Why contraceptive access matters

All patients deserve access to the contraceptive method of their choice. Birth control can help open doors to self-determination, education and careers—but access is not equitable across America today.

Out of 6 million pregnancies in the U.S. each year, nearly 3 million are unplanned

Most women who experience unintended pregnancies are either not using contraception or using a method that doesn’t work well for them. When patients can achieve their own goals of becoming pregnant only if and when they want to, they—and their families—can experience positive ripple effects throughout their lives.

In a recent survey, more than half of women said that contraceptive use is key to pursuing education, achieving their career goals and caring for their families. Studies show that unplanned pregnancy disproportionately affects poor and low-income women—which, along with other social determinants, can perpetuate negative health, economic and social outcomes. We believe that the lack of contraceptive access is a clear social justice and health equity issue for all individuals across the socioeconomic spectrum.

How systemic gaps in contraceptive access fail patients

Decisions about pregnancy and contraception are complex and personal; they should be made in full partnership between patients and their providers. However, systemic inequities in healthcare prevent providers from offering the full range of birth control methods to all patients. To put it simply, access to birth control is not equitable across America. 

In 2015, only 30% of community health centers provided same-day access to IUDs, often due to a lack of training and the cost associated with stocking the contraceptives. Upstream trains providers to offer the full range of contraceptive options and staff to provide medically accurate, patient-centered contraceptive counseling and care.

Institutionalized racism and reproductive oppression impact patient care and experience. Upstream trains staff and providers on how to recognize their own bias and avoid coercive contraceptive practices.

Conversations about family planning and reproductive health should be a regular, standardized part of healthcare conversations between all patients and their providers, but they happen far too infrequently. Upstream trains staff and providers to offer counseling that is efficient, effective and centers the needs and desires of the patient—resulting in high satisfaction among patients.

Roughly half of women who are required to make an unnecessary follow-up visit in order to receive an IUD will not return for that second visit. Upstream works with agencies to identify barriers to same-day contraceptive access so that patients have easy access to their desired method at the time of their appointment.

Health centers may not be able to appropriately bill for services or stock methods on their shelves due to outdated billing and coding practices or contracts that don’t maximize reimbursement. Upstream offers tailored billing and coding support, and assistance stocking the full range of methods

Upstream is transforming healthcare

Every person should have access to the full range of contraceptive methods, so that they can become pregnant only if and when they want to. That happens when healthcare providers can:

  • Ask all patients about their reproductive health goals and pregnancy intentions at each visit
  • Offer all forms of available contraception to interested patients utilizing a shared decision-making model
  • Implement a patient’s choice in a single visit

It requires that birth control and reproductive health are a regular, normal part of the healthcare conversations between every patient and their provider. Standard primary care for all should include convenient, timely access to contraception.

Upstream gives patients the power to make their own choices about contraceptive care. At Upstream, we are changing healthcare—and making sure that it lasts. Results from our early partners demonstrate that our work is sustainable: patients are able to choose from the full range of birth control options long after our work has concluded with individual health centers.

Our partners

Learn more about our state partnerships.

Partnerships