Women in Labor Sport VR Headsets to Ease Pain

Elizabeth Millard

February 07, 2020

Women who used a virtual reality (VR) headset to watch relaxing immersive scenes — such as a walk through a forest or along a beach — experienced a reduction in labor pain, according to results from a randomized controlled study.

"In a relatively short-term intervention, we were seeing considerable pain reduction among women in labor using VR, even those above a 7 on the pain scale," said Melissa Wong, MD, a maternal–fetal medicine subspecialist at Cedars-Sinai in Los Angeles.

"Initially, I came into this as a skeptic, but now I'm very interested in seeing this as a complementary option for controling labor pain," she told Medscape Medical News.

For their study, conducted from March 2018 to February 2019, Wong and her colleagues looked at 40 women whose contractions were at least every 5 minutes and who had a pain score of at least 7.

None of the participants received any pain medication, including epidural anesthesia, and use of the VR was voluntary, Wong reported at the Society for Maternal–Fetal Medicine 2020 Annual Pregnancy Meeting in Grapevine, Texas.

The 21 women in the VR group experienced a significant reduction in pain, whereas the 19 women in the control group, who received no intervention, experienced a significant increase (–0.52 vs +0.58; P = .03).

Blood pressure was unchanged during the VR period, but postintervention heart rates were lower in the VR group, which could be an indication of less sympathetic activation, Wong noted. There was no difference in other baseline parameters, including cervical dilatation, between the two groups.

I came into this as a skeptic, but now I'm very interested in seeing this as a complementary option for controlling labor pain.

The VR scenes presented to the women were related to nature or had previously been found to be soothing. Some women watched a crackling campfire, for example, and others watched waves on a beach or a tree with its trunk and leaves gently swelling and receding.

The contractions of some women synched up with the movement of the virtual scenes. "This is a strong indication that pain is more than somatic; there is a sensory component than can be addressed," Wong said.

"It's possible that for some patients, this could delay use of an epidural. There is absolutely something about the mind–body connection when it comes to pain, and use of VR could be an option that taps into that," she explained.

Potential Addition to Labor Rooms

This type of technology is already being used in the medical community in a number of applications, such as for those who have had a brain injury or stroke and for general pain management, said Wong. However, this is one of the first attempts to use VR to reduce pain during labor.

"We're looking forward to more studies and trials on this, because there's tremendous interest from women in complementary labor options, like hypnobirthing and acupressure," she said.

This strategy could also increase alertness and engagement during labor because it might give women an opportunity to rest without the use of narcotics, said G. Thomas Ruiz, MD, an obstetrician–gynecologist at the MemorialCare Orange Coast Medical Center in Fountain Valley, California.

The short-term use of narcotics during labor is common and doesn't tend to add to addiction concerns, but it does cause changes in the fetal heart rate, which is not ideal, he told Medscape Medical News.

"This study is very promising," Ruiz said. It gives "women another option to create a state of mind in which the pain is still present but they're able to disconnect from it."

"This seems to be similar to the type of breathing and focusing techniques seen with hypnotherapy, where a woman is able to distract herself from the pain, which alters the perception of her pain level," he added.

Wong and her colleagues are planning a more extensive study with additional participants to determine the effect of VR over longer time periods during labor.

Society for Maternal–Fetal Medicine (SMFM) 2020 Annual Pregnancy Meeting: Abstract 39. Presented February 7, 2020.

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