Virtual Reality Reduces Pain in Laboring Women: A Randomized Controlled Trial

Abstract

Objective Virtual reality (VR) represents a potential method for easing labor pain and in nonpregnant patients has been shown to achieve similar or greater analgesia than hydromorphone. Few studies of VR have been performed in pregnant women. The aim of this randomized controlled trial (RCT) is to evaluate whether VR is effective in reducing pain in laboring women. Study Design An open-label, RCT of nulliparous, term women in labor in a tertiary care hospital. We included women with a pain score level of 4 to 7 having regular contractions at least every 5 minutes. We excluded women who had received any pharmacologic pain relief including neuraxial analgesia and those with contraindications to VR. Participants were randomized to up to 30 minutes of either VR or the control arm (no additional intervention). Our primary outcome was the difference in differences from pre- to postintervention pain score. Prespecified secondary outcomes included postintervention pain scores, duration of intervention use, pharmacologic analgesia use, maternal vitals, and obstetric outcomes. Results From March 2018 to February 2019, 40 subjects were enrolled, randomized, and completed the study; 19 were randomized to control and 21 to the VR arm. Most baseline characteristics were similar between groups. For the primary outcome, those assigned to the control arm had a statistically significant increase in pain of +0.58, while the VR arm had a significant reduction in pain of −0.52 (p = 0.03). There was also a difference in the proportion who had a minimum clinically important difference in pain (0% control and 23.8% VR; p = 0.049). Postintervention maternal heart rate was higher in the control arm (86.8 vs. 76.3, p = 0.01). Most other secondary outcomes did not differ. Conclusion In our study, we found that VR was effective for reducing pain in women in labor as compared with those receiving no intervention. Key Points

The Effect of Showing Images of the Foetus with the Virtual Reality Glass During Labour Process on Labour Pain, Birth Perception and Anxiety

“…The study revealed that VR reduced the perceived pain level of the pregnant woman when dilatation was 9 cm. Wong et al (2020) Similarly, the randomised controlled studies by Frey et al (2019) showed that using VR during labour reduced pain. JahaniShoorab et al (2015) also determined that women who used VR in episiotomy repair experienced less pain.…”

“…As known by the researchers, there is limited number of studies that determined that effect of VR on labour pain. In these studies, pregnant women were shown ocean waves, blooming trees, crunching campfire and submarine creatures with VR (Frey et al, 2019; Wong et al, 2020). Differently, images of the mother's foetus were shown to pregnant women in this study.…”

Virtual reality experience for in utero fetal surgery: a new era of patient counselling and medical education

“…From a clinical perspective, VR has been shown to have several benefits beyond education. For example, in a recent randomised control trial, Wong et al found VR to be effective for reducing pain in women in labour as compared with those receiving no intervention 7. While the authors did not specifically study patient perception and acceptability of the VR platform, the clinical benefit suggested a direct biological effect and future studies are warranted to study the acceptability of VR by patients at the bedside.…”

Giving Birth on a Beach Women's Experiences of Using Virtual Reality in Labour A Pragmatic Mixed Methods Approach

“…Virtual reality is used in a variety of healthcare settings focusing on pain attenuation, anxiety and distress while undergoing painful medical procedures for paediatric and adult patients such as burn wound care, physical therapy, chemotherapy, dental procedures and routine procedures such as venipuncture and intravenous placement (Aminabadi et al, 2012;Gold et al, 2006;Hoffman et al, 2011;Piskorz & Czub, 2017;Schneider & Workman, 2000;Tashjian et al, 2017). Very recently, VR has been used in labour and birth (Cowles et al, 2019;Frey et al, 2018;Pratiw et al, 2017;Wong et al, 2020) due to its combination of visualisation, hypnotic and meditative features which are regarded as optimising relaxation and pain attenuation and decreasing anxiety in labouring women.…”