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OPINION: Addressing maternity care deserts in Alaska

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OPINION: Addressing maternity care deserts in Alaska


By Madisyn Parker

Updated: 1 minute ago Published: 1 minute ago

As the pristine wilderness of Alaska captivates the world with its natural beauty, there’s a hidden challenge lurking within its vast landscapes — a challenge that affects the most vulnerable among us: expectant mothers and their infants. Maternity care deserts, areas where access to essential maternity services is limited or absent, persist across the state, posing significant risks to the health and well-being of our communities.

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Accessible and affordable maternal care plays a crucial role in reducing the risk of pregnancy complications and safeguarding the health and well-being of both the parent giving birth and the fetus. Despite extensive research highlighting the significance of maternal care, the provision of obstetric health services in the U.S. remains inadequate. Remarkably, the U.S. holds the highest maternal mortality rate among high-income countries, despite its substantial health care expenditure. Any county lacking health care facilities offering obstetric care or obstetric providers is classified as a maternal care desert. In the U.S., more than 2 million individuals of reproductive age reside in maternal care deserts, with an additional 3.5 million residing in counties with severely restricted access to obstetric care.

Alaska, with its rugged terrain and remote communities, faces unique obstacles in delivering adequate health care, particularly in maternal and obstetric care. The Alaska Rural Health Plan, implemented in 2001, has made commendable strides in improving access to health care in rural regions, including maternal and obstetric care. However, there’s still much work to be done.

The statistics are sobering—over 75% of Alaska’s communities lack road connectivity to hospitals, leaving expectant mothers in these areas isolated from critical maternity services. This disparity disproportionately affects marginalized populations, including low-income families and people of color, exacerbating existing health inequities.

In Alaska, individuals giving birth encounter exceptionally challenging circumstances regarding maternal care. Across the state, 50% of census areas qualify as maternal care deserts (compared to 32.6% in the entire U.S.), and expectant individuals typically travel an average of 52.4 minutes to reach the nearest birthing facility. In severe instances, pregnant individuals in Alaska may need to travel distances as vast as 830 miles — equivalent to approximately 83 hours — to access the nearest birthing center.

Limited infrastructure and insufficient funding compound the challenges faced by pregnant individuals in accessing health care services, particularly in remote and underserved regions like Southeast Alaska. The scarcity of financial resources hinders efforts to establish and sustain adequate maternal care facilities. Birthing centers, hospitals, and clinics require substantial funding for modern medical equipment, facility maintenance, and hiring trained medical professionals. Without adequate funding, health care providers in remote areas struggle to keep birthing facilities operational or recruit obstetricians to provide specialized care.

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Moreover, the lack of funding in maternal care deserts prevents the implementation of comprehensive prenatal and postnatal care programs essential for the health of pregnant individuals and their infants. These programs offer vital services such as prenatal screenings, nutritional support, education, and breastfeeding assistance. Insufficient funding leaves expectant parents without access to essential resources and support.

Furthermore, inadequate funding perpetuates health care access disparities based on socioeconomic status. Marginalized communities and low-income individuals bear a disproportionate burden of maternal care deserts. Limited health insurance coverage and inadequate access to support services exacerbate the inequity stemming from insufficient funding for maternal care in rural communities. Without prioritizing funding initiatives targeting MCDs, vulnerable populations remain vulnerable to adverse maternal health outcomes.

The solution lies not only in bolstering health care infrastructure but also in fostering a collective commitment to address this pressing issue. Telehealth initiatives under the Alaska Rural Health Plan have shown promise in overcoming geographical barriers, allowing pregnant individuals in remote areas to access prenatal care and maternity services remotely. By embracing innovative solutions like telemedicine, we can bridge the gap in health care access and ensure that no mother or infant is left behind.

To truly effect change, we need widespread awareness and support from every corner of our society. It’s time for policymakers to prioritize maternal health and allocate resources towards expanding access to maternity services in underserved areas. It’s time for health care providers to advocate for comprehensive care for expectant mothers, regardless of their geographic location. And it’s time for communities to rally together, demanding equitable access to health care for all.

Together, we can rewrite the narrative of maternity care deserts in Alaska. Let’s envision a future where every expectant mother receives the care she deserves, regardless of where she lives. Let’s commit to building a healthier, more equitable Alaska for generations to come.

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Madisyn Parker, born and raised in Alaska, is a graduate student at the University of North Carolina at Chapel Hill, where she is studying maternal, child and family health at the Gillings School of Global Public Health.

The views expressed here are the writer’s and are not necessarily endorsed by the Anchorage Daily News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary(at)adn.com. Send submissions shorter than 200 words to letters@adn.com or click here to submit via any web browser. Read our full guidelines for letters and commentaries here.





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Alaska

Bristol Bay salmon would benefit from added protection in federal law • Alaska Beacon

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Bristol Bay salmon would benefit from added protection in federal law • Alaska Beacon


As we write, tens of millions of salmon are swimming their way back to Bristol Bay. And for the second year running, those who work the 15,000 jobs the salmon provide each year can celebrate that the proposed Pebble mine no longer threatens to contaminate the headwaters of the greatest wild sockeye salmon fishery in the world. 

At least for now. 

The U.S. Environmental Protection Agency issued Clean Water Act protections for this amazing fishery in January 2023. That news was welcomed by residents of the region and scores of businesses that are reliant upon the Bristol Bay fishery, along with its $2.2 billion annual economic impact. Since then, Pebble and the state of Alaska have filed four lawsuits in an attempt to keep this ill-conceived, acid-producing mine on life support. Math and science aren’t on their side — not only would the mine irreversibly harm a fishery that could, if not contaminated, continue to produce and provide jobs for centuries to come, but the state of Alaska made a basic math error in one of its lawsuits, leading it to inflate the amount they’re suing American taxpayers for by $630 billion. Clearly, those seeking to exploit Bristol Bay at the risk of its sustainable fishery aren’t taking “no” for an answer.

Fortunately, on May 1, Rep. Mary Peltola introduced the Bristol Bay Protection Act in the U.S. House of Representatives. This bill would codify EPA’s Clean Water Act protections, which protect the headwaters of Bristol Bay, where the Pebble deposit is located, from mining activity. Rep. Peltola’s bill makes the protections Tribes, fishermen and Alaskans fought for in a decades-long battle over the fate of the world’s greatest sockeye salmon fishery more difficult to overturn by administrative action alone. Thank you, Rep. Peltola, for this much-needed legislation. 

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We’ve each been involved in Bristol Bay’s fishery for decades, one in the lodge business and one running a commercial fishing and direct marketing business. One of us brings people to the fish and the other brings the fish to people. Between the two of us, we’ve got nearly 70 years of hard-won experience in Bristol Bay.  We’re not antidevelopment. We’ve both worked in Alaska’s oil fields. And we’ve both traveled to our nation’s capital to testify in front of Congress about the wonders of Bristol Bay and how it’s too valuable to risk losing. 

The proposed Pebble mine is an issue that not only cuts across party lines: it obliterates them.  The late Sen. Ted Stevens called Pebble the “wrong mine in the wrong place,” and Sens. Lisa Murkowski and Dan Sullivan have both expressed their opposition to Pebble. The Army Corps of Engineers denied a key Pebble permit in 2020, during the Trump administration. These are historic positions for Alaska politicians to take, but facts, science, and public opinion are in Bristol Bay’s corner.  In addition to Alaska’s leaders (absent our current governor, Mike Dunleavy), the last three presidents of the United States have all taken actions to protect Bristol Bay and prevent the advancement of the Pebble mine. The EPA began its Clean Water Act review under Obama; the U.S. Army Corps of Engineers denied Pebble’s permit under Trump; and the EPA finalized Clean Water Act protections under Biden. Rep. Peltola’s bill is the next,  desperately needed step. It also reflects that the majority of Alaskans have consistently opposed this uniquely dangerous project.

For roughly 20 years, the dark cloud of uncertainty that Pebble cast over the region has united local residents, subsistence, recreational and commercial fishers. That coalition, born in Bristol Bay, is backstopped by organizations, businesses and individuals from coast to coast. Over the course of this campaign, more than 4 million public comments have supported protections for Bristol Bay. Whether you’re a catch and release angler, a big game hunter, someone who loves watching the brown bears snatch salmon mid-air, or whether you just enjoy eating delicious, nutritious wild Bristol Bay sockeye, all those who have spoken in favor of protecting this amazing region can support the Bristol Bay Protection Act.

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Alaska

King Salmon Stocks Decline in Alaska | Sport Fishing Mag

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King Salmon Stocks Decline in Alaska | Sport Fishing Mag


In fresh water, spawning king (Chinook) salmon can change to browns, reds or purples. Also look for a hooked upper jaw, the telltale sign of a male Chinook.
Courtesy Peter Westley

“Memorial Day weekend has long marked the traditional – and unofficial – opening of the Southcentral salmon fishing season as this is roughly when the first significant numbers of Chinook begin to return to the Kenai, Anchor and Susitna River systems, among others. Runs build in June, peaking in the Kenai River and upper Susitna drainages in early to mid-July.”

— This excerpt from the Alaska Department of Game & Fish website, published only a decade ago in July 2014, now serves as a bittersweet reminder of much better days for the Alaskan Chinook salmon fisheries.

This month marks the 39th anniversary of Les Anderson’s world record king salmon catch on Alaska’s famed Kenai River. On May 17, 1985, Anderson, an auto dealer from nearby Soldotna, hooked the salmon fishing from his boat, then took to shore to land the 97-pound, 4-ounce Kenai king. Though bigger king salmon have reportedly been caught and released by anglers since then, Anderson’s world record stands. It also stands for a magnificent fishery now gone. These days, the fight for kings is to save them.

“We’ve seen a severe decline in the king salmon stocks in the Kenai and in other Alaskan river systems,” says Shannon Martin, Executive Director of the Kenai River Sportfishing Association (KRSA). “We’ve had complete closures to sportfishing for kings on the Kenai and other rivers. On some rivers, only hatchery-raised king salmon may be harvested. These days, I won’t target kings anywhere,” she said.

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Chinook (King) Salmon See Major Declines

Fly fishing the Kenai River
Fly fishing the Kenai River is changing dramatically as Chinook numbers decline.
Courtesy Berkely Bedell, USFWS

Called kings around the Kenai, the species is commonly called Chinook across its range in the North Pacific. In many locations in Alaska, Chinook’s decline has been so severe in the last 30 years that the wild fishery is in peril. The stocks are diminished by all measures, including the numbers of fish returning to rivers each year, the size of those individual fish, and the seasons to catch them.

 “I remember the Kenai,” says Peter Westley, an associate professor in the College of Fisheries and Ocean Sciences at the University of Alaska, Fairbanks. “You could put your head into the mouth of one of those big fish. People are feeling pretty pessimistic, saddened, depressed, longing for the good old days.

“Across the entire North Pacific region, Chinook are not doing well,” he said. “The story is told river by river, but there are big patterns, and Chinook salmon in lots of places are circling the drain.”

Threats to Chinook

The threats to Chinook are multifold, complex, and many decades in the making — degraded habitat, dams, rising sea temperatures, and increasing predation by protected sea mammals. Add to all that fishing pressure and hatchery-raised salmon that compete with native fish. Westley says, “Unless something fundamentally changes with how we interact with them, the future for Chinook is really grim.

“On some level,” he adds, “there are Chinook, but they’re hatchery fish. The habitat is so messed up that there wouldn’t be Chinook without those hatchery fish. The evidence is saying that the hatchery fish diminish the wild fish though. In places like the Kasilof and Ninilchik, you can fish for hatchery Chinook, but the problem is that no one can distinguish what gets caught.”

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Westley presents a comprehensive vision of the threats facing Chinook when he says, “The ocean has always been dangerous and risky, but in recent years, it has become even more dangerous for fish. The Chinook’s life-history strategy of growing slowly and being in the ocean most of its life isn’t benefitting the species lately.”

The Future of Alaska Fishing

Alaska chinook swimming underwater
A chinook salmon swims up Ship Creek to spawn.
Courtesy Ryan Hagerty, USFWS

Both Westley and Martin suggest that anglers shift their expectations of Alaskan fishing and realize that the kings need help and that there are plenty of other incredible fish to go for across the state and the region.

“We need to do our part to take the pressure off Chinook salmon,” says Westley. “If they want Chinook, people should go to places where the fishing has as little impact as possible on the wild stocks, places like Ship Creek, where it’s all hatchery fish,” he says. “There are also some healthy fisheries for wild sockeye. That’s a different ball game.”

Martin, from KRSA, said she is seeing a change in mentality in many anglers.

“Anglers are looking for other species, trying to protect that run of kings returning from the ocean. At the same time, our organization advocates for fishery managers to implement paired closings with commercial fisheries to include additional restrictions and protections. This would share the burden of conservation amongst all user groups. What matters is to get eggs in the gravel and that’s what we’re looking for.”

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An Uncertain Future

king salmon caught in the ocean
Shannon Martin, with a Yakutat hatchery king salmon, caught in the ocean.
Courtesy Shannon Martin

The fight will be long and hard to help protect Chinook, one of the Western World’s totemic sport fish, food fish, and a lynchpin of Alaska’s coastal ecosystem. Only recently, in March, the State of Alaska Board of Fisheries voted to lower the spawning escapement goal for the late-run Kenai River king salmon to support additional commercial fishing opportunities for other salmon, a decision that Martin and the KRSA lamented, painfully. Martin called it a “dark day for conservation in Alaska.” She said, “We’re essentially signing off on the managed decline of a species that has defined our region.”

Anyone who’s ever seen the broad, pink-green back of a Chinook salmon rising in a turquoise-colored, glacial river’s flow, while connected to that fish only by a thin line, knows the fear and the heartache that the fish might just break off and be gone, forever.



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VIDEO: Improving the navigation in Petersburg, Alaska

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VIDEO: Improving the navigation in Petersburg, Alaska


The U.S. Army Corps of Engineers has just released a video about the Petersburg Borough’s South Harbor dredging project.


View on Youtube.

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Located in Southeast Alaska between Juneau and Ketchikan, the Petersburg Navigation Improvements project restored the South Harbor to original design depths ranging from minus 9 to 19 feet and improved general navigation features to allow for safe passage of vessels.

The first ever dredging operation within the basin since it was built in 1982 removed about 57,000 cubic yards of material.



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