Children whose births are unplanned are likelier to have health complications, to be born into poverty, to stop their education sooner and to earn less. Mothers of unplanned children tend to give birth when they are younger, leave school earlier and earn less when older.

“I think if we’re looking for the biggest levers we have in this country to expand opportunity, one of the most important ones is helping women to achieve their own goals,” said one of Upstream’s founders, Mark Edwards. “The whole conversation about opportunity begins before the child is born.”

Two more states — Washington and Massachusetts — announced this year that they would bring in the company to start similar projects there.

‘Set it and forget it’

There is some resistance to contraception in America — the Roman Catholic Church remains broadly opposed, and some anti-abortion and religious groups object to particular forms — but birth control is mostly uncontroversial. According to data from the Centers for Disease Control and Prevention, 99 percent of sexually active women between 15 and 44 have used some form of contraception.

Access widened in 2012, when the Affordable Care Act started requiring all insurers to cover every form of F.D.A.-approved contraception without any co-payment. (The Trump administration is trying to weaken those rules.) But that doesn’t mean that women are using birth control all the time — or using the methods that work best. Over the course of a year, 70 women out of 1,000 using birth control pills will become pregnant. For women using a hormonal IUD, a small device placed in the uterus, fewer than 4 out of 1,000 will become pregnant.

Use of long-acting devices remains low in the United States compared with other developed nations, in part because of the harmful poor design of an IUD in the 1970s. But modern IUDs are considered very safe. And an implant — a newer, match-size device in a woman’s upper arm — lasts three years and is the most effective form of contraception available.

These devices, often called LARCs, for long-acting reversible contraceptive, change a woman’s fertility default. Without a LARC, preventing pregnancy means taking steps like filling prescriptions and remembering to take a pill every day. With one, a woman won’t become pregnant until she takes the step of removing it.