health services, health promotion, and disease
prevention programs, as well as dental services
and environmental health services. Remote
healthcare services are provided by five primary care clinics in the Yukon-Kuskokwim Delta
Region, and YKHC’s Community Health
Aide Program provides village-based primary
healthcare in forty-seven village clinics.
The biggest challenge in delivering prenatal and pregnancy care, according to Ellen Hodges, MD, chief of staff at YKHC for
ten years, is the remote location of pregnant
patients and getting them needed and necessary care in Bethel.
Much of prenatal and pre pregnancy care is
provided by the hospital’s Community Health
Aide Program, initiated in the 1950s and
1960s, which taps local residents to be trained
as practitioners. They attend to patients during normal clinic hours and also are on-call
service after hours. They are also trained in
emergency childbirth, but YKHC makes every
effort to ensure mothers-to-be get to Bethel, or
Anchorage if needed, for delivery, says Hodges.
“Our community health aides can provide
basic prenatal care in our villages, but for ul-
trasounds and blood tests, our moms travel in
to Bethel for care,” Hodges explains. “We have
dedicated providers in Bethel who provide the
needed prenatal care and we have outstand-
ing case managers who coordinate their care.
Once women have been identified as needing
prenatal care, we track them throughout their
pregnancy to ensure the healthiest possible
outcome for mom and baby.”
About 620 women deliver in YKHC’s care
region annually, and the organization provides
all pregnancy care from preconception coun-
seling through post-partum care and beyond.
“We educate our moms on the importance of
early prenatal care and what to do if they notice
problems with the pregnancy,” says Hodges.
About 400 women deliver in Bethel and
the rest deliver in Anchorage, mostly due to
high-risk conditions, says Hodges.
“If our moms need specialized testing, including specialized ultrasounds and consultation with a maternal fetal medicine specialist, they travel in to Anchorage for this care,”
she says, noting YKHC has a well-staffed and
equipped labor and delivery unit in Bethel.
“We have a physician and a nurse anesthe-
tist available 24 hours a day for emergency
C-sections if needed. We have an OB/GYN
doctor who lives in Bethel part-time and An-
chorage part-time for consultation, and if he
isn’t available we have the ability to obtain
phone consultation with OB/GYN doctors in
Similar to Southcentral Foundation,
YKHC offers a pre-delivery home to mothers
as they are required to arrive in Bethel one
month prior to their due date.
“If a patient does go into early labor, we make
efforts to get them to Bethel via our air medevac service, LifeMed. This isn’t always possible,
which is why our community health aides are
trained in emergency childbirth,” says Hodges.
Citing healthcare privacy laws and regula-
tions, Hodges can’t share specific delivery ex-
periences, but she says there are many stories
of the heroes who have played a life-saving
role for moms and newborns.
“Healthcare providers in our communities
have always gone above and beyond to care
for our moms and babies. The community
health aides deserve special recognition for
their dedication and service.” R
Judy Mottl writes about important issues
country-wide with an affinity for Alaska.
“We have dedicated providers
in Bethel who provide the
needed prenatal care and
we have outstanding case
managers who coordinate
their care. Once women have
been identified as needing
prenatal care, we track them
throughout their pregnancy to
ensure the healthiest possible
outcome for mom and baby.”
—Dr. Ellen Hodges
Chief of Staff, YKHC
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