March 21, 2019

Why Cedars-Sinai is sending women in labor to the (virtual) beach

Daily Briefing

    Hospitals around the country are testing out virtual reality (VR) headsets as a way to reduce women's pain during labor, and early research suggests the technology might be effective, Andrea Peterson reports for the Wall Street Journal

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    Why more hospitals are testing VR

    Melissa Wong, a fellow in maternal-fetal medicine at Cedars-Sinai in Los Angeles who is currently leading a study of VR in labor, explained, "Women are interested in having other ways they can help cope with contractions during labor." She added that the VR headsets may help women "have some degree of control in an otherwise difficult-to-control" situation.

    For example, researchers at several hospitals are looking at whether VR can help women in the early part of labor, when pain isn't as intense. Wong noted that VR might help women avoid an early epidural—which some studies have tied to longer labors and higher risk of caesarean section. Researchers at Stanford University School of Medicine are also exploring whether VR could be used while a patient is receiving an epidural.

    That said, researchers don't view VR as a complete replacement for intravenous medication and epidurals, Peterson reports, but rather as another tool in the arsenal.

    How VR during labor works

    At Cedars Sinai, and other hospitals, VR content for childbirth is specifically designed to refocus women's attention during labor and delivery by including breathing and mindfulness exercises as well as supportive language from a "virtual doula, or birth coach," according to Wong. 

    And that was the case for Aviva Lahmany, who took part in the Cedars-Sinai VR study eight months ago during her labor. Lahmany had asked for an early epidural to ease the pain, but hospital staff advised her to wait and try VR.

    "The pain was really bad," Lahmany said. "At that point, I was willing to do anything."

    When Lahmany put on the headset and goggles she saw a blooming tree and a woman's voice instructed her to match her breathing with the movement of its leaves and branches. In the next scene, Lahmany saw waves crashing on the beach. The 30-minute session "takes you out of that hospital room," Lahamany said. And the result was positive, her pain fell from a seven to a three on a 10-point scale, and allowed her labor to progress further before receiving the epidural.

    "I was able to actually breathe," Lahamany said. "It really helped center me and calm me."  

    Early data suggest VR could ease early labor pain

    Research shows Lahmany isn't the only patient to experience effects like this.

    In a recent study published in Anesthesia & Analgesia in July, researchers found a 10-minute VR session during early labor helped reduce participants' worst pain intensity by 21% participants' time spent thinking about the pain by 43%. Women's scores of how unpleasant the pain was dropped by 34% with VR compared with those who did not use the technology.

    In addition, Banner Health recently completed an unpublished trial on the benefits of VR during early labor and found that patients who used VR were 50% less likely to use IV pain medication Stadol than the patients who didn't use VR. 

    While researchers have yet to determine how VR alleviates pain and anxiety, scientists said that the immersive nature of VR might distract patients from their pain, Petersen reports

     Is VR coming to a delivery room near you?

    More hospitals are likely to employ VR in delivery rooms in the future, especially as VR becomes more widespread and the equipment becomes more affordable, Petersen reports.

    But Petersen writes that there can be "hurdles" to using VR during labor and delivery. For one, VR can cause nausea, which is undesirable for pregnant women who are already prone to nausea. Additionally, VR isn't practical to use for extended periods of time, and labor can sometimes last days.

    Despite the negatives, one of the "selling points" of VR is that it gives patients control, as well as the chance to change their minds, Petersen writes. "If it bothers you, you can take [the goggles] off," said Michael Foley, chair of the department of obstetrics and gynecology at Banner-University Medical Center (Petersen, Wall Street Journal, 2/6).

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