{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:46:56Z","timestamp":1760060816814,"version":"build-2065373602"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012285","name":"Department of Economy, Science, and Innovation of the Flemish Government","doi-asserted-by":"publisher","award":["3100R3004"],"award-info":[{"award-number":["3100R3004"]}],"id":[{"id":"10.13039\/501100012285","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Virtual Worlds"],"abstract":"<jats:p>Background: Virtual reality has been shown to reduce pain during labour. We aimed to determine whether virtual reality reduces analgesia use and shortens labour duration. Methods: A non-randomised pilot study was conducted, using a matched case\u2013control design (1:2 ratio). Cases were women who voluntarily used virtual reality alongside standard intrapartum pain management, including non-pharmacological methods and\/or epidural analgesia. Controls received standard intrapartum pain management. Results: A total of 108 women were included for analysis (36 cases vs. 72 controls). Perceived pain scores before and after virtual reality use did not differ significantly (p = 0.43, p = 0.73), suggesting a limited immediate analgesic effect under current conditions. Epidural analgesia rates and cervical dilation at initiation of analgesia did not show significant differences between cases and controls (p = 0.13, p = 0.42). After adjusting for induction of labour and cervical dilation at admission, there were no significant differences for duration of epidural analgesia (p = 0.86, p = 0.56), duration of labour (p = 0.64, p = 0.55), or vaginal birth (p = 0.23). Adjusted models indicated a non-significant trend toward shorter durations of labour, birth, and epidural exposure for cases. Conclusions: Our pilot study did not reveal a decrease in perceived pain or epidural analgesia use or an effect on duration of labour and vaginal birth.<\/jats:p>","DOI":"10.3390\/virtualworlds4040043","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T08:09:42Z","timestamp":1758614982000},"page":"43","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effects of Virtual Reality During Labour on Perceived Pain, Use of Pain Relief and Duration of Labour: A Pilot Matched Case\u2013Control Study in Belgium"],"prefix":"10.3390","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9252-4060","authenticated-orcid":false,"given":"Luka","family":"Van Leugenhaege","sequence":"first","affiliation":[{"name":"Department of Health and Science, AP University of Applied Sciences and Arts, Noorderplaats 2, 2000 Antwerp, Belgium"},{"name":"Centre for Research and Innovation in Care (CRIC), Faculty of Medicine, University of Antwerp, Campus Drie Eiken, 2610 Antwerp, Belgium"},{"name":"Immersive Lab, Department of Science and Technology, AP University of Applied Sciences and Arts, Ellermanstraat 33, 2060 Antwerp, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3169-1708","authenticated-orcid":false,"given":"Natacha","family":"Van de Craen","sequence":"additional","affiliation":[{"name":"Department of Health and Science, AP University of Applied Sciences and Arts, Noorderplaats 2, 2000 Antwerp, Belgium"}]},{"given":"Leen","family":"Vanden Bergh","sequence":"additional","affiliation":[{"name":"Department of Health and Science, AP University of Applied Sciences and Arts, Noorderplaats 2, 2000 Antwerp, Belgium"}]},{"given":"Sarah","family":"Van Vlierberghe","sequence":"additional","affiliation":[{"name":"Maternity and Labour Ward, Sint-Vincentius Hospital, Ziekenhuis aan de Stroom (ZAS), Sint-Vincentiusstraat 20, 2018 Antwerp, Belgium"}]},{"given":"Barbara Elizabeth","family":"Luten","sequence":"additional","affiliation":[{"name":"Maternity and Labour Ward, Middelheim Hospital, Ziekenhuis aan de Stroom (ZAS), Lindendreef 1, 2020 Antwerp, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0116-0738","authenticated-orcid":false,"given":"Eveline","family":"Mestdagh","sequence":"additional","affiliation":[{"name":"Department of Health and Science, AP University of Applied Sciences and Arts, Noorderplaats 2, 2000 Antwerp, Belgium"},{"name":"Centre for Research and Innovation in Care (CRIC), Faculty of Medicine, University of Antwerp, Campus Drie Eiken, 2610 Antwerp, Belgium"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4200-0522","authenticated-orcid":false,"given":"Yvonne Jacoba","family":"Kuipers","sequence":"additional","affiliation":[{"name":"Department of Health and Science, AP University of Applied Sciences and Arts, Noorderplaats 2, 2000 Antwerp, Belgium"},{"name":"Centre for Research and Innovation in Care (CRIC), Faculty of Medicine, University of Antwerp, Campus Drie Eiken, 2610 Antwerp, Belgium"},{"name":"School of Health and Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh EH11 4BN, UK"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.1016\/j.wombi.2017.09.007","article-title":"Predictors of women\u2019s positive childbirth pain experience: Findings from an Icelandic national study","volume":"31","author":"Karlsdottir","year":"2018","journal-title":"Women Birth"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1002\/ijgo.15489","article-title":"Quality of analgesic care in labor: A cross-sectional study of the first national register-based benchmarking system","volume":"166","author":"Emrich","year":"2024","journal-title":"Int. J. Gynaecol. Obs."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"215","DOI":"10.3109\/01674829609025686","article-title":"The complexity of labor pain: Experiences of 278 women","volume":"17","author":"Bergman","year":"1996","journal-title":"J. Psychosom. Obs. Gynaecol."},{"key":"ref_4","first-page":"CD000331","article-title":"Epidural versus non-epidural or no analgesia for pain management in labour","volume":"5","author":"Smyth","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e056517","DOI":"10.1136\/bmjopen-2021-056517","article-title":"Systematic review and meta-analysis to examine intrapartum interventions, and maternal and neonatal outcomes following immersion in water during labour and waterbirth","volume":"12","author":"Burns","year":"2022","journal-title":"BMJ Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s11916-016-0543-2","article-title":"New Labor Pain Treatment Options","volume":"20","author":"Koyyalamudi","year":"2016","journal-title":"Curr. Pain Headache Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"272","DOI":"10.20344\/amp.13599","article-title":"Impact of Labor Epidural Analgesia on Maternal Satisfaction and Childbirth Expectations in a Tertiary Care Center in Portugal: A Prospective Study","volume":"34","author":"Fernandes","year":"2021","journal-title":"Acta M\u00e9dica Port."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"h846","DOI":"10.1136\/bmj.h846","article-title":"Patient controlled analgesia with remifentanil versus epidural analgesia in labour: Randomised multicentre equivalence trial","volume":"350","author":"Freeman","year":"2015","journal-title":"BMJ"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Freeman, L., Middeldorp, J., van den Akker, E., Oudijk, M., Bax, C., van Huizen, M., Radder, C., Fong, B., Bloemenkamp, K., and Dahan, A. (2018). An economic analysis of patient controlled remifentanil and epidural analgesia as pain relief in labour (RAVEL trial); a randomised controlled trial. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0205220"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1046\/j.1523-536x.1999.00139.x","article-title":"Nulliparas\u2019 preferences for epidural analgesia: Their effects on actual use in labor","volume":"26","author":"Goldberg","year":"1999","journal-title":"Birth"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"100070","DOI":"10.1016\/j.ijnsa.2022.100070","article-title":"Predictors associated with low-risk women\u2019s pre-labour intention for intrapartum pain relief: A cross-sectional study","volume":"4","author":"Kuipers","year":"2022","journal-title":"Int. J. Nurs. Stud. Adv."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Van Leugenhaege, L., Degraeve, J., Jacquemyn, Y., Mestdagh, E., and Kuipers, Y.J. (2023). Factors associated with the intention of pregnant women to give birth with epidural analgesia: A cross-sectional study. BMC Pregnancy Childbirth, 23.","DOI":"10.1186\/s12884-023-05887-w"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2301","DOI":"10.1111\/jocn.15768","article-title":"The Effect of Showing Images of the Foetus with the Virtual Reality Glass During Labour Process on Labour Pain, Birth Perception and Anxiety","volume":"30","author":"Akin","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Carus, E.G., Albayrak, N., Bildirici, H.M., and Ozmen, S.G. (2022). Immersive virtual reality on childbirth experience for women: A randomized controlled trial. BMC Pregnancy Childbirth, 22.","DOI":"10.1186\/s12884-022-04598-y"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e93","DOI":"10.1213\/ANE.0000000000003649","article-title":"Virtual Reality Analgesia in Labor: The VRAIL Pilot Study-A Preliminary Randomized Controlled Trial Suggesting Benefit of Immersive Virtual Reality Analgesia in Unmedicated Laboring Women","volume":"128","author":"Frey","year":"2019","journal-title":"Anesth. Analg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1111\/ajo.13591","article-title":"Virtual reality is beneficial in decreasing pain in labouring women: A preliminary study","volume":"63","author":"Massov","year":"2023","journal-title":"Aust. N. Z. J. Obstet. Gynaecol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e167","DOI":"10.1055\/s-0040-1708851","article-title":"Virtual Reality Reduces Pain in Laboring Women: A Randomized Controlled Trial","volume":"38","author":"Wong","year":"2021","journal-title":"Am. J. Perinatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e36695","DOI":"10.2196\/36695","article-title":"The Effects of Virtual Reality in Maternal Delivery: Systematic Review and Meta-analysis","volume":"10","author":"Xu","year":"2022","journal-title":"JMIR Serious Games"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ebrahimian, A. (2022). Comparison of the effectiveness of virtual reality and chewing mint gum on labor pain and anxiety: A randomized controlled trial. BMC Pregnancy Childbirth, 22.","DOI":"10.1186\/s12884-021-04359-3"},{"key":"ref_20","first-page":"5","article-title":"Woman-centered care 2.0: Bringing the concept into focus","volume":"2","year":"2018","journal-title":"Eur. J. Midwifery"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1007\/s00404-020-05467-9","article-title":"A meta-analysis of the effects of intramuscular and intravenous injection of oxytocin on the third stage of labor","volume":"301","author":"Wu","year":"2020","journal-title":"Arch. Gynecol. Obs."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3398","DOI":"10.1111\/jocn.15865","article-title":"Efficacy and safety of non-pharmacological interventions for labour pain management: A systematic review and Bayesian network meta-analysis","volume":"30","author":"Hu","year":"2021","journal-title":"J. Clin. Nurs."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1515\/jpm-2013-0236","article-title":"Mother knows best? Comparing primiparous parturients\u2019 expectations and predictions with actual birth outcomes","volume":"42","author":"Benyamini","year":"2014","journal-title":"J. Perinat. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"5740534","DOI":"10.1155\/2016\/5740534","article-title":"The Effect of Epidural Analgesia on the Delivery Outcome of Induced Labour: A Retrospective Case Series","volume":"2016","author":"Antonakou","year":"2016","journal-title":"Obstet. Gynecol. Int."},{"key":"ref_25","first-page":"847","article-title":"Epidural anesthesia during childbirth\u2014Retrospective analysis of maternal and neonatal results","volume":"93","author":"Baczek","year":"2022","journal-title":"Ginekol. Pol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Nguyen, L.D., Nguyen, A.D., Farber, M.K., Phan, C.T., Khuat, L.T., Nguyen, H.T., Dang, T.M., and Doan, H.T.N. (2021). Sociodemographic Factors Associated with Request for Labor Epidural Analgesia in a Tertiary Obstetric Hospital in Vietnam. Biomed Res. Int., 2021.","DOI":"10.1155\/2021\/8843390"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"22","DOI":"10.3109\/0167482X.2012.760541","article-title":"Women\u2019s prelabour preference for epidural analgesia: A cross-sectional study among women from the Netherlands and Belgium","volume":"34","author":"Wassen","year":"2013","journal-title":"J. Psychosom. Obstet. Gynecol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/00000539-200001000-00024","article-title":"Predictors of recommendation and acceptance of intrapartum epidural analgesia","volume":"90","author":"Sheiner","year":"2000","journal-title":"Anesth. Analg."},{"key":"ref_29","unstructured":"Goemaes, R., Fomenko, E., Laubach, M., De Coen, K., Bogaerts, A., and Roelens, K. (2023). Perinatale Gezondheid in Vlaanderen\u2014Jaar 2022, Studiecentrum voor Perinatale Epidemiologie."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"238","DOI":"10.3109\/00016340903280974","article-title":"Epidural analgesia for labor pain: Whose choice?","volume":"89","author":"Schytt","year":"2010","journal-title":"Acta Obs. Gynecol. Scand."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1097\/AOG.0b013e3182a9c92c","article-title":"Contemporary labor patterns and maternal age","volume":"122","author":"Zaki","year":"2013","journal-title":"Obs. Gynecol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1196\/annals.1365.039","article-title":"Maternal age and the duration of the second stage of labor","volume":"1092","author":"Papadias","year":"2006","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1111\/j.0730-7659.2006.00069.x","article-title":"The impact of parity on course of labor in a contemporary population","volume":"33","author":"Vahratian","year":"2006","journal-title":"Birth"},{"key":"ref_34","unstructured":"Goemaes, R., Fomenko, E., Laubach, M., De Coen, K., Roelens, K., and Bogaerts, A. (2022). Perinatale Gezondheid in Vlaanderen\u2014Jaar 2021, Studiecentrum voor Perinatale Epidemiologie."},{"key":"ref_35","first-page":"574","article-title":"Virtual Reality as a Method to Cope with Labor Pain: What Do Women Want?","volume":"42","author":"Maes","year":"2024","journal-title":"Comput. Inf. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e376","DOI":"10.1016\/j.wombi.2020.08.002","article-title":"The comparison of the interpersonal action component of woman-centred care reported by healthy pregnant women in different sized practices in the Netherlands: A cross-sectional study","volume":"34","author":"Kuipers","year":"2021","journal-title":"Women Birth"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1213\/01.ANE.0000061581.23351.29","article-title":"The numeric rating scale and labor epidural analgesia","volume":"96","author":"Beilin","year":"2003","journal-title":"Anesth. Analg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e162","DOI":"10.4088\/JCP.17f11446","article-title":"Propensity Score Matching in Nonrandomized Studies: A Concept Simply Explained Using Antidepressant Treatment During Pregnancy as an Example","volume":"78","author":"Andrade","year":"2017","journal-title":"J. Clin. Psychiatry"},{"key":"ref_39","first-page":"448","article-title":"Transition from latent to active labor","volume":"68","author":"Peisner","year":"1986","journal-title":"Obs. Gynecol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4263","DOI":"10.1111\/jog.15053","article-title":"Spontaneous labor curve based on a retrospective multi-center study in Japan","volume":"47","author":"Shindo","year":"2021","journal-title":"J. Obs. Gynaecol. Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"102856","DOI":"10.1016\/j.midw.2020.102856","article-title":"The effect of cognitive behavioral techniques using virtual reality on birth pain: A randomized controlled trial","volume":"91","author":"Apay","year":"2020","journal-title":"Midwifery"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1002\/nur.22438","article-title":"Childbirth Journey Through Virtual Reality: Pain, Anxiety and Birth Perception: A Randomized Controlled Trial","volume":"48","author":"Boyuk","year":"2025","journal-title":"Res. Nurs. Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e12272","DOI":"10.1111\/jjns.12272","article-title":"The effect of sacral massage on labor pain and anxiety: A randomized controlled trial","volume":"17","author":"Karaduman","year":"2020","journal-title":"Jpn. J. Nurs. Sci."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5184","DOI":"10.1080\/14767058.2021.1875439","article-title":"Birthing ball for reducing labor pain: A systematic review and meta-analysis of randomized controlled trials","volume":"35","author":"Grenvik","year":"2022","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_45","first-page":"208","article-title":"Effectiveness of Birthing Ball Exercises Therapy in Improving Labor Pain and Labor Outcomes: A Systematic Review","volume":"18","author":"Phalswal","year":"2024","journal-title":"J. Fam. Reprod Health"},{"key":"ref_46","first-page":"CD003934","article-title":"Maternal positions and mobility during first stage labour","volume":"2","author":"Lawrence","year":"2009","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.midw.2010.10.013","article-title":"The relationship between prenatal control, expectations, experienced control, and birth satisfaction among primiparous women","volume":"28","author":"Fair","year":"2012","journal-title":"Midwifery"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1111\/j.1365-2648.2003.02981.x","article-title":"Factors related to childbirth satisfaction","volume":"46","author":"Goodman","year":"2004","journal-title":"J. Adv. Nurs."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1046\/j.1523-536X.2003.00253.x","article-title":"Feeling in Control During Labor: Concepts, Correlates, and Consequences","volume":"30","author":"Green","year":"2003","journal-title":"Birth"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/j.midw.2017.09.003","article-title":"\u2018It\u2019s your body, but\u2026\u2019 Mixed messages in childbirth education: Findings from a hospital ethnography","volume":"55","author":"Newnham","year":"2017","journal-title":"Midwifery"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Alakeely, M.H., Almutari, A.K., Alhekail, G.A., Abuoliat, Z.A., Althubaiti, A., AboItai, L.A.-R., and Al-Kadri, H. (2018). The effect of epidural education on Primigravid Women\u2019s decision to request epidural analgesia: A cross-sectional study. BMC Pregnancy Childbirth, 18.","DOI":"10.1186\/s12884-018-1766-5"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e118","DOI":"10.1016\/j.wombi.2020.02.009","article-title":"Exploring the medicalisation of childbirth through women\u2019s preferences for and use of pain relief","volume":"34","author":"Westergren","year":"2021","journal-title":"Women Birth"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"104329","DOI":"10.1016\/j.ijoa.2025.104329","article-title":"Factors affecting womens\u2019 attitude towards labor epidural analgesia in a culturally diverse population: A prospective patient-reported outcome study","volume":"61","author":"Goldinfeld","year":"2025","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1213\/ANE.0000000000000357","article-title":"A Prospective Observational Study Evaluating the Ability of Prelabor Psychological Tests to Predict Labor Pain, Epidural Analgesic Consumption, and Maternal Satisfaction","volume":"119","author":"Carvalho","year":"2014","journal-title":"Anesth. Analg."}],"container-title":["Virtual Worlds"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2813-2084\/4\/4\/43\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:47:31Z","timestamp":1760035651000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2813-2084\/4\/4\/43"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,23]]},"references-count":54,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["virtualworlds4040043"],"URL":"https:\/\/doi.org\/10.3390\/virtualworlds4040043","relation":{},"ISSN":["2813-2084"],"issn-type":[{"type":"electronic","value":"2813-2084"}],"subject":[],"published":{"date-parts":[[2025,9,23]]}}}