Study aim: Comparing the effects of virtual reality and SP6 acupressure on labor pain and anxiety in nulliparous women during the active phase of labor. Design: Randomized controlled clinical trial with three parallel groups and pretest-posttest design. Settings and conduct: Study setting: Labor wards of Hazrat Abolfazl and Motazedi hospitals, Kermanshah. Eligible primiparous women (37–42 weeks, active labor, dilatation >6 cm) will be randomized into three groups: 1) VR group: 20-minute VR headset use with nature scenes and relaxing audio; 2) Acupressure group: SP6 point pressure applied by a researcher for 15 minutes (3–5 min intervals) until 8 cm dilatation; 3) Control: Routine care Participants/Inclusion and exclusion criteria: Inclusion criteria: Nulliparous women, 37–42 weeks singleton pregnancy, cephalic presentation, intended vaginal delivery, active labor (cervical dilatation >6 cm), and providing informed consent. Exclusion criteria: Indicated cesarean section or acute maternal/fetal complications during labor. Intervention groups: Participants will be randomly allocated into three parallel groups: 1) Virtual reality group (VR intervention); 2) SP6 acupressure group (acupressure at SP6 point); 3) Control group (routine intrapartum care). Main outcome variables: Outcomes: Labor pain intensity (Visual Analog Scale - VAS); labor anxiety (State-Trait Anxiety Inventory - STAI).