While procedural abortions are common outpatient procedures, achieving optimal pain and anxiety relief remains challenging, especially when pharmacologic options such as moderate sedation or general anesthesia are limited. Many patients also wish to avoid the potential risks and inconvenience associated with these options. Exploring alternative or adjunct methods for outpatient pain and anxiety control may improve patient experiences and acceptability.

Virtual reality (VR), a rapidly advancing technology, has shown promise for pain and anxiety control in various medical settings, including obstetrics and gynecology. However, there are no published studies evaluating the effect of VR on pain during a procedural abortion. We will conduct a two-arm open label randomized controlled trial with the control arm being the usual care protocol for pain and anxiety, which at the study site includes oral analgesics, cervical block, and nonpharmacologic supportive measures such as verbal reassurance, handholding, stress balls, and distraction techniques. The intervention arm is the use of the Meta Quest 3S VR headset displaying a meditative nature video during the procedure, in addition to usual care methods. Our overall goal is to evaluate whether this noninvasive, low-risk intervention using a VR headset can reduce pain and anxiety and improve patient satisfaction during first trimester outpatient procedural abortions without IV sedation at Planned Parenthood of Western Pennsylvania (PPWP).