Background and Objectives: Labour is a complex and very painful experience. Poorly relieved pain result in prolonged and stressful labour, maternal impatience in opting for caesarean section and postpartum complications. A positive childbirth experience has a lasting impact on the postpartum health and wellbeing of the new mothers. Music therapy has been studied to reduce labour pain perception and behaviours and provide a positive childbirth experience.
Methods: A total of 120 primiparous women in the latent stage of labour with regular contractions and dilatations less than 4 cms were included in the study and randomly divided into two groups. music group (n=60) received music therapy in the form of deep breathing and chanting exercises for one hour between each and every contraction and the control group (n=60) received only standard treatment. A 10-point visual analogue pain scale (VAS) and Behavioural Pain Rating Scale (BPRS) were measured and recorded by the investigators. Independent and paired t tests were used for statistical analysis.
Results: Independent t tests indicated that pain levels and the total BPRS scores showed statistically significant reduction in the music therapy group (p<0.001). Also, the BPRS domain scores in facial expression, restlessness, vocalization and consolation indicated significant reduction in the music therapy group (p<0.001). The domain of BPRS – muscle tone did not have a significant reduction in the music therapy group. Paired t tests revealed non-significant increase in pain scores and significant decrease in pain behaviour scores in the music group with p=0.046 and p<0.001 respectively and significant increase in both the pain scores and pain behavioural scores in the control group with p values <0.001 post intervention.
Conclusion: Chanting and deep breathing experiences as music therapy during the latent stage of labour may reduce pain perception and pain behaviours. Such music therapy interventions may provide positive experiences during child birth and could be a safe and dependable method adopted for an effective labour pain management
Keywords: music therapy, mothers-to-be, first stage of labour, pain, pain perception, pain behavioural symptoms
1. Vermelis JM, Wassen MM, Fiddlers AA, Nijhuis JG, Marcus MA. Prevalence and predictors of chronic pain after labor and delivery. Curr opin Anaesthesiolo 2010; 23(3):295-299
2. Rook JP. Labour pain management other than neuraxial: what do we know and where do we go next? Birth. 2012; 39(4):318-322
3. Phumdoung S, Good M.., Music reduces sensation and distress of labour pain. Pain Management Nursing.2003; 4(2): 54-61. http://dx.doi.org/10.1016/S1524-9042(02)54202-8
4. Fulton K B. Effects of Music Therapy on Physiological Measures, Perceived Pain, and Perceived Fatigue of Women in Early Labour. Master’s thesis; School of Music. Florida State University, Florida,2005; available at http://purl.flvc.org/fsu/fd/FSU_migr_etd-4376
5. Nilsen E, Sabatino H, Lopes MH. The pain and behavior of women during labor and the different positions for childbirth. Revista da Escola de Enfermagem da USP. 2011;45(3):557-65. http://dx.doi.org/10.1590/S0080-62342011000300002
6. Keever KJ, Shepherd P. The Use of Music in Labour: Pain Perception. Air force inst of tech wright-patterson afb oh; 1991.
7. Brownridge P. Treatment options for the relief of pain during childbirth. Drugs. 1991;41(1):69-80.
8. Codding P A. An exploration of the uses of music in the birthing process (Doctoral dissertation, Florida State University).1982.,
9. Winokur M A., The use of music as an audio-analgesia during childbirth. Unpublished master’s thesis, The Florida State University.1984.
10. Simavli S, Kaygusuz I, Gumus I, Usluogulları B, Yildirim M, Kafali H. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. Journal of affective disorders. 2014 Mar 1; 156:94-9.
11. Hosseini SE, Bagheri M, Honarparvaran N. Investigating the effect of music on labor pain and progress in the active stage of first labor. Eur Rev Med Pharmacol Sci. 2013;17(11):1479-87.
12. Browning CA. Music therapy in childbirth: Research in practice. Music Therapy Perspectives. 2001;19(2):74-81.
13. Silvestrini N, Piguet V, Cedraschi C, Zentner MR. Music and auditory distraction reduce pain: Emotional or attentional effects. Music and Medicine 2011; 3(4) 264-270.doi:10.1177/1943862111414433.
14. Hanser SB. Larson SC, O’Connell AS. The effect of music on relaxation of expectant mothers during labour. Journal of Music Therapy. 1983;20:50-58
15. Tournaire M, Yonneau AT. Complementary and alternative approaches to pain relief during labour. Advance Access Publication. 2007;4(4) 409-17 doi:10.1093/ecam/nem012
16. Good M, Anderson GC, Stanton-Hicks M, Grass JA, Makii M. Relaxation and music reduce pain after gynaecologic surgery. Pain Manag Nurs 2002;3:61-70
17. Sen H, Yanarates O, Sizlan A, Kilic E, Ozkan S, Dagli G. The efficacy and duration of the analgesis effects of musical therapy on post operative pain. Agri 2010;22:145-150
18. Ebneshahidi A, Mohseni M. The effect of patient-selected music on early postoperative pain, anxiety and hemodynamic profile in caesarean section surgery. J Alter Complement Med 2008;14:827-831
19. Simavli S, Kaygusuz I, Gumus I, Usluogulları B, Yildirim M, Kafali H. Effect of music therapy during vaginal delivery on postpartum pain relief and mental health. Journal of affective disorders. 2014 ; 156:194-9.
20. Wells C, Nown G. The Pain Relief Handbook: Self-Health Methods for Managing Pain. Firefly Books Ltd.1998
21. Boso M, Polito P, Barale F, Enzo E. Neurophysiologyand neurobiology of the musical experience. Functional Neurology. 2006;21:187-191. PMid:17367577
22. Liu YH, Chang MY, Chen CH. Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers. Journal of Clinical Nursing. 2010;19:1065-1072. Doi:10.1111/j.1365-2702.2009.03028.x