Most Americans born in this country have a birth certificate issued from a hospital. But, for a lot of Navajos born in remote areas of the Navajo Nation before the 1970's, it was common to be born at home. So, getting a birth certificate later - otherwise known as a "delayed birth certificate" - can be very difficult. That's especially true in Arizona because of its strict regulations.

About 8 years ago, Matilda Perdue decided to help Navajos through this lengthy process because she heard all their stories. "A lot of these folks, they've done it for 10 years, 20 years, some 30 years and have gotten nowhere."

Recently, she helped an elderly Navajo gentleman, Bennie Bedane, who drove over an hour and a half to get to her office. For Bedane to even have a chance of getting his birth certificate, he needs to prove that he was born in Arizona.

He says he was, in 1934, at home, far from any hospital. "From where I lived, it's about 60 miles," Bedane says. "Dirt roads, no paved. But mostly wagons. It takes days."

Bedane has his Navajo Census record, but that's just one document. Matilda Perdue says he needs many more. "He would need to provide 4, 5, maybe 6 documents with the same name, the same date of birth, the same mother's name, and the same father's name all across these documents," she says.

And this is where confusion comes in because first and last names were sometimes changed later. That's what happened to Bedane when he joined the army during the Korean War. "I went to change my name," he says. "But the Census Office don't have that record. That's not right."

Without a birth certificate, people risk eligibility for many things - from retirement and disability benefits, to medical care. That's why Matilda Perdue's guidance is so vital to people like Bennie Bedane. And, her efforts inspired one Coconino County Supervisor to offer this same service on the Navajo Nation, closer to home for many people seeking help.

Lena Fowler is the only Navajo on the County's board. Her office is in an old, stone building about 80 miles from Flagstaff. Fowler invited Matilda Perdue to do her county health care work here 2 days a month. And on those days, a line forms outside before the office even opens.

"Today is birth certificate day in Tuba City at the Coconino County District Office," Fowler declares. While Matilda Perdue meets with clients, Fowler walks around the crowded waiting room making sure everyone is comfortable. She says one man told her he'd been trying for 6 years to get his birth certificate. "He burned all the papers that he had accumulated because he was so frustrated," she says. "Then, he recently received a letter saying if you don't show your birth certificate, it's going to jeopardize your retirement benefits."

Fowler says she became so frustrated with stories like this that she finally contacted state officials about a year ago. "It took a while," she says, "calls and emails - for the state to acknowledge that there was actually an issue that Native Americans were having a very difficult time obtaining their birth certificates.

The Navajo Nation stretches across 3 states, but only in Arizona are the rules so stringent for getting a delayed birth certificate, and they haven't been updated in 25 years. Arizona's Department of Health Director Will Humble says that may soon change - in the form of a new policy statement. "The efforts that we're going through now would give the county health departments clear guidance about what kind of tribal documents would get applicants delayed birth certificates," he says. "But right now, that guidance doesn't exist." Humble says the new policy would drastically cut down on the number of documents required, and would apply to all 22 tribes in Arizona. He says, "What we hope this will do is make it a one stop shop."

County Supervisor Lena Fowler says she's happy with the progress, but hopes for something more permanent - a change to state regulations. And Fowler admits, the issue is very personal for her.

Fowler grew up on the Navajo Nation, near her current office in Tuba City. But there's still a long, winding, dirt road that leads to her family's home, where her mother still lives.

It sits between 2 mesas in the remote high desert. "We have several sheep corrals, there's one way out there on that hill," Fowler points out. "We have our horse corral, and then we have our shade house here."

Lena Fowler was the first in her family to be born in a hospital. That's why she has her birth certificate. "My older sisters, they do not have birth certificates. My mother doesn't have a birth certificate. My uncle, my aunts...they all don't have birth certificates," she says.

Fowler's older sister, Elizabeth, who's visiting on this day, says because she was born here - at home - her only official proof of birth is with the Navajo Census Office. But, there was a mix-up, she says, when the family first registered her. "My Uncle Jimmy said that when they went to register me, they asked when my birth date was, and he figured they were asking for his birthday, so he said his birth date." It wasn't until Elizabeth's first visit to a hospital that her father listed her actual birthday. She hopes that discrepancy won't work against her when she eventually applies for a delayed birth certificate. "I still want to try when it becomes easier," she says, "because I'm going to be applying for Social Security. And I'm sure with 2 different birth dates, they don't want me," she laughs.

Outside, Coconino County Supervisor Lena Fowler points to where her umbilical cord is buried. It's a Navajo tradition that connects her to home. "Mine is burned right over there in the sheep corral," she points out. "All my children's baby cords are here." Fowler says for her - and her family - that's how they really know who they are and where they're born. "That is proof for us," she says, "and probably more important than a birth certificate. But to the state and the legal system, we need a birth certificate."