North Carolina

Upstream North Carolina is a multi-year initiative launched by Upstream USA to ensure all patients have access to the full range of birth control methods in a single visit by providing training and technical assistance to health centers.

Our approach empowers patients to decide when and if they want to become pregnant

We work with health care providers of all types, including hospitals, private practice groups, state and local health departments, Federally Qualified Health Centers (FQHCs), Planned Parenthood clinics, community agencies and more to reduce barriers preventing patients from accessing the same-day birth control method of their choice.

Upstream recognizes the horrific history of eugenics in North Carolina and understands the importance of ensuring a system of care that supports patient autonomy. Our work focuses on training providers to offer patient-centered, non-coercive contraceptive care and health equity across our programming. Here’s how we do it.

To achieve our shared vision for a healthy North Carolina, I strongly encourage North Carolina health systems and providers to partner with the nonprofit organization Upstream USA and the NC Department of Health and Human Services to work together to reduce our state’s high rate of unintended pregnancies.”

Dr. Mandy Cohen

of all pregnancies in North Carolina are unintended.


Impact goals

In 4 years of training, starting in 2020, we strive to make a significant impact on the state of contraceptive care in North Carolina for all patients, regardless of where they get their healthcare.

4 years of training

Length of Upstream’s engagement to provide training and technical assistance to health centers across North Carolina, starting in 2020.

40+ participating agencies

Agency partnerships that could include FQHC’s, hospitals, local health departments and other community-based health care practices.

400,000+ patients reached

Women of reproductive age served by fully trained health centers when project is complete.

Are you a North Carolina provider?

Upstream provides comprehensive contraception training, technical assistance and coaching at no charge to healthcare providers, hospital systems and community-based organizations.

Partnering with Upstream

In North Carolina, at least 43% of all pregnancies are unintended

Publicly supported family planning centers in North Carolina met 27% of North Carolina women’s need for contraceptive services and supplies in 2013.

Upstream is working to expand opportunity by reducing unplanned pregnancy and improving outcomes for parents, children and society.

Source: Guttmacher Institute

Excerpt from Leading on Opportunity's "Child & Family Stability Report"

We were particularly impressed by a presentation from Upstream, a program that asks one simple question: “Do you intend to get pregnant in the next year?” If the answer is “Yes”, the woman should be connected to services that help ensure a healthy birth. If the answer is “No”, the individual should be provided with information about the full range of options to help with that decision, from abstinence to long acting reversible contraceptives. We believe pregnancy delay and prevention is an achievable goal for young people and is a worthy investment for our community. We also acknowledge the reality that low-income residents receive disparate health care information and service, specifically on reproductive health.”

Resources & Publications

Ensuring contraceptive access during the COVID-19 pandemic
Thank you to all of the healthcare heroes on the frontline working diligently to prevent, help and heal our communities during this unprecedented time. We are grateful for your service. Here are several strategies to ensure that the contraceptive needs of your patients can still be addressed while you work to manage the COVID-19 outbreak.

North Carolina COVID-19 Resources
This FAQ summarizes recent telehealth guidelines issued by Medicaid and how they apply to contraceptive services.

North Carolina Reproductive Life Planning Summit Summary
In January 2020, Upstream North Carolina convened over 100 stakeholders at The North Carolina Reproductive Life Planning Summit. The purpose of the Summit was to discuss the current status and future direction of reproductive life planning in the state. This summary provides a high-level overview of that event, including an overview of the NC reproductive healthcare landscape, barriers to contraceptive care access, and recommendations for future practice and policy.

Meet the team

Meet the team bringing Upstream’s work to North Carolina.