Values

Upstream USA is an organization operating at the intersection of reproductive health and social justice. Every day our staff and health center partners work to increase equitable access to all contraceptive methods to all patients – regardless of ethnicity, religion, sexual orientation or gender identification – across the nation. We advocate for patient-centered, gender-affirming care without coercion, to support bodily reproductive autonomy and to combat and undo poorer outcomes for patients who face racism and other injustices in the healthcare system.

Voluntary contraceptive counseling, centered around the patient

We train health centers to take a patient-centered approach to contraceptive counseling. Centering counseling around the patient’s stated contraception goals is essential to quality care and is designed to reduce bias and avoid coercion. There is no “one size fits all” contraceptive method, and some patients are seeking contraception for benefits in addition to, or other than, pregnancy prevention.

Upstream USA has endorsed the LARC Statement of Principles created by SisterSong and the National Women’s Health Network and we are proud to live these principles through our program and in every interaction we have with health care agencies.

LARC Statement of Principles

Access to the full range of contraceptive options

We partner with health centers to ensure patients have access to their desired method on the day they want it, including Long-Acting Reversible Contraception (LARCs) such as IUDs and the Implant.

Research published in the Journal of the American Board of Family Medicine found that only 11% of primary care providers regularly provide IUDs and implants, and a recent Kaiser Family Foundation survey found that only 4 in 10 OBGYNs offer same-day LARC placement.

Upstream works with partner agencies to offer the full range of methods, integrate policies and protocols that increase contraceptive access and reduce other administrative or structural barriers to single-visit access.

Respecting patient choice and fighting coercion

The choice to use or not use contraception is always the patient’s, and it must be respected. There is an ugly, long and recent history of forced sterilization and reproductive coercion in this country, targeted towards people of color and vulnerable populations such as people with low-income, disabled Americans, and indigenous communities; a chapter we abhor. We’re committed to changing these harmful patterns by trusting patients, improving the culture of healthcare to include contraceptive care as a normal part of primary care, and supporting access to the full range of birth control options—including the option to not use contraception.

Upstream’s work with health centers supports all patients having access to quality counseling and choice around contraception when they visit their provider.

Utilizing a Reproductive Justice framework

Upstream is a reproductive health organization that utilizes a Reproductive Justice framework to inform our approach and our program. As such, we aim to amplify, and be in solidarity with Reproductive Justice organizations.

We require clinicians and support staff at our partner health agencies and all Upstream staff to receive specific training on our patient-centered approach, the history of reproductive coercion and racism in reproductive healthcare, and recognizing bias.

Upstream and the Reproductive Justice Movement

Equity, diversity and inclusion

To do our best work and to achieve better outcomes for all patients and their families nationwide, Upstream understands that our staff and the diversity of the experiences, genders, backgrounds, languages and skills they represent need to be recognized and are essential to drive innovation and achievement. If we are to truly become an anti-racist organization, then we must hold ourselves accountable towards greater equity, diversity and inclusion. This space represents our starting point and we hope you will join us on this journey.

We are learning and growing

We are continually evaluating and innovating our program and the ways in which our staff demonstrate our values with health center partners. This includes seeking out and listening to feedback from patients from diverse backgrounds, healthcare providers, and those working in the reproductive justice space.

Who we are:

At Upstream, we pledge to live our values, make space for each other and our lived experiences, hold ourselves accountable and learn from each other. As a team, we are committed to:

  • Leadership, training and development
  • Empowered decision-making and accountability
  • Equity, Diversity and Inclusion — from recruitment to retention and belonging

We are on a journey to continuously improve, and are committed to our mission to strengthen reproductive care and autonomy by increasing equitable access to the full range of contraceptive options.