Alaska's obstetrical delivery systems: a descriptive epidemiologic study.

Delivery of obstetrical care in rural Alaska can be very challenging, due to remoteness, lack of medical resources and transportation difficulties. This descriptive study looks at what the current delivery systems for obstetrical care in Alaska are. Alaska's obstetrical delivery systems can be divided into three basic systems. 1) Full comprehensive obstetrical care limited only by lack of neonatal ICU capability. 2) Cesarean delivery capable, but with limited resources. 3) Low risk vaginal deliveries with no cesarean delivery capability except by transports approaching 6 hours. This study raises questions about which system is most effective for which communities. Further studies need to be undertaken to better understand how to provide effective obstetrical care in rural and bush Alaska at an acceptable risk, and at reasonable cost.