About this trial
Cesarean section is a common surgical procedure performed to deliver a baby when vaginal birth may pose risks to the mother or infant. Although it is often life-saving, recovery after cesarean section is frequently associated with multiple physical and psychological challenges, including postoperative pain, delayed gastrointestinal function, reduced mobility, fatigue, and decreased overall well-being. These factors may negatively affect a woman's ability to care for her newborn, initiate breastfeeding, and adapt to the postpartum period.
In recent years, there has been increasing interest in non-pharmacological interventions that can safely support postoperative recovery without causing additional side effects. Among these, music therapy, breathing exercises, and virtual reality applications have been identified as promising approaches. Music therapy may promote relaxation and reduce pain and anxiety through auditory stimulation and emotional regulation. Breathing exercises may enhance parasympathetic activity, improve oxygenation, reduce stress, and support gastrointestinal motility. Virtual reality applications, by providing immersive audiovisual experiences, may reduce pain perception, decrease anxiety, and improve overall comfort through distraction and relaxation mechanisms.
Although these interventions have individually demonstrated beneficial effects in postoperative care, the existing literature is limited in directly comparing their relative effectiveness within the same study design. Furthermore, most studies have primarily focused on pain outcomes, while other important aspects of recovery, such as obstetric recovery quality and gastrointestinal symptoms, have received less attention.
This randomized controlled trial aims to comparatively investigate the effects of music therapy, breathing exercises, and virtual reality application on obstetric recovery, pain, and gastrointestinal symptoms in women following cesarean section. Participants will be randomly assigned to one of three intervention groups or a control group receiving routine care. Standardized protocols will be applied for each intervention to ensure consistency.
The primary outcomes of this study include obstetric recovery, pain intensity, and gastrointestinal symptoms. By evaluating these outcomes simultaneously, the study aims to provide a more comprehensive understanding of post-cesarean recovery.
The findings of this study are expected to contribute to evidence-based clinical practice by identifying effective, safe, and feasible non-pharmacological interventions that can be integrated into routine post-cesarean care. Ultimately, this research may help improve maternal comfort, accelerate recovery, and enhance the overall postpartum experience for women undergoing cesarean section.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Women aged 18 years and older
Able to speak and understand Turkish
Gestational age between 37 and 42 weeks
Undergoing cesarean section under spinal anesthesia
Disqualifiers
Passage of flatus before the intervention
Presence of any diagnosed medical condition during pregnancy
Development of maternal postpartum complications such as postpartum hemorrhage (>1000 mL), infection, wound dehiscence, sepsis, thromboembolism, or need for intensive care
Presence of neonatal complications such as neonatal distress requiring intensive care, congenital anomalies, severe respiratory distress, infection, or perinatal mortality
Trial design
Parallel
Treatments tested in this trial
Music Therapy
BehavioralParticipants will receive music therapy using standardized audio content delivered through wireless headphones. The intervention will be applied in two sessions at the 4th and 12th postoperative hours, each lasting 20 minutes, in a quiet and controlled environment.
Breathing Exercises
BehavioralParticipants will perform guided breathing exercises under researcher supervision. The intervention will be conducted in two sessions at the 4th and 12th postoperative hours, each lasting 20 minutes, using slow and controlled breathing techniques.
Virtual Reality
BehavioralParticipants will receive a virtual reality intervention using a headset to view standardized immersive audiovisual content. The intervention will be applied in two sessions at the 4th and 12th postoperative hours, each lasting 20 minutes.
Treatment groups
Trial outcomes
Primary outcomes
Obstetric Recovery (ObsQoR-11)
Obstetric recovery will be assessed using the Obstetric Quality of Recovery Score-11 (ObsQoR-11), a validated patient-reported outcome measure evaluating physical comfort, emotional status, functional independence, and pain.
Postoperative Pain (VAS)
Pain intensity will be assessed using the Visual Analog Scale (VAS), a validated 10-cm scale ranging from no pain to worst possible pain.
Gastrointestinal Symptoms (GSRS)
Gastrointestinal symptoms will be evaluated using the Gastrointestinal Symptom Rating Scale (GSRS), which assesses abdominal pain, reflux, diarrhea, indigestion, and constipation. Higher scores indicate more severe symptoms.
Secondary outcomes
Time to First Flatus
Time to first passage of flatus will be recorded as an indicator of gastrointestinal recovery. Participants will be asked whether flatus has occurred and, if applicable, the exact time will be recorded.
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