This profile was prepared when Mark Edwards was elected to the Ashoka Fellowship in .
The New Idea
Mark has worked for more than two decades on interrupting intergenerational poverty. He got his start working with organizations focused on early education and homelessness and started working at the national level when he founded Opportunity Nation, a bi-partisan coalition of more than 300 antipoverty organizations. Through conversations with one of these organizations, the National Campaign to Prevent Teen and Unplanned Pregnancy, he learned about a startling, but well-documented statistic: over half of all pregnancies in the U.S. are accidental and unplanned. Of the 6.6 million pregnancies in the U.S. each year, 3.4 million are unplanned. The downstream impact on mothers, fathers, and children is significant and can reverberate for generations. Mark circled back to many of the Opportunity Nation organizations – nonprofits, community colleges, youth development organizations – and virtually all of them confirmed that unplanned pregnancy was a significant issue with the populations they served. National surveys of poor and low-income women from the Centers for Disease Control and Prevention showed that 65% of their pregnancies were unplanned. But what was even less understood what that so many of these women were using a contraceptive method when they became pregnant – but the method they were using wasn’t working for them, which led to an unplanned pregnancy. And all this was taking place despite new, rigorous research showing that there were new methods of contraception that women actually preferred, but were rarely offered: the new IUDs and implants. These methods are twenty times more effective than other methods, as safe as any other method of contraception, and were held up by the CDC, the American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics as the best methods of contraception for all women. Mark believed that if we could change healthcare so that women could get access to these new methods of contraception, it would give them more control over their lives. And by helping women achieve their own goals and become pregnant only when they want to could be a powerful way to support women, men, and children, and help break the cycle of intergenerational poverty in America. So Mark co-founded Upstream USA, a non-profit organization that is changing the U.S. healthcare system so that all women can receive the highest quality services and conveniently access the full range of modern contraceptive methods, particularly the most effective ones, IUDs and implants. Upstream USA is showing that this transformation of women’s healthcare is possible in the U.S. They’ve already changed the practices of twelve health centers around the country that serve 37,000 women of reproductive age per year, and their ambition is to do much more. The difference in patient experiences in a pre- and post-Upstream health center is night and day. But this isn’t just about better customer service training. Upstream USA trains clinicians on how to place and remove these new methods; they train the billing and coding staff about how to get reimbursed for them; they ensure that these methods are stocked so that they can be offered the same day they are desired; they teach counseling skills so that patients can make an informed choice. Upstream USA is working with nurses, doctors, receptionists, CEOs, translators, and others in healthcare to make contraceptive counseling and care a centerpiece of women’s health and by doing so, ensure that women can achieve their own goals and have children only when they want them and plan for them.