For the past few years I have served on an advisory committee for Upstream USA, joining conference calls to hear about results, ask questions and share suggestions for how the program could be improved. In doing so, I have learned about some aspects of Upstream’s work in Delaware that are not widely known, yet are important in supporting women’s contraceptive decision making:
- Free IUD and Implant removals: Delaware was one of several states that had a Medicaid policy that placed restrictions on when Medicaid would pay for an IUD or implant removal. When Upstream began its work in Delaware, they worked with the state Medicaid program to have this policy formally eliminated such that there is no longer any restriction on when/whether women can have IUDs or implants removed under Medicaid. This policy change better supports reproductive autonomy for women across Delaware.
- Free transportation: Upstream conducted a series of focus groups in Delaware to identify barriers preventing women from receiving contraceptive care. As transportation was commonly cited as a significant barrier, Upstream launched a campaign to provide free door-to-door transportation to participating Delaware health centers. Whether it’s Uber, Lyft, bus or taxi, women in DE can get a free ride to participating health centers to receive comprehensive women’s health care.
- All contraceptive methods for free: Upstream’s Delaware consumer campaign enables all woman to visit an Upstream-trained healthcare provider and obtain any contraceptive method for free, regardless of insurance status. Any out-of-pocket removal costs for LARC devices are covered by Upstream as well.
As someone committed to supporting women’s reproductive autonomy and advancing reproductive health equity, I applaud the steps Upstream has taken to expand access to the full range of contraceptive methods in Delaware.
Sonya Borrero, MD, MS is an Associate Professor of Medicine; Clinical and Translational Science, and Obstetrics, Gynecology, and Reproductive Sciences at the University of Pittsburgh. She is also the director of the Center for Women’s Health Research and Innovation (CWHRI) and the Career Education and Enhancement for Health Care Research Diversity (CEED) Program for Medical Students. Dr. Borrero’s research examines disparities in reproductive health care.
