provide free feminine hygiene products to prisoners. In federal prisons, feminine hygiene products can be purchased at a commissary or a canteen at inflated prices. Some states have enacted legislation requiring or ensuring adequate access to menstrual products in state prisons. As of 2020, 13 states (AL, CA, CO, CT, FL, KY, LA, MD, NY, TN, TX, VA) and Washington, D.C. have enacted legislation requiring free access to such products. However, reports from different States indicate that free feminine hygiene products are less absorbent than industry standard products that can only be purchased in the canteen. In a survey conducted at The Missouri Department of Corrections it was found that even though free sanitary napkins were provided, 80.3 per cent of respondents to the survey reported that they had created tampons themselves because of poor absorption and had reported problems related to increased reproductive and urinary tract infections. Other reproductive health care Cancer and general gynecological care According to the U.S. Department of Justice Bureau of Justice Statistics, cancer is one of the leading causes of death for women (both inside and outside prison), and one-quarter of deaths of incarcerated women due to cancer are from breast, cervical, ovarian, and uterine cancer. In particular, women in prison are at a high risk for contracting cervical cancer due to their high rates of substance abuse and diseases such as hepatitis C, HIV, and other STIs. However, reproductive health care reform in prisons generally focuses on pregnancy or HIV. Incarcerated women have higher rates of STIs and gynecologic infections than non-incarcerated women. In fact, one study estimated that about 9% of incarcerated women tested positive for gonococcus infection, and between 11 and 17% of incarcerated women are infected with chlamydia. However, not every infected woman will be diagnosed and given treatment, because many prisons only test women who request to be tested, or show symptoms. States often have their own legislation regarding correctional health care, but it doesn't always completely take into consideration the complexities of women's reproductive health. For example, the New York State Department of Corrections and Community Supervision (DOCCS) has issued two main documents which outline their institutional health care policies: the Health Services Policy Manual, and the Women's Health Primary Care Practice Guideline (first published in 2000, and updated in 2008 and 2011). Within these documents, the Patient Bill of Rights includes the right of a patient to