Improving care across the nation

Upstream partners with states to reduce unplanned pregnancy by expanding equitable access to the full range of contraceptive options. By 2024, we will have worked with healthcare practices serving over 1 million women of reproductive age each year.

Impact at scale

Upstream is transforming health care so that the full range of contraceptive options are available to all patients wherever they access care. By forming public-private partnerships with states, our systems-change approach:

  • Provides training and technical assistance to healthcare providers of all types and sizes, including hospital systems, federally qualified health centers, private practices and more
  • Reaches more patients by integrating contraceptive care as a standard part of primary care for all women of reproductive age
  • Reduces state-level policy barriers such as insurance reimbursement issues
  • Sustains changes in contraceptive access with support from state and community leadership

Scale and Sustainability

Current states

We provide comprehensive training and technical assistance to health centers across an entire state at once to ensure all patients have access to the birth control method of their choice.

Simulated unintended pregnancy rates dropped 24% among Title X family planning clients aged 20–39 in Delaware compared with 3% nationally

Child Trends issued a report using available contraceptive data from 2014 to 2017 in Delaware among Delaware Title X family planning clients ages 20–39. The observed movement from moderately effective contraception to highly effective Long-Acting Reversible Contraception (LARCs), paired with a small decrease in no method, was linked to a substantial simulated decrease (24.2 percent) in the unintended pregnancy rate among this population. The complete report, including methodology and limitations, was commissioned by Upstream and can be found at Child Trends.

Graph comparing the simulated 24% reduction in unplanned pregnancies in Delaware among Title X patients to the simulated 3% reduction in unplanned pregnancies among Title X patients across the U.S.

Study limited to women at risk of unintended pregnancy (sexually active and not pregnant or seeking pregnancy). Complete methodology and limitations can be found at Child Trends.  

FamilyScape simulations using state-level Title X data from Delaware and from the U.S. Title X data, 2014-2017.   

Future work

As we continue to validate and strengthen our model, we will continue to expand throughout the United States. Contact us to learn more about future statewide and regional engagements.

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