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ANNUAL REPORT2018-2019Evidence. Empowerment. Impact2019-2020

A NOTE FROM OUR DIRECTOR“Extraordinary times like these require us to do everythingwe can to protect people’s health and well-being.That includes ensuring that everyone gets the safe,compassionate abortion care they need.”DR. JODY STEINAUER in Morning Consult“Surviving a pandemic requires a collective effort.Ensuring those most vulnerable in our society receive thesupport they need is an ethical imperative. To suggestthat birthing people be isolated from the essential supportthey need as they bring new people into the world should beconsidered only as a last resort.”DR. MONICA MCLEMORE in Scientific American“An inherent and unresolvable tension remains betweenviewing family planning as a tool to mitigate climatechange and valuing an individual’s right to choose tohave a child.”DR. KELSEY HOLT in the Los Angeles TimesThis challenging year hasbrought many surprises, butit wasn’t unpredictable.A dangerous rejection of science by those in power left the countryunprepared for a devastating pandemic. Cities erupted in uprisingsfor justice in response to the racism that has plagued our country forcenturies.While we have continued to move forward with our wide-rangingwork in reproductive health, our members have responded quickly toprioritize responses to these dual crises. We’re studying the impactsof the pandemic on reproductive health and making sure people canget safe, compassionate care. We’re focusing on equity in the care weprovide, the research we do, and the environment we create to supportour community internally. We’re highlighting our work relevant to thesemajor historical moments in this year’s report.While this year has been difficult, it has also been clarifying. We’ve seenthat solutions that were once deemed unrealistic are possible underthe urgent demands of this pandemic. Our commitment to anti-racismmust and will deepen and permeate every aspect of our work.With your support, this transformative year can feed our work toward aDR. BRITTANY CHAMBERS in Apoliticalmore just, equitable future.Jody Steinauer, MD, PhDCover Photo: Victoria Pickering (CC BY-NC-ND 2.0)“Black women are ready for action-oriented policies andprograms to increase access to housing and quality medicalcare, as well as community resources to improve theirhealth outcomes and experiences before, during,and after pregnancy.”

CLINICAL CAREEQUITYCOVID-19Zuckerberg San Francisco GeneralFamily AIDS Care & Education Servicescontinued to deepen equity work,developed a comprehensive approachinvesting in a Perinatal and Pediatric Equityto mitigating COVID-19 risk and spread,Taskforce, an interdisciplinary group trainedincluding reducing congestion at theirby the National Birth Equity Collaborative,clinics in Kenya by half during the pandemictasked with making concrete improvementsby providing most of their patients withto the care environment via training and themultiple months of antiretroviral treatment.development of tools for anti-racism.Cindy ChewFACES“Access to no-cost birthcontrol is one tool thathelps the people I carefor determine their ownfuture paths. TakingMaksim Goncharenok/PexelsThe New Generation Health CenterVAlaSiurua (CC BY-SA 4.0)Advancing New Standards inand Women’s Options Centers offeredReproductive Health (ANSIRH)continuing to provide quality anda protocol for no-test medicationmore telemedicine appointments,accessible health care during thepandemic.researchers and partners createdabortion to keep abortion care safeand accessible during the pandemicand beyond.The Gender Spectrum CollectionHIVE helped develop anddisseminate best practices toprovide gender-affirming healthcare to pregnant transgender andgender-diverse patients.away that choice is aninjustice that will havehuge repercussions for mypatients and my community.”DR. KATIE BROWN in Truthout

TRAINING & EDUCATIONEQUITYCOVID-19The California Prevention Training Centeris leading a national, virtual COVID-19training program to develop a contacttracing workforce with CDC funding.Seventy trainers completed the Training ofTrainer program and have already trainedmore than 600 Case Investigators andContact Tracers.IERH and course director Dr. Zoë Julianproduced the learner-led and justice-informed “Structures & Self: AdvancingEquity and Justice in Sexual andReproductive Health,” helping clinicallearners see how systems of power andlegacies of oppression impact patients.Engin Akyurt/UnsplashInnovating Education in Reproductive Health (IERH)released new videos to keep providers up-to-date on best practices for telehealth abortion andcontraceptive care.Innovating Education in Reproductive HealthInnovating Education in Reproductive HealthOTHER TRAINING HIGHLIGHTS“This isn’t about providing care that’s just as good as whatTraining in Early Abortion for ComprehensiveHealthcare introduced primary care providersto mifepristone for both early abortion andmiscarriage management care. 170 people havecompleted the online training in the first year.pregnant people get now. It’s about elevating the standardof care we provide and giving patients across the statewhat they need and deserve.”DR. BIFTU MENGESHA on expanding access to midwifery care in CalMattersTEACH Program

RESEARCHEQUITYCOVID-19Bixby members responded quickly tomeasure the impacts of COVID-19 onsexual health. Studies are exploring:Changes in access to birth control,abortion care, and pregnancy care,and how providers are developing newUCSF California Preterm Birth InitiativeDr. Brittany Chambers found that in Oakland, California, Black women in poor neighborhoods weremore likely to experience racial discriminationat school, when getting medical care, or throughthe police or courts compared to Black women inwealthier neighborhoods, showing the link betweenracism and socioeconomic status at the communityand personal levels.models to deliver this care across the US.How economic hardship and burdensof the pandemic change people’s atti-tudes toward pregnancy in the US andIndia.The impacts of the pandemic on birthexperiences and outcomes in the US,with a focus on Black, Indigenous, andother people of color.Dr. Sarah Roberts showed that about a quarterof Medicaid-eligible Louisiana women gave birthinstead of having an abortion due to the HydeProviders’ experiences of stress andamendment.anxiety in the US, Kenya, and Ghana.RF. .studio/PexelsOTHER RESEARCH HIGHLIGHTS“Sharing results with the people who are most affected bythem makes us better researchers and ensures thatour work can be used to improve people’s lives.”DR. JERRY NUTOR in The ConversationThe first ever female-controlled HIV prevention method, a vaginal ring tested byBixby partners at the University of Zimbabwe, got one step closer to market inareas hardest hit by HIV.The East Africa Preterm Birth Initiative’s package of quality improvementinterventions for health care providers in Kenya and Uganda reduced stillbirth andnewborn deaths among preterm infants.A clinical trial led by Drs. Craig Cohen and Anke Hemmerling found that thebiotherapeutic LACTIN-V following antibiotic treatment was more effective inreducing bacterial vaginosis recurrence than typical antibiotic treatment alone.

ADVOCACYAfter a multi-year effort, California removed theunnecessary requirement for a physician toDrs. Monica Hahn and Deborahsupervise certified nurse-midwives, a victory thatCohan led a letter to the FDAwill increase access to care. Bixby members spokeurging them to end the discriminatoryat hearings, met with legislators, testified at thepolicy of banning blood donationsCalifornia Medical Board and advocated in thefrom men who have sex with men.media for the change.Deborah CohanCalifornia became the first state in the nation torequire medication abortion care be available fromstate university health centers. ANSIRH researchshowed the need for care and capacity ofstudent health centers to provide care, andresearchers were expert witnesses at the stateRF. .studio/PexelsDr. Jody Steinauer testified before the legislature in her home state ofNebraska to oppose a ban on a common, safe, second-trimester abortionprocedure.legislature.Michael Maloney/SFCDrs. Jody Steinauer, Christine Dehlendorf, Eleanor Drey, Jennifer Kerns and NikaSeidman participated in the Stop the Bans video campaign with ACLU ofGeorgia, discussing the potential impacts of the state’s draconian abortion ban.We launched the Bixby Advocacy and Communications Fellowship, a newprogram to provide Bixby members with the training and support to share theirresearch and expertise in the media and policymaking.Victoria Pickering (CC BY-NC-ND 2.0)In June Medical Services v. Russo, the US Supreme Court struck down“These harms aren’t hypothetical: They’re real, deep,painful, dangerous, and likely to fall on the most vulnerablepeople in our communities.”DR. JODY STEINAUER on common Catholic health care restrictions in Conscience MagazineLouisiana’s requirement that abortion providers have admitting privileges ata local hospital.ANSIRH led a social science research brief, highlighting their work showingthat admitting privileges requirements do not benefit patients.Bixby members spoke out through a video campaign with #MyRightMyDecisionand in The Hill, The Washington Post, The New Yorker, Salon, and more.

ABOUT THE BIXBY CENTERThe UCSF Bixby Center for Global Reproductive Healthbelieves that all people have the right to dignity in their sexual andreproductive lives. Every day, we work to ensure that all peoplehave access to birth control, abortion, sex education, pregnancyand birth care, and HIV/STI treatment – regardless of their age,race, ethnicity, income, or where they live. Your contributionsmake it possible for us to achieve these goals through offeringcompassionate clinical care, training health care professionals,conducting cutting edge, multidisciplinary research, and sharingour expertise in the public debate.To give, visit makeagift.ucsf.edu/bixbybixbycenter.ucsf.edu [email protected] 628.206.51101001 Potrero Avenue, Box 0842San Francisco, CA 94110

After a multi-year effort, California removed the unnecessary requirement for a physician to supervise certified nurse-midwives, a victory that will increase access to care. Bixby members spoke at hearings, met with legislators, testified at the California Medical Board and advocated in the media for the change. In June Medical Services v.