Dr. Sonya Borrero Wants Reproductive Health to Be Shaped by Real Life

“There are so many assumptions embedded in the way we deliver health care,” said Dr. Borrero, a physician, health services researcher, and member of the Jewish Healthcare Foundation (JHF) Board of Trustees. “How can we really meet the needs of our patients when we’re completely blind to their actual contexts?”

That question has driven much of her career.

Over nearly two decades on the faculty at the University of Pittsburgh, she has challenged traditional thinking about contraception, pregnancy, and family formation; investigated inequities in reproductive health care; brought together researchers from medicine, social science, law, policy, and other disciplines; and taken her work from academic research to the federal government and back again.

At the center of it all is an idea that sounds simple but becomes far more complicated in practice: people should have the ability and resources to make decisions about whether, when, and how they build their families.

Following the Questions

Dr. Borrero did not set out with a carefully mapped career plan.

Growing up in Cincinnati with a physician mother, she was drawn to biology but equally interested in humanities. At Amherst College, the liberal arts gave her space to move between the two, an approach she would eventually bring to her research.

“I’ve always been someone who likes all subjects,” she said.

Medical training narrowed that lens again. Graduating with her medical degree from Case Western Reserve University School of Medicine in 2001, she arrived at the University of Pittsburgh for her internal medicine residency, finding herself increasingly drawn to women’s health and, particularly, reproductive health.

Then, during residency, she spent a month working at a remote rural clinic in the Guatemalan highlands.

She was there primarily to learn medical Spanish and work in a pediatric clinic. But word spread that there was a women’s health physician at the clinic, and mothers began approaching her with a different question.

They wanted contraception their husbands would not know they were using.

The women wanted to stop having children. Their husbands wanted larger families. Dr. Borrero began referring them to an international Planned Parenthood clinic and carrying information back to the rural community.

The experience left her fascinated not simply by contraception itself, but by the forces surrounding it: culture, power, gender, and the circumstances that determine whether someone can act on what they want for their own life.

“I really started getting interested in the cultural phenomenon of family building and contraception, more from a social science perspective rather than contraceptive technology,” she said.

Questioning the Idea of “Planning”

Following those leads eventually brought Dr. Borrero back to one of the most fundamental assumptions she had learned in medicine: that pregnancy should be planned.

Her research with people from low-income and historically marginalized communities showed her why that seemingly sensible expectation could itself be limiting.

Planning assumes a certain degree of control over life: financial stability, secure housing, stable relationships, reliable healthcare access, and the freedom to make and act upon reproductive decisions.

Those conditions are not equally available to everyone.

Dr. Borrero also heard from people whose feelings about pregnancy did not fit neatly into categories like “planned,” “unplanned,” “intended,” or “unintended.”

A pregnancy that wasn’t planned could be joyful. Another could be devastating. Someone could want a child while knowing their circumstances did not fit society’s expectations of when they should have one.

“This concept of planning for many people just doesn’t even resonate,” she said.

The lesson changed the way Dr. Borrero understood reproductive autonomy.

It's not simply giving someone choices. People also need the resources and conditions that allow them to act on those choices.

Family formation, she argues, is central to human life, whether it occurs through pregnancy, other paths to parenthood, or the families people create through kinship and community.

Her goal is to understand how health care and society can make genuine autonomy possible.

Building a Different Kind of Research Center

That complexity requires more than medicine alone.

In 2016, Dr. Borrero founded CONVERGE after her division chief Wishwa Kapoor, MD, saw an opportunity to create an academic home for researchers across Pitt whose work in women’s health extended beyond traditional biomedical research.

Today, CONVERGE brings together researchers from across disciplines around shared principles of reproductive autonomy, patient-centeredness, and health equity.

It is deliberately collaborative.

To Our Nation’s Capital and Back 

In 2022, Dr. Borrero had the opportunity to test those ideas from inside the federal government when she became Chief Medical and Scientific Advisor in the Office of Population Affairs at the U.S. Department of Health and Human Services.

She arrived eager to help develop a national vision for sexual and reproductive health equity.

The experience instead taught her about the limits of trying to create long-term change inside a system whose leadership and priorities can – and often do – shift every four years.

“I realized I am a true-blue academic,” she said. “I need to work with people who have a more expansive vision for what we should be working towards.”

But her time in Washington also changed how she thought about where lasting change could happen.

“I came back from HHS with this renewed mission,” she said. “The federal government is not going to save us.”

Rather than abandoning the ambition for systems-level change, Dr. Borrero brought it closer to home. Pennsylvania could become a place to test what was possible when researchers, clinicians, policymakers, advocates, and communities worked toward change together.

“It is going to take the collective we to make change,” Borrero said. “We are the ones we have been waiting for.”

Out of that experience came PA Catalyst, a five-year research-to-impact initiative led through CONVERGE toadvance equitableand sustainable contraception and abortion care in Pennsylvania.

The initiative has assembled a network of roughly 100 providers, state officials, policymakers, community organizations, reproductive justice groups, and advocates. Its work extends beyond traditional research to pursue change in three interconnected areas: policy, clinical practice, and culture. 

The approach reflects something Dr. Borrero has learned repeatedly throughout her career: there is rarely a single intervention that transforms a complex system.

“Policy change is not enough,” she said. “There’s never going to be a silver bullet.”

PA Catalyst is studying everything from pharmacists’ willingness to provide contraception to Pennsylvanians’ attitudes and experiences around reproductive health, while using communication and decision science to understand how information can reach people in ways grounded in their values.

After spending its first year building a team of more than 40 people and establishing a research infrastructure, the initiative is currently entering a new phase in which those findings will increasingly move into the world.

“We’re trying so many different things, and some will work and some won’t,” Dr. Borrero said. “We’re learning from all of it.”

Finding a Kindred Spirit in JHF

That willingness to try, learn, and move across disciplines is also what first attracted Dr. Borrero to JHF.

Her introduction came through adolescent medicine physician Elizabeth Miller, MD, PhD, who asked her to fill in on a JHF panel about HPV vaccination.

Dr. Borrero loved it.

Compared with the rigid structures of traditional academic research, she found the Foundation’s willingness to bring people together and experiment with new approaches “liberating.”

“I just really enjoyed the collaborations I had with JHF,” she said.

Those collaborations grew with JHF increasingly calling on her expertise in women’s health. She eventually joined its Board of Trustees in 2021.

Today, she sees strong parallels between JHF and the way CONVERGE approaches its work: multidisciplinary, responsive, and willing to tackle complicated problems from multiple directions.

She also believes independent organizations like JHF have an increasingly important role to play in protecting evidence-based approaches to health.

“I think JHF is incredibly principled,” Dr. Borrero said. “I think they have always demonstrated a lot of integrity around those principles.”

JHF’s ability to respond quickly when new community needs emerge is equally important, she added.

From healthcare quality and HIV/AIDS to aging and women’s health, she sees the Foundation willing not only to take on difficult issues, but to approach them through partnerships, education, policy, advocacy, and perspectives that rarely fit neatly into a single discipline, which feels familiar.

“I think it’s very similar to the way we’ve been trying to address things at CONVERGE,” she added.

In It for the Long Haul

Dr. Borrero does not expect the problems she has spent her career studying to yield easy victories.

Her forthcoming book, Reproducing Control, written with two colleagues, examines the history and ethics of the family planning movement and imagines a future centered less on whether pregnancies conform to a planning ideal and more on reproductive health, equity and well-being.

It is another extension of the question she began asking years ago: What if the framework itself needs to change?