The Need

In 2022, almost 50% of pregnancies in Tennessee were unplanned – often a result of not using contraception at all or inconsistent or incorrect use of contraception.

While access to birth control and preventive education programs are the two most effective measures in reducing unplanned pregnancies, our state severely lacks equity in both.

Pew Research

In Tennessee…

46%

of pregnancies are unplanned

54%

of births are covered by Medicaid / TennCare

1300+

babies were born exposed to opioids in 2023

The  percentage of unintended pregnancies is higher among: 

Non-Hispanic Black females who have a prevalence more than twice that of non-Hispanic white females. 

​Females with incomes below 200% of the federal poverty level compared with females with higher incomes.  

Females without a high school education compared with females with higher educational attainment. 

Unmarried and cohabiting females, who have a prevalence more than four times that of married females. 

An alarming lack of reproductive health literacy programs result in individuals being completely unaware of contraceptive methods, community resources to access it, as well as basic reproductive health knowledge.  

There are countless benefits to providing reproductive health education to individuals who want it. For one, it is valuable for folks who didn’t receive comprehensive health education in their adolescent years and now want to fill in the gaps in their knowledge. Likewise, reproductive health education is crucial to prevent gender-based violence and discrimination against females. It can contribute to combating homophobia and transphobia - creating a safer and more inclusive community for all. Reproductive health education classes are also an ideal context for raising awareness about the sexual and reproductive health and rights of females, including access to contraception. ​

Access to Reproductive Health Education

Access to Contraception

Annually in Tennessee, more than 719,000 individuals need support accessing contraception due to barriers related to their socioeconomic status, marginalized racial/ethnic identities, geography, and health care insurance status (Guttmacher, 2014). Over 400,000 “in need” Tennessee individuals live in contraceptive deserts, which are defined as “counties that lack reasonable access to the full range of [contraceptive] methods” (Power to Decide). 

The result of unplanned pregnancies resulting from no form of contraception are directly linked to 1) poor maternal (e.g., postpartum depression and parental stress) and infant (e.g., low birthweight) health outcomes, 2) increase in adverse childhood experiences, and 3) family instability.  

Since 2017

A Step Ahead has:

connected

4500+

individuals across 16 East Tennessee counties with contraception and associated healthcare — at no cost to them


prevented

1,200-1,600

unplanned pregnancies


saved

$24-32M

taxpayer dollars, if these unplanned pregnancies were covered by TennCare

The annual impact: 

330-440

prevented pregnancies

&

$6.6-$8.8M

saved in tax dollars

Our Clients

91% are uninsured or have insurance that limits birth control choice.

36% are 18 to 24 years old.

51% are mothers.

A Step Ahead Foundation of East Tennessee provides women in financial need with an opportunity to choose if, when, and under what circumstances she will have a baby by providing access to long-acting, reversible contraception (LARC), which is proven to be over 99% effective in preventing pregnancies, at no cost to the client. 

Our average client is 29 years old, already has a child, and wants to prevent a future pregnancy.

For many women, fighting the cycle of poverty becomes very difficult as unplanned births occur. With access to LARC, women can achieve their educational, economic, and family goals without having to handle an unplanned pregnancy. We aim to increase positive pregnancy outcomes for both mother and child, lower infant mortality, and improve family life.

Together, we can build a stronger, healthier, and more inclusive community for everyone.

At A Step Ahead Foundation of East Tennessee (ASAFET), we are dedicated to ensuring that all East Tennesseans have the resources and support they need to make empowered choices about their reproductive health.

Empowering Choice

Access to effective contraception and family planning services empowers individuals to make choices that are right for them and their families. Whether it's preventing unintended pregnancies or spacing out births, having the ability to plan and control one's reproductive health is a fundamental aspect of personal freedom and well-being.

Promoting Health and Wellness

Preventive contraception is not just about avoiding pregnancy—it's about ensuring that individuals and families can achieve optimal health. By providing access to a range of contraceptive methods and family planning resources, we support healthier lives, reduce healthcare costs, and contribute to the overall well-being of our community.

Breaking Down Barriers

Many individuals in East Tennessee face barriers to accessing reproductive health services due to cost, geographic isolation, or lack of available options. We work to dismantle these barriers by offering free and confidential services, ensuring that no one is left behind due to financial or logistical constraints.

Supporting Families

Family planning is a key component of strong, healthy families. By helping individuals and couples plan their families according to their circumstances and desires, we contribute to more stable and nurturing environments for children. Our services help families grow and thrive by providing the resources they need to make informed decisions.

Fostering Equity

We are committed to creating a more equitable healthcare landscape where everyone has the opportunity to access the care they need. By focusing on underserved and marginalized populations, we aim to reduce disparities and promote fairness in reproductive health access.

Building a Better Future

Our work is not just about addressing immediate needs—it's about creating lasting change. By increasing access to preventive contraception and family planning services, we help pave the way for a brighter future where every individual has the opportunity to achieve their personal and family goals.

  • “Love this organization. I recommend to every woman looking to family plan."

    —Daniela, client

  • “I went through your program for my Mirena. I love it! Thanks...I am an advocate for A Step Ahead always.”

    —anonymous, client

  • "A Step Ahead is the best program ever. I am so grateful for it. It has saved me from a lot of misery and saved me a lot of money! May God bless everyone that plays a part."

    —anonymous, client

  • “Just wanted to let everyone know that I went to an appointment at the Union locations and was very impressed with the office and all the people that work there. I will definitely recommend A Step Ahead to everyone I know that needs your services.”

    —Lisa, client

  • "I chose a long term reversible method of birth control because I have goals in my life. I want to finish college and I want to get a better education and find a stable job before I have children."

    —Destiny, client

  • "I'm a single mother of an 18-year-old son, I'm 33 years old, which means I had my son when I was 15. I didn't know about birth control and different birth control options, which is part of the reason I support A Step Ahead Foundation. They provide education and birth control options for young women so they can make better decisions for their lives and put themselves in a better position to have a good life and children when they are ready."

    —Summer Owens, advocate

  • "I choose to use birth control because I recently had a child and I'm not trying to have anymore anytime soon. I'm trying to go to school and have a career in my life. I'm trying to be able to provide for the one that I do have and I'm not trying to add anymore right now."

    —Moriah, client