The Effect of Virtual Reality Intervention on Labor Pain and Fear of Childbirth in Pregnant Women: A Randomized Controlled Trial.

PURPOSE: This study was conducted to examine the effects of a virtual reality (VR) intervention on labor pain and the fear of childbirth in pregnant women during the active phase. DESIGN: The parallel-group randomized controlled trial with repeated measures was performed according to CONSORT guidelines. METHODS: A total of 34 pregnant women (16 intervention, 18 control group) were enrolled in the study. Women in the intervention groups watched a 360° immersive video using a VR goggles while their cervical dilation was 6 cm and 8 cm, and their pain levels were assessed before and after the intervention using the Visual Analog Scale (VAS). The control group received only routine care. Fear of childbirth was assessed 24 hours after delivery using the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). Data were analyzed using parametric tests, and effect sizes (Cohen's d and Hedges' g) were calculated. RESULTS: In the intervention group, VR significantly reduced pain scores at both 6 cm (mean difference = 2.19, p < 0.001, Hedges' g = 0.96) and 8 cm dilation (mean difference = 1.31, p = 0.003, Hedges' g = 0.80). At 8 cm dilation, the intervention group reported significantly lower pain scores compared to the control group (p = 0.009). The mean W-DEQ scores difference was not statistically significant (p = 0.059). A moderate positive correlation was observed between post-intervention pain scores and fear of childbirth at 8 cm (r = 0.439, p = 0.025). CONCLUSIONS: VR is an effective, safe, and non-invasive method for reducing labor pain, especially in the final stages of the active phase of labor. CLINICAL IMPLICATION: The use of VR technology in intrapartum care has the potential to foster the development of innovative, patient-centered, and evidence-based care approaches in nursing and midwifery practice.