Effectiveness of Gestaverso Virtual Reality Birth Preparation in Women With Previous Negative Birth Experiences

A previous negative childbirth experience may contribute to increased fear and anxiety during subsequent pregnancies. Women who have experienced a distressing or traumatic birth may develop negative expectations about future childbirth, potentially affecting their emotional well-being and confidence in their ability to cope with labor.

Conventional childbirth preparation programs provide information about pregnancy, labor, pain management, and coping strategies. However, women with previous negative birth experiences may benefit from additional approaches that address the emotional aspects of childbirth and help them become familiar with the birth environment in a safe and controlled setting.

Virtual reality (VR) offers an immersive educational experience that allows pregnant women to become familiar with different stages of labor, practice coping strategies, and develop confidence in managing childbirth-related situations. Although VR has been investigated for pain and anxiety management during labor, its potential as a prenatal preparation tool specifically for women with previous negative childbirth experiences remains insufficiently explored.

Gestaverso is an immersive VR-based childbirth preparation program designed to simulate the childbirth journey, from the onset of labor at home to hospital admission, labor progression, and birth. The program combines visual, auditory, tactile, and sensory stimuli with professional guidance from a trained midwife.

This multicenter, randomized controlled trial will compare Gestaverso with usual childbirth preparation provided by midwives. Participants will be randomly allocated to two parallel groups in a 1:1 ratio.

The Gestaverso intervention consists of one individualized 60-minute session, including a 10-minute briefing, approximately 40 minutes of immersive VR simulation, and a 10-minute debriefing. The experience is guided by a midwife certified in Gestaverso training and adapted to the participant's individual needs.

During the simulation, participants will experience different childbirth scenarios, including the onset and progression of contractions at home, the transition to the hospital, admission procedures, and the different stages of labor. They will practice breathing, relaxation, movement, pain management strategies, and communication with healthcare professionals. The birth partner will also be involved in learning supportive techniques.

The control group will receive usual childbirth preparation delivered by midwives through group-based educational sessions, either in person or online. These sessions address third-trimester symptoms, signs of labor, types of birth, contraction management, breathing techniques, and pelvic movement.

The study will be conducted at three hospitals in Spain: HM Puerta del Sur, HM Nuevo Belén, and HM Montepríncipe.

The study aims to determine whether Gestaverso can reduce fear of childbirth and improve the childbirth experience compared with usual childbirth preparation in women with previous negative birth experiences. It will also explore participants' satisfaction with and acceptance of virtual reality as a childbirth preparation tool.