The loss of an unborn child is a tragic event. Unfortunately, this happens often with about 1 in 5 pregnancies ending in a miscarriage in the first 20 weeks. The experience of an involuntary pregnancy loss, even in early stages, has been shown to be linked to persistent symptoms of post-traumatic stress, anxiety, and depression, which can seriously hamper the daily activities of individuals who experience such symptoms. Early psychological and emotional support has been shown to be key for coping with the grief and reducing the incidence of psychological disorders in the long term. However, professional psychological support for earlier pregnancy loss is often scarce or not available at health institutions, leaving the parents unprotected in such a delicate phase.

Technology-based support delivery methods arise as valid alternatives to overcome this lack of support. This is the case of Virtual Reality (VR), a technology that has been widely used in mental health applications for different disorders with very good results in terms of acceptance and effectiveness. Nevertheless, no VR paradigm has been specifically developed to provide psychological support after pregnancy loss. With the AViR project, we aim to fill this gap in the literature by proposing the development of a multi-scenario VR prototype that leverages on the adaptability of VR and traditional psychological support protocols to deliver a personalized intervention specifically targeted at perinatal grief. Specifically, we propose a protocol that encompasses 4 different virtual scenarios, each one designed to address a specific phase in the grief management process. We will use procedural generation, non-conversational empathetic avatars, and interactive narratives to deliver an experience that is personalized to each user. The virtual scenarios will be deployed in an all-in-one Head-Mounted Display to increase the level of immersion and allow the patient to be in a safe space where emotions can be freely expressed.

This exploratory project will assess the feasibility of the proposed approach by testing a prototype system in a controlled study with 20 women that suffered an early pregnancy loss in the last 6 months. Patients allocated to the treatment group will undergo an intervention that comprises 3 weekly sessions of 60 minutes for 4 weeks with the VR prototype. Patients will be assessed for symptoms of grief, post-traumatic stress, and depression before and after the intervention. The results will be compared with the ones of a control group that will receive standard care. We hypothesize that our VR paradigm will lead to a significant reduction of symptoms of psychological distress that will be significantly larger when compared to the control group.

The project that we propose is highly innovative on the target population and use of VR specifically shaped to early pregnancy loss, and opens a new avenue of research on a topic that is still silenced and seen as a taboo in our society. Hence, this interdisciplinary research has an expected impact at scientific, technological, and societal levels, namely: 1) it contributes to further understand the process of psychological recovery after an early pregnancy loss; 2) adds to the advancement of evidence-based technologies for psychological support; 3) has the potential to accelerate the resolution of grief by bringing emotional and psychological support to women that have no access to other means of support; and 4) contributes to reducing the societal and economic healthcare burden by providing tools to improve the wellbeing of patients.