Music during pregnancy

“Mothers-to-be who listen to lullabies, classical music and sounds of nature are less likely to feel stressed about their pregnancy,” reports the Daily Mail . A study that “split pregnant women into two groups, with 116 given music CDs and 120, in the control group, receiving normal pregnancy care” found that after two weeks “those in the music group were far less stressed, depressed or anxious,” the newspaper says.

Although this study did show that there was a small reduction on the stress scale for the women who listened to music, the design of the study meant that both the women and the researchers knew who was in which group, and this could have influenced the results. Also, the women were not selected because they had been diagnosed with anxiety or depression disorders, therefore the results may not apply in this group. However, as music is easily accessible to all, if pregnant women find that listening to music helps them to relax, then there is no harm in doing so; and there may even be benefits.

Where did the story come from?

Mei-Yueh Chang and colleagues from Kaohsiung Medical University and the Chi Mei Medical Center in Taiwan carried out this research. The study was funded by the National Science Council of Taiwan. The study was published in the peer-reviewed medical journal, Journal of Clinical Nursing .

What kind of scientific study was this?

This was a randomised clinical trial looking at the effects of music therapy on stress, anxiety and depression in pregnant women.

The researchers enrolled 241 pregnant women attending a medical centre in Taiwan between September 2002 and February 2003. To be included, the women had to be in the 18th to 22nd or 30th to 34th weeks of pregnancy (second or third trimester), and expecting to have a normal vaginal delivery. The women were randomly assigned to receive either music therapy in addition to routine care, or just routine care alone.

Women assigned to music therapy were given a CD of music and asked to listen to at least 30 minutes a day for two weeks. There were four different CDs available consisting of 30 minutes of lullabies, classical music, nature sounds or “crystal music” (Chinese children’s rhymes and songs). All of the music had a tempo of 60 to 80 beats per minute, the same as the human heart. The women kept diaries to record what they listened to, and what they were doing while they listened.

At the start of the study, women completed a questionnaire about their characteristics, such as their age, education, occupation, social class and religion. Women’s psychological health was assessed before and after the study, using three measures: the Perceived Stress Scale (scores range from 0 to 40), the State Scale of State-Trait Anxiety (scores range from 20 to 80 points), and the Edinburgh Postnatal Depression Scale (scores range from 0 to 30 points). The researchers then compared changes in these measures over time between the music therapy and routine care groups.

What were the results of the study?

Of the 241 women randomly assigned, 236 completed both the before- and after-study assessments. There were no differences between the music therapy and control groups in their characteristics at the start of the study, including their levels of stress, anxiety or depressive symptoms. Women in the music therapy group listened to the lullabies most often, followed by the nature sounds, crystal music and classical music. They usually listened when they were at rest, at bedtime or while doing chores.

After two weeks of music therapy, the women in the music therapy group had reduced levels of stress, anxiety and depressive symptoms (between about a 1.5- to 2-point reduction on each measurement scale). After two weeks of routine care, the women’s levels of stress had reduced (by about 1 point) but not levels of anxiety or depression. Music therapy reduced stress, anxiety and depressive symptoms more than routine care alone (by between roughly 1 to 3 points on the measurement scales).

What interpretations did the researchers draw from these results?

The researchers concluded that their study “provides preliminary evidence that two-week music therapy during pregnancy provides quantifiable psychological benefits”. They suggest that their results “could be used to encourage pregnant women to use this cost-effective method of music in their daily life to reduce their stress, anxiety and depression”.

What does the NHS Knowledge Service make of this study?

This study should be seen as very preliminary, and the following points need to be taken into account:

• The women in this study were not selected because they had clinically diagnosed anxiety or depression disorders. Therefore the results cannot be extrapolated to pregnant women who have these serious conditions.
• The differences between the music therapy and control groups, although statistically significant, were relatively small (between 1 to 3 points on the measurement scales, which had 30- to 60-point ranges). It is unclear exactly what the implications for changes of this size could be.
• The study only lasted for two weeks, and it is unclear whether these results would be maintained in the longer term.
• The women could not be blinded to what treatment they were receiving. If they knew what the aims of the study were, this may have affected how they reported their levels of stress. In addition, the researchers themselves were not blinded to which group the women belonged, and this may have produced biased results.
• It is not clear whether it is resting while listening to music that is beneficial, or the music itself. It is also unclear whether different types of music would have different effects.

Relaxation is important for everyone, including pregnant women. As the authors report, listening to music is not expensive, and if pregnant women find that it helps them relax then there is no harm in doing so; and it may even bring benefits.