During a recent trip to the Navajo Nation, Window Rock, Arizona, to attend a birth as a certified nurse midwife, I experienced a contentious, Catch 22 situation faced by many indigenous health workers trying to provide services to marginalized communities. The sovereign territory of the Navajo Nation overlaps New Mexico, Arizona and Utah. I knew full well that catching this baby in the wrong state--but still working within the primary boundaries of Navajo Nation--could potent