Upstream at 5: Our path toward 1 million patients annually

When we began our work five years ago, we knew that we would have to be ambitious in order to expand contraceptive access in this country. We also knew that trying to change entire systems of healthcare so that all patients could access best-in-class contraceptive care was going to be hard.

Five years ago, we trained one health center serving a few thousand women a year. I’m very proud to report that five years later, Upstream is now on a trajectory to reach health centers that will serve more than 1 million women annually across Delaware, Washington, Massachusetts and North Carolina by 2024.

We recently checked back in with our first health center partner, Haven Health.

Haven Health staff members at the 2014 training
Haven Health staff members at the 2014 training

I traveled to that first health center partner in Amarillo, Texas five years ago with a small team to deliver Upstream’s very first training. In the heart of the Texas panhandle, CEO Carolena Cogdill and her clinic, Haven Health, were doing all they could to provide healthcare to their rural community. As is the case with so many healthcare providers across the country, it is common at Haven Health for patients to drive an hour or more to access health services and to delay care due to cost. Haven Health struggled to meet the needs of their patients, let alone offer the full range of contraceptive options. Carolena told us:

Unfortunately, many patients left without care and without their preferred form of birth control. Some were even turned away because we did not have the funds to pay for their care. Patients were placed on a waiting list if they wanted an IUD. When we got enough money to purchase an IUD, we would call the next patient on the list to see if they still wanted one. We weren’t able to offer the implant because we didn’t have a trained practitioner.

Following our work with Haven Health—Upstream’s first engagement as an organization—everything changed. Five years after our work there—without any additional investment of time and resources from Upstream—Haven Health is still offering patients the full range of contraceptive methods.

Before Upstream, we weren’t able to deliver great care; post-Upstream, the expertise Upstream provided is embedded in our DNA and we are still delivering best-in-class care, five years later. Today, patients in the Panhandle are able to see us and leave with the method of their choice, rather than being offered just the limited methods we had in stock before. They’re empowered, and fully in charge. Upstream knocked the first barrier down like a domino and then all the others fell.

We have worked with thousands of healthcare providers across the country since Amarillo. In 2019 alone, Upstream:

As we reflect on five years of Upstream, we are so grateful and thankful for all of our healthcare providers, partners, supporters, staff and friends who are with us on this journey to increase best-in-class care.

But it’s the voices of patients themselves that matter the most in our work. Please take a moment to listen to patients from our statewide initiative in Delaware who shared their hopes, dreams, and thoughts with us:

This is why we do what we do—all people should be able to achieve their own goals of becoming pregnant only if and when they want to.

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