Upstream USA

Expanding Women’s Access to Effective Contraceptives

Model and Strategy

Upstream USA focuses on reducing unplanned pregnancy in the US by removing barriers in health centers so that women have access to the most effective methods of contraception. The goal is to ensure that women are empowered to make their own choices about their contraception. Upstream USA’s experience is that when women are able to access the full range of contraceptive methods, they choose long-acting, reversible contraception (LARC) methods – the most effective methods of contraception – more frequently. There is a direct line between more effective contraception and reduced unplanned pregnancy. The team is dedicated to helping women achieve their goals by planning their pregnancies only if and when they want them. When women are able to plan their families, it is better for their futures, and for their children. Upstream USA’s theory is that empowering women to reach their full potential will vastly improve educational, social, and economic mobility in America.

Impact

Research shows that over 40% of unplanned pregnancies occur among women who are using contraception, but the method they are using is not working well for them. Many women are not able to access LARC because health centers either do not offer or counsel on these methods at all, or have multiple systems barriers that make them difficult to provide. When women are not informed about or offered LARC, it doesn’t matter how effective or cost-free these methods are – women are not empowered or able to choose them when they visit their provider.

Upstream USA developed its intervention in response to the strong evidence base that points to quality improvements in contraceptive care as a driving force behind women being offered LARC among other contraceptive methods. Several studies on LARC access and our own pilot projects have demonstrated that women prefer IUDs and implants at much higher rates when they are available and accessible.

Upstream USA’s solution is to deliver training, technical assistance, and quality improvement to health centers so that they can offer patients same-day access to the full range of contraceptive methods, including LARC. Our model is a customized, whole health center approach to creating system-level, clinic-level, and provider-level changes necessary to ensure that all women of reproductive age have access to, and are informed about, IUDs and implants. The theory is that improvements in contraceptive care and access will significantly increase use of LARC and, ultimately, lead to dramatic reductions in unplanned pregnancy and downstream costs.

Leadership

  • Peter Belden &

    Peter Belden & Mark Edwards

    Co-Founders