Women’s Health and Mindfulness Care
An Interview with Dr. Sara Paiva
Sara Paiva is a Medical Doctor from Brazil who got her PhD in Physiology at Georgetown University in the United States of America. She is an Ob/Gyn at the UFMG University Hospital in Brazil and a Professor at the UFMG School of Medicine, where she conducts research projects using mindfulness meditation to reduce stress, anxiety, and improve quality of life and general wellbeing. She currently lives in the USA, where she is an Adjunct Professor at Georgetown University and teaches Women’s Health in the Americas for the Women and Gender Studies Program. I met Dr. Paiva at Georgetown University where she accepted to answer a few questions about her work and how she encompasses mindfulness in both her life and medical practice.
10 Marzo 2025 – Intervista, Nascita, RicercaTempo di lettura: 12 minuti
10 Marzo 2025
Intervista, Nascita, Ricerca
Tempo di lettura: 12 minuti
Why did you decide to specialize in Obstetric and Gynecology?
My passion for women’s health stems from my own experiences. As the only daughter in a Brazilian family, I witnessed firsthand how women are often undervalued in a patriarchal society. This inspired me to pursue Obstetrics and Gynecology, to offer compassionate care and advocacy for women.
According to recent research, one third of women who give birth has a traumatic experience, and several women denounce episodes of obstetric violence during childbirth. In Brazil and in the United States childbirth is highly medicalized and medical interventions are the norm also in the event of physiological pregnancies. As a woman and as an Ob/Gyn who is sensitive to the topic of violence, what is your opinion on trauma, obstetric violence, and over-medicalization of childbirth, and how are they related?
In my medical practice, I’ve witnessed obstetric violence in both Brazil and the USA. The prevailing norms in both countries prioritize medicalized childbirth, often disrupting natural processes for the sake of speed or control. This over-medicalization increases the risk of trauma, leading some women to forgo future pregnancies due to PTSD.
You teach a course on “Women and Health in the Americas” in the Women and Gender Studies Program at Georgetown University. Could you describe the current situation and challenges for women in the Americas, and how reproductive care should and could be improved?
While the United States has made significant strides in women’s rights, including sexual and reproductive freedom, there’s still a critical need to protect these rights. Access to safe abortion remains a fundamental issue, both in the US and globally, and we must continue to advocate for policies that ensure all women have control over their own bodies and futures.
You hold a Medical Degree from the Federal University of Minas Gerais (UFMG), you did an Ob/Gyn Residency at Maternity Oldete Valadares (FHEMIG), you have both a Master and a PhD Degree from Georgetown University and a Post-Doctorate degree from the Federal University of Minas Gerais (UFMG). You have worked extensively in Brazil and the United States, and you even did an internship at Spedali Civili in Brescia, Italy. According to your experience, what are the main differences among these realities and contexts for what is concerning maternal care?
My journey through medical schools and hospitals in Brazil, Italy, and the United States has been a fascinating exploration of cultural differences in healthcare. While the core goal of alleviating suffering remains constant, the methods vary. The US prioritizes advanced technology, while in Brazil and Italy I found a greater emphasis on the art of medicine – using words and touch to understand and connect with patients.
You conduct mindfulness workshops for both patients and health care professionals: could you explain us how mindfulness works and how these trainings are usually organized?
Mindfulness, an ancient practice rooted in Buddhist tradition, involves cultivating focused attention on the present moment. Using the breath as an anchor, we learn to observe our thoughts and sensations without judgment. This practice fosters self-awareness, reduces stress, and enhances overall well-being. Mindfulness-based programs typically involve weekly group sessions (2 hours in-person or 1 hour online) over 8 weeks. Each session includes guided meditation, group discussions, and practical exercises to integrate mindfulness into daily life, such as mindful eating, journaling, and gratitude practices.
How do you work with health care professionals and what are their main needs?
In my years as a doctor, I’ve collaborated closely with a diverse team of healthcare providers, from nurses and therapists to social workers. Health care professionals are dedicated to caring for others, but the chronic stress of our work can take a toll. Long hours, high pressure, and the emotional weight of caring for patients can lead to burnout and negatively impact our own health. We need systemic changes that address these challenges, including reasonable working hours, access to mental health resources, and a culture that prioritizes the well-being of healthcare providers. In the meantime, we must advocate for ourselves and our colleagues by prioritizing self-care practices like exercise, leisure activities, and hobbies.
Health care professionals may suffer from vicarious trauma. In your experience, what could help doctors, nurses, and midwives to better cope with vicarious trauma and with difficult situations in general?
As a gynecologist and obstetrician specializing in caring for survivors of sexual violence, I’m acutely aware of the risk of vicarious trauma. To mitigate this, I’ve developed strategies to maintain boundaries between my work and personal life. After each patient session, I take time to pause, reconnect with myself, and prioritize my mental health. This allows me to return to my work refreshed and better able to provide compassionate care.
In a previous interview with Professor Bourdeau we discussed the importance of narrative medicine to help Ob/Gyn professionals to raise awareness about obstetric violence. Communication between patients and doctors does not always work as expected and patients complain about lack of empathy and lack of informed consent. In your opinion, what steps are needed to improve communication between health care professionals and their patients?
In teaching medical students and residents, I emphasize the importance of seeing the person behind the patient. I encourage them to imagine the individual before them as a loved one – a sister, mother, or friend. This fosters empathy and reminds us that effective healthcare requires not just medical expertise, but also genuine human connection.
For what is concerning patients, how can mindfulness help with infertility, and how do you usually work with people who have fertility issues?
Mindfulness offers a valuable resource for individuals experiencing infertility. This practice can alleviate the emotional burden associated with infertility, including stress related to treatments, financial strain, and the emotional rollercoaster of hope and disappointment. By fostering present moment awareness, mindfulness helps individuals cultivate acceptance, reduce anxiety, and navigate this challenging journey with greater ease.
How can mindfulness help in the event of pregnancy loss and stillbirth, and how do you work with parents who are facing these events?
Pregnancy loss can be a deeply painful experience. Mindfulness offers a compassionate approach to healing by encouraging a gentle focus on the present moment. This can help individuals process grief, reduce fear and anxiety about the future, and cultivate a sense of peace amidst difficult emotions.
How can mindfulness help during pregnancy and childbirth, and how do you work with women in labor?
Mindfulness offers expectant mothers a unique set of tools to navigate the journey of pregnancy and childbirth with greater awareness and agency. By learning to connect with their breath, body, and inner wisdom, women can reduce fear, manage pain, and cultivate a more positive and empowered birth experience. Mindfulness practices like movement and music can further enhance this process, creating a beautiful and transformative experience.
What does mindfulness mean to you?
Mindfulness has been a transformative force in my life for the past 22 years. It’s not just about my own inner peace, but also about the ripple effect it creates. I’ve witnessed how my mindfulness practice contributes to a calmer and more supportive environment for my patients, their families, and the entire birth team. As one pediatrician remarked, the atmosphere during births I attend is noticeably more tranquil, benefiting both mother and baby.
Selected publications by Dr. Sara Paiva
2015 – Impact of a short-term, mindfulness-based stress reduction program on the well-being of infertile women: a mixed-method study. (Journal of Endometriosis and Pelvic Pain Disorders)
2017 – The impact of mindfulness-based interventions on the wellbeing of cervical cancer patients on chemoradiotherapy. (Obstetrics & Gynecology International Journal)
2018 – Extremely brief mindfulness interventions for women undergoing breast biopsies: a randomized controlled trial. (Breast Cancer Research and Treatment)
2019 – Mindfulness-based program for stress reduction in infertile women: Randomized controlled trial. (Stress and Health)
2020 – Mindfulness-based program to support lifestyle modification and weight loss in infertile women: randomized controlled trial. (Journal of Psychosomatic Obstetric & Gynecology)
2021 – Mindfulness-based intervention for college faculties and students in Brazil. (Education for Health)
2021 – Mindfulness-Based Interventions for Healthcare Professional throughout the COVID-19 Pandemic: a strategy for stress reduction and mental health care (Revista Medica de MG)
2023 – Characteristics, prevalence and sources of stress in individuals who discontinue assisted reproductive technology treatments: a systematic review. (RBMO)
2024 – Online mindfulness-based intervention (eMBI) in management of dyspnea in patients with interstitial lung disease: a randomized clinical trial. (Complementary Therapies in Medicine)
2024 – Perception of gratitude during an online mindfulness-based intervention (eMBI) in patients with interstitial lung disease in Brazil: an exploratory qualitative study. (Journal of Religion and Health)
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