After working as an independent obstetrician and gynecologist in the area for the past 10 years, Dr. Seema Nayak has joined the Care for Her team at MCHC Health Centers.
For years, Nayak operated a private practice, delivered babies, and performed surgeries at Adventist Health Ukiah Valley, but as other obstetrical providers retired or moved away from the area, Nayak was left without a partner, requiring her to be on-call for her patients day and night without a break.
Rural areas all over the country are struggling to attract and keep medical providers, especially obstetricians. According to the American College of Obstetricians and Gynecologists,
50 percent of US counties do not have an ob-gyn, and more than half of women in rural communities live more than 30 minutes away from a hospital offering perinatal services.
As Nayak considered her options, she did not want to abandon the community she considered her second home. “Before I burned out, I wanted to make a change that would allow me to stay here,” she explained.
Nayak came from a medical family in India and growing up, she saw first-hand what happened in poor, rural areas without enough medical care for women. She decided early to pursue a medical degree in hopes of reducing the health disparities between classes and to empower women to make informed choices about their bodies.
After Nayak finished her medical residency at the University of Toledo in Ohio, she was interested in moving to the San Francisco Bay Area but when an opportunity in Ukiah came open, it piqued her interest. “To be honest, I had never heard of Mendocino County,” she said. I had to look it up on a map. Now, however, she says “the size and speed of Ukiah is less stressful than the Bay Area, and I love the pace and quality of life here.”
At her private practice, Nayak provided the full spectrum of ob-gyn care, including handling routine visits and low-risk deliveries. She performed many types of procedures including Cesarean sections, hysteroscopic surgeries, laparoscopies, and hysterectomies. She also worked with patients to diagnose and manage pelvic floor issues, abnormal bleeding, perimenopausal symptoms, and menopause.
Over the years, she had gotten to know many of the certified nurse-midwives at Care for Her, but it was not until the pandemic that she began working more closely with them to support patients in the hospital. It was a great informal partnership, so they decided to make it official.
As a physician at Care for Her, Nayak says she is “surrounded and supported by a team, and I can complement the midwives by focusing on high-risk situations and emergencies. Together we are able to provide excellent care for the community.”
One of the reasons Nayak is so passionate about caring for high-risk patients is because she had a complicated pregnancy herself that required her to be on bedrest. “That really changed my personal and professional outlook,” she said. “I can really empathize with people experiencing infertility as well as complicated pregnancies.”
Also, as a woman of color, she feels she can relate to her patients who belong to racial minority groups. She said, “As a person of color, I feel strongly about equalizing the balance.” In the US, Black women are three times more likely to die from a pregnancy-related cause than white women, for example. The good news is, a number of studies have shown that when a minority patient is treated by a minority doctor, they tend to have better health outcomes. Today, there are more Black, brown, and Indigenous doctors than ever.
Nayak feels strongly about women having the ability to plan their pregnancies. This includes preparing one’s body and being able to choose the timing through access to contraception. She usually recommends long-acting reversible contraception such as intrauterine devices (IUDs) for people who wish to avoid pregnancy, because they are highly effective and less prone to failure when compared to interventions that require daily attention. “Outcomes are better for everyone when a pregnancy is planned,” she explained. “Having children too close together increases a lot of risks, as does having a child if you aren’t mentally, physically, or financially ready.”
Nayak says she is happy to be part of a team that provides continuity of care to all patients, something that is “more and more rare in rural communities like ours.” Care for Her is part of MCHC Health Centers, which includes Hillside Health Center and Dora Street Health Center in Ukiah, Little Lake Health Center in Willits and Lakeview Health Center in Lakeport. It is a community-based and patient-directed organization that provides comprehensive primary healthcare services as well as supportive services such as education and translation that promote access to healthcare.