Immersive VR reduces pain and anxiety in obstetric procedures

This systematic review and meta-analysis of randomised controlled trials evaluated the efficacy of immersive virtual reality (VR) technology compared with standard care for pain and anxiety management in women undergoing obstetric or gynaecological procedures. The analysis included 5355 participants across multiple trials, with outcomes focusing on pain and anxiety scores during labour and minor procedures.

For pain scores during labour, VR resulted in a large and consistent reduction compared with standard care (standardised mean difference [SMD] -0.93; 95% CI -1.25 to -0.60). Similarly, for pain during minor procedures, VR showed a reduction (SMD -0.64; 95% CI -0.97 to -0.32). Anxiety scores also significantly improved with VR: during labour (SMD -1.13; 95% CI -1.80 to -0.45) and during minor procedures (SMD -0.74; 95% CI -1.18 to -0.29).

The findings suggest that immersive VR is a promising non-pharmacological intervention for reducing pain and anxiety in these settings. However, the analysis was limited by high levels of statistical heterogeneity and variability in procedural protocols across studies. This heterogeneity may reflect differences in VR technology, procedure types, and outcome measurement tools, which could affect the generalisability of the results.

Adverse events, serious adverse events, and discontinuations were not reported in the included studies, so the safety profile of VR in this context remains unclear. The comparator was standard care, which may include various pharmacological and non-pharmacological approaches; thus, the relative efficacy of VR compared with other specific non-pharmacological interventions cannot be determined from this analysis.

Despite these limitations, the consistent direction and magnitude of effect across outcomes support the potential clinical utility of immersive VR. The technology may be particularly beneficial during labour, where pain and anxiety are often high and pharmacological options may have limitations. Implementation strategies should consider patient preferences, resource availability, and integration into existing care pathways.

Further research is needed to standardise VR protocols, identify patient subgroups most likely to benefit, and assess long-term outcomes and safety. Establishing clinical practice guidelines will require additional high-quality trials with consistent methodologies and reporting of adverse events.

In summary, this meta-analysis provides evidence that immersive VR effectively reduces pain and anxiety in obstetric and gynaecological procedures, with large effect sizes. Clinicians may consider VR as an adjunctive non-pharmacological option, particularly for labour pain management, while remaining aware of the heterogeneity and lack of safety data.