Pregnant women in Skagway want road

Canadian doctors turn away U.S. patients over insurance

Posted: Thursday, March 17, 2005

The Road Series

Laurie Magee of Skagway wants a road to Juneau, not just for herself but for the baby she's expecting in August.

Maternity care isn't available in Skagway, so Magee had hoped to give birth to her second child in Whitehorse, Yukon, 110 miles to the north by road.

But Magee had to change her plan. She will have to give birth in Juneau, which can be reached only by plane or ferry. The delivery could cost more than four times what it would in the Canadian city.

Canadian doctors are turning away Magee and other pregnant Skagway and Haines women. As of Jan. 1, 2004, the Canadian Medical Protective Association stopped providing malpractice insurance for Canadian doctors treating non-Canadian patients in non-emergencies.

For nearly a year, the two obstetrician-gynecologists in Whitehorse had been helping Alaskans at their own risk. In November they decided not to take new patients, said Wayne MacNicol, president of the Yukon Medical Association and one of the two obstetricians.

Their latest delivery of an Alaska baby in Whitehorse occurred in February because the woman was already in labor. Canadian doctors are covered by malpractice insurance under such emergencies.

It is hard to estimate how many Alaskans are affected by the new policy because the number of births fluctuates every year. Eight Alaskans were born in Whitehorse in 2003, and seven in 2004.

Many pregnant women in Haines and Skagway have no choice but to come to Juneau.

And it's expensive. In addition to paying for doctors' appointments, they have to pay at least $170 for a round-trip plane ticket or $60 - $80 from Skagway - for a round-trip ferry ticket as a walk-on passenger. That is repeated every month for prenatal checkups. They must stay in Juneau at least two weeks before the due date in case the baby comes early or transportation is not available. That means staying in a hotel if the expectant mother doesn't have family members or friends in Juneau.

"If there were a road to Juneau, that would make my life so much easier," Magee said. "I would drive to Juneau for my prenatal checkups. And I wouldn't have to stay in Juneau that long for my delivery."

Magee said a road to Juneau probably would be safer than the Klondike Highway connecting Skagway and the Yukon.

"The pass is pretty nasty," Magee said. "The day my daughter was born, the road was closed. We were lucky that we arrived a few days earlier."

According to the Yukon government, the Klondike Highway between Carcross, Yukon, and Skagway was shut down 15 times between November of 2004 and March of 2005, mostly due to poor visibility caused by blowing snow.

Christy Murphy, a 12-year resident of Skagway, said she was against the road until February, when she gave birth to their third child, Tessa, by Caesarean section in Whitehorse. She was the last Alaskan to have a scheduled delivery in Canada.

"We're really bummed that we are not able to have babies in Whitehorse anymore," Murphy said. "It's a really nice option to be able to drive and get your medical and not have to rely on ferries. The weather for flying isn't all that great in the winter."

Tessa was Murphy's third delivery in Whitehorse. She also had her son, Gavin, 6, and her older daughter, Sadie, 2, by Caesarian. She was lucky with Tessa. In her third trimester, she was told that Canada's policy could change before her due date.

It cost her $7,000 to have Tessa in Whitehorse. It would have cost her $30,000, in ferry, hotel and medical fees, to have the baby at Bartlett Regional Hospital in Juneau, she said.

"At this point, I'm probably for the road," Murphy said. "With young children, you feel a little bit insecure. What if something should go wrong and the weather's bad and the ferry's not operating?"

Murphy said she is torn because she doesn't want the road to ruin Skagway's small-town existence.

"It would be really sad if the road came through Lower Lake," Murphy said. "I love it up there, and I know so many people that enjoy going up there and having a quiet time and getting away from the craziness of Skagway. Having cars go by you every 20 minutes is really disenchanting."

Jamie Bricker of Skagway is 26 weeks pregnant. She said the state government should either improve transportation to Juneau or work with the Canadian government to allow women in Haines and Skagway to have babies in Whitehorse again.

MacNicol, the Whitehorse obstetrician, said the Canadian Medical Protection Association had promised him that it would work out a plan that allows Canadian doctors to see Alaska patients again. But until that happens, pregnant women from Haines and Skagway will keep seeking maternity care elsewhere.

Magee is planning to have her baby at the Juneau Family Birth Center. She said she is excited but cannot help worrying about the huge hotel expenses and temporary separation from her husband.

"I want there to be a road," Magee said. "If there were a road, he could just drive me to the birth center."

• I-Chun Che can be reached at ichun.che@juneauempire.com.



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