptions about menstruation and are promoting informed conversations about fertility and menstruation.

Our data compared attitudes around menstruation in communities where the Pragati games were played and those where they were not. We found more positive attitudes toward menstruation in the Pragati game sites. One of the nine games, the Menstrual Cycle game, provides information about fertility, the fertile window, and the menstrual cycle. This game challenges existing social norms that make it taboo to talk about menstruation and fertility, and even involves men in these discussions. Through our interviews with Pragati game facilitators – men and women who have played these games in the community – we learned that the menstrual cycle game is normalizing discussion around menstruation and reducing taboos and misconceptions within communities.

“It [Pragati] has helped to bring change in people’s thinking like few of the elder people have understood about what menstruation actually is. They know that it is a natural phenomenon. Earlier, people used to consider/view menstruation as dirty process and now they have realized that menstruation is related to reproduction.” – Female community member

Through the games, community members have come to understand that menstruation is a natural phenomenon and that it isn’t bad, impure, or dirty. They now have accurate information about the menstrual cycle and can debunk myths and misconceptions, and even understand when it is important to see a health care provider when dealing with menstrual irregularities.

Where are these changes in menstrual norms headed?

Literature indicates that norms can change due to structural factors, such as socio-economic development, introduction of new policies and programs, and exposure to new ideas through formal and informal channels. Though change is happening across Nepal, these changes in menstrual norms are not consistent. While the practice of Chhaupadi has discontinued or decreased in many places, it remains common in parts of western Nepal. Other restrictions on women still exist throughout the country. Most women we interviewed still shared some type of restriction during menstruation, although they recognized certain benefits too.

Interestingly, we found that there are differences in the practice of menstrual norms across communities. For example, our data indicates that menstrual norms are more severe in Brahmin and Chhetri communities, whereas Tamang and Dalit communities have fewer restrictions. One possible explanation for this is the emphasis on ritual cleanliness and purity in Brahmanical religious practices.

Like many other types of norms, changes in menstrual norms will not occur overnight. It will take sustained efforts to change attitudes and practices around menstruation. Interventions such as Pragati – designed for the community, and designed in consultation with the community – can help catalyze and accelerate the pace of these changes.

In the ever-changing landscape around menstrual norms and practices, where do we go next? In the third and final part of this series, my colleague Sarah will explore how researchers and practitioners can contribute to long-term changes in menstrual health in Nepal and around the world.