Virtual Reality, Labor Pain, Anxiety, Birth Perception
Condition: Labor Pain; Anxiety
MeSH terms: Labor Pain; Anxiety Disorders
Study type: Interventional

Summary: 
      The research was carried out in a randomized controlled trial to determine the effect of
      using virtual reality glasses on labor pain, anxiety, and labor perception of pregnant women.
      60 pregnant women participated in the study at the Maternity and Children's Hospital located
      in the city center of Bolu. The data were collected via Introductory information form, Visual
      Comparison Scale-Pain, Visual Comparison Scale-Anxiety, labor follow-up form, Mother's
      Perception of Birth Scale, and virtual reality satisfaction evaluation form. Number,
      percentage, mean, standard deviation, Pearson chi-square, t-test for both groups were used to
      evaluate the data via the SPSS program. Statistical significance was accepted as p<0.05.
      Pregnant women in the experimental and control groups were found to be homogeneous in terms
      of sociodemographic and obstetric characteristics (p>0.05). At the beginning of labor, both
      pregnant groups showed similar score of the mean pain and anxiety(p>0.05). After applying 20
      minutes in the active phase and 10 minutes in the transitional phase, the mean pain and
      anxiety scores of the experimental group were found to be lower, and this difference was
      found to be statistically significant(p<0.001). In the postpartum period, it was determined
      that the birth Perception Scale mean scores of the groups were similar. 90% of the pregnant
      women reported that they were satisfied with the virtual reality application and 93% of them
      reported that they would recommend this application. As a result, the use of virtual reality
      during birth reduces pain and anxiety at birth but does not affect the perception of birth.
    

Detailed description: 
      Childbirth is one of the important experiences in a woman's life and this experience is
      affected by subjective, psychological and physiological processes. While birth is a positive
      life experience for some women , it is a traumatic and negative experience for others .

      One of the factors that most affect women who experience many emotions together during the
      birth process is labor pain. The perception and severity of labor pain, which is part of the
      normal process, varies from person to person. In the literature, it has been shown that
      50-52% of women experience severe labor pain. Severe labor pain may be associated with
      decreased uteroplacental perfusion, prolongation of labor and labor with intervention,
      postpartum depression and anxiety by causing an increase in maternal catecholamine levels.
      This leads to a prolonged hospital stay, difficulty in performing basic activities, and
      consequently a negative birth experience It also leads women who want to avoid pain to prefer
      cesarean delivery instead of vaginal delivery.

      The birth process is also an important source of anxiety in women. Studies have shown that
      women experience moderate anxiety about childbirth. It is known that anxiety experienced at
      birth affects the health of the mother, fetus and newborn negatively and increases the
      severity of labor pain. Pain that comes at frequent and intense intervals increases the
      anxiety level of the woman, leading to increased tension in the pelvic muscles, fatigue, and
      inadequate coping with pain . There is a two-way relationship between anxiety and pain in
      childbirth, and this vicious cycle between anxiety and pain negatively affects the course of
      labor, reduces the self-confidence of the pregnant woman and causes her to feel helpless and
      unsuccessful.

      Pain and anxiety are important factors affecting birth perception and birth outcomes.
      Effective management of pain and anxiety at birth for a positive birth experience is among
      the main goals of obstetric care. The most effective strategies for a positive birth
      experience; It has been reported that creating a positive birth environment, supporting women
      during childbirth, intrapartum care with minimal intervention, preparation for childbirth,
      relaxation and pain relief applications .

      Pharmacological and non-pharmacological methods are used to effectively cope with pain at
      birth. Pharmacological methods require attention in their use because of their side effects,
      application limitations, and uncertainties of their effects on the mother and fetus .

      The use of non-pharmacological methods, which are easy to apply, safe, and have various
      advantages in ensuring active participation and cooperation of women in the birth process,
      without using any medication, is becoming more common in pain management. Studies have
      emphasized that non-pharmacological methods reduce pain and anxiety levels during the birth
      process, increase maternal satisfaction at birth, and strengthen mother-infant communication.

      Distraction, focusing and relaxation by daydreaming are among the commonly used
      non-pharmacological methods in reducing pain. However, since dreaming and daydreaming can be
      difficult during the birth process, it is recommended to use applications that will
      facilitate this . For this purpose, virtual reality glasses have been used in recent years.
      With these glasses, a visual experience environment is created through three-dimensional
      videos by creating a real-like virtual world for individuals.

      It has been shown that the clinical use of virtual reality glasses, which can be used in many
      areas, is useful and reliable. These glasses are used in children during painful invasive
      procedures, acute and chronic pain management, burn treatments, preoperative anxiety,
      psychiatric diagnosis and treatment interventions, physical therapy and rehabilitation
      applications are used.

      Although virtual reality has been shown to be an effective method in the management of pain
      and anxiety, studies showing its effect on pain at birth and anxiety are limited. Based on
      these data, in this study, it was aimed to determine the effect of the video watched by using
      virtual reality glasses during labor on labor pain, anxiety and labor perception of pregnant
      women.

      Research Hypotheses H0 : Watching video with virtual reality glasses has no effect on labor
      pain, anxiety and birth perception.

      H1: Watching video with virtual reality glasses has an effect on labor pain. H2: Watching
      video with virtual reality glasses has an effect on anxiety at birth.

      H3: Watching a video with virtual reality glasses has an effect on birth perception.
    

Intervention name(s): Standard of care+virtual reality glasses
Intervention type(s): Other
Intervention description(s): At the beginning of the active and transitional phases of labor, videos were watched with virtual reality glasses.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized controlled experimental research
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: labor; pain; anxiety; birth perception; virtual reality