Upstream USA

Improve the downstream outcomes for mothers, children and society by empowering women to decide if and when to become pregnant

The Scale of the Problem

Nearly half of the six million pregnancies in the US are unplanned, and unplanned pregnancy is one of the strongest predictors of future poverty for mothers and children alike.

Children of unplanned pregnancies suffer higher rates of deferred prenatal care, lower birth weight, and a host of other negative consequences, feeding a cycle of multi-generational poverty. Yet fewer than 20 percent of all clinics providing publicly funded family planning services offer patients the full range of contraceptive methods, and many exclude the most effective options. The financial burden of unplanned pregnancies is staggering, every year costing $20 billion in Medicaid alone.


of unplanned pregnancies result from ineffective contraception methods


of female high school dropouts left school as a result of becoming a parent


annual Medicaid costs of unplanned births in the US

A Promising Solution

Expanding contraceptive access can help break the cycle of multi-generational poverty for the millions of women who have unplanned pregnancies annually and save taxpayers billions of dollars. Upstream USA provides on-site training and technical assistance to health and family planning centers so they can offer access in a single visit to the full range of safe, effective contraceptives, including Long-Acting Reversible Contraception.


Every unplanned pregnancy averted yields additional benefits later in life for families, including decreased reliance on public assistance, better child development outcomes, and increased economic mobility


estimated Medicaid savings in a single year from a mere 5% reduction in unplanned pregnancies

Blue Meridian's Investment

Our investment supports the first chapter of Upstream USA’s Scaling Plan. Upstream is pursuing a state-by-state approach, modeled on its initial success in Delaware. Each phase of Upstream’s Scaling Plan targets a diverse portfolio of states. This first seven-year phase aims to bring the intervention to scale in four states and demonstrate reductions in the unintended pregnancy rate. Key markers of success include the following:

$60 million invested over 7.5 years

Reach 1.2 million women annually across DE, MA, NC, WA

Why We Are Excited About Upstream USA

Every organization in our investment portfolio is ready to embark on significant scaling and displays a multitude of strengths. Here are some highlights of the tremendous potential we saw in Upstream’s scaling strategy that motivated us to invest:

Breaking the Cycle of Poverty

Upstream’s model presents a clear way to disrupt the link between unplanned pregnancy and intergenerational poverty by putting reproductive choice in a woman’s hands.

Visionary Leaders

Upstream is led by Mark Edwards, an experienced leader with a track record of success and an ambitious vision for reaching the entire country with their model.

Before co-founding Upstream USA, Mark founded and served as executive director of Opportunity Nation, a national bipartisan campaign made up of 300 national nonprofits to expand economic mobility through federal policy reform.

Sustainable Economics

Upstream’s training of health clinics is time-bound and ensures that access to the full range of contraception is embedded in their practice. This approach benefits increasing numbers of women and families for years to come, long after training is completed and Upstream exits.

Scaling Upstream USA Nationally

Co-founder and CEO Mark Edwards shares how Upstream USA's partnership with Blue Meridian contributes to the expansion of contraceptive access nationwide.

Scaling Upstream USA Nationally

About Upstream USA

Upstream USA provides training and technical assistance to health centers so they can offer patients the full range of contraceptive methods, including Long-Acting Reversible Contraception. Founded in 2014, Upstream USA has worked with health centers serving over 150,000 women annually in seven states and Puerto Rico. Its Delaware initiative has reached nearly 60% of women ages 13–44 statewide.

Learn more about Upstream USA

Mark Edwards

Co-founder and CEO

Mark Edwards, co-founder and CEO of Upstream USA, is a nationally recognized leader on the intersection of upward mobility and reproductive health care. Previously, Edwards founded and directed Opportunity Nation, a bipartisan campaign by 300 national nonprofits to expand economic mobility through federal policy reform. A Draper Richards Kaplan Foundation Entrepreneur and an Ashoka Fellow, Edwards graduated from Harvard College.

"This Could Be Life-Changing"

Upstream partnered with the Family Health Center of Worcester, MA, empowering patients to make decisions about their reproductive health.

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