UDMessenger

Volume 12, Number 2, 2003


A commitment to public service

"The Wind breathed life...the beautiful baby girl lay on her cradle board built of amber sun beams with a canopy made from the rainbow.... She is given freshly blessed corn pollen and suckles the dew of wildflowers. Her body grows healthy, her spirit strong and her mind in harmony with nature...and on the fourth day, she becomes a woman. This is the creation story of Changing Woman." A Navajo legend

They call themselves the "Di Neh" but outsiders named them the Navajo people. And, for the past year, Cynthia Opderbeck, HNS '81, has been providing prenatal care, delivering their babies and absorbing their culture as midwife and coordinator of the Fort Defiance Indian Hospital's gestational diabetes program on the Navajo reservation in northeastern Arizona.

The Navajo once had a beautiful, spiritual way of life, with plenty of exercise and good foods, Opderbeck says. But, the serious disruption of their culture by the West--bringing a sedentary life with little or no exercise and a diet with greater amounts of junk food--has contributed to health problems.

"Diabetes, an epidemic of rapidly mounting proportions in the United States and in the world, is growing significantly in the Native American population. The Navajo--by genetic predisposition and with the changes in traditional diet and activity--are very susceptible to type II diabetes mellitus. It's often first discovered in pregnancy, and these moms and their babies are at a higher risk for complications," she says. Uncontrolled blood sugar during pregnancy puts the baby at risk for abnormalities.

A museum on the reservation recounts the history of Fort Defiance and the Navajo people, and Opderbeck says it's a beautifully done portrayal of what happened to people and the land the Navajo once called "Tséhootsooí," or meadow between the rocks.

According to Harrison Lapahie Jr., a Navajo and chronicler of that nation's history, the area that is now Fort Defiance was once treasured by the indigenous people as a place where they could meet to graze their animals, have horse races and toss white shells and turquoise into its bubbling springs as payment for blessings.

Then, according to Lapahie, the U.S. Army established Fort Defiance as Arizona's first military post for patrolling Indian territory. Later, it was used to carry out Kit Carson's "scorched Earth policy." Soldiers shot Navajo livestock and horses, burned their homes and possessions and began exterminating the people. At first, the Navajo hid, but as they began to starve and freeze, they surrendered.

Today, the area houses the Fort Defiance Indian Hospital, a 36-bed facility, staffed by physicians, psychiatrists, nurse midwives and practitioners, dentists and optometrists, providing emergency and ambulance services for more than 100,000 patients each year.

The Indian Hospital is where Carl Opderbeck, Cynthia's obstetrician/gynecologist husband, found himself, in 1984, when he signed up for an American College of Obstetricians and Gynecologists program to relieve doctors in understaffed areas. Cynthia joined him for the last week of his service.

They fell in love with the land, the Navajo, their history and culture. But, at the time, he was working in private practice in Wilmington and Newark, she was earning her master's degree in nurse midwifery and her certification as a midwife at the University of Pennsylvania and they were raising a family. So, they stayed in Delaware. Nearly two decades would pass before they would feel free to commit to Fort Defiance.

For Cynthia, midwifery is more than just a birthing choice.

"A mother who is as happy as is possible with her birth experience is a mother who is optimally capable of bonding with, of falling in love with, her baby, and that is a wonderful beginning for the new family. The father of the new baby is encouraged and supported from the first in his involvement, and his support of the mother of his baby and his happiness at the birth is a gift to both mother and baby," she says.

Pregnancy and childbearing are physiological and healthy events in the life of a woman, not pathology waiting to happen, Opderbeck says.

"A woman who feels she is doing a good job carrying, nurturing, bearing and caring for her new baby is a woman who feels herself growing in strength and maturity. There are those who feel--I am one--that a happy and satisfying birthing experience is essential to the growth and development of the childbearing woman."

And, childbearing with a midwife is safe, Opderbeck says. Only about 20 percent of the women in this country develop complications during pregnancy and/or childbirth that would require the medical care of an obstetrician.

In the late 1980s, Carl decided to establish a solo practice in Newark and Cynthia became his office nurse, collaborating midwife and practice administrator.

In 1990, the Opderbecks were asked to provide health care for pregnant women in the Delaware Women's Correctional Institution. Cynthia jumped at the chance.

"This was such an area of need and the women responded so well to the care and attention. They were so appreciative," she says.

She provided the women with care from the beginning of their pregnancies through delivery, after which the babies were sent to live with relatives or put in foster care.

All inmate deliveries were at St. Francis Hospital in Wilmington. Then, in 1993, St. Francis became the first medical facility in the state to grant private privileges to a midwife to deliver babies, and Cynthia was that midwife. This change allowed her to follow her private prenatal patients, as well as those from the prison, through the labor and birth process. She also was providing, along with other midwives, ante and postpartum care to women through the Tiny Steps Community Prenatal Program offered by the West End Neighborhood House in Wilmington.

In 1994, the University recognized Cynthia's contributions by awarding her the Presidential Citation for Outstanding Achievement.

In 1995, Carl accepted a staff position with Bassett Hospital in Cooperstown, N.Y., and Cynthia became a staff nurse and midwife in its obstetrics/gynecology unit.

Even though it was a beautiful rural setting where they could own a farm, raise animals, rear their youngest child and live in a peaceful, natural environment, neither was completely content with the idyllic life.

Cynthia says she has always been committed to public service, and while in Cooperstown, she volunteered at the local food bank.

"What's the point if you're not going to take the gifts you've been given and help make others' lives better?" she says. "Going to work and making money just isn't it!"

In 2000, Carl and Cynthia applied for positions within the Indian Health Service, hoping to secure positions at Fort Defiance.

Carl, who was recently named chief of obstetrics and gynecology at the hospital, made the move to Arizona first in March 2002, and Cynthia and son, Chris, soon followed.

"I really feel a love for my patients. There is a patience, courtesy and stoicism among the people that is very heartening and pleasant to be with," Cynthia says.

"The beauty of the area is wonderful. We enjoy our colleagues. And, even though the cultural differences can be challenging, we feel that we are learning every bit as much as we are teaching."

--Barbara Garrison