Effect of Music on Labor and Delivery in Nulliparous Singleton Pregnancies: A Randomized Clinical Trial

Arch Gynecol Obstet. 2020 Mar;301(3):693-698. doi: 10.1007/s00404-020-05475-9. Epub 2020 Mar 3.


Background: Women's experience of pain during labor varies greatly, and pain control is a major concern for obstetricians. Several methods have been studied for pain management for women in labor, including drug and non-drug interventions.

Objective: To test the hypothesis that in nulliparous women with singleton pregnancies at term, listening to music would reduce the pain level during labor.

Methods: Parallel group non-blinded randomized clinical trial conducted at a single center in Italy. Nulliparous women in spontaneous labor with singleton pregnancies and vertex presentation admitted in labor and delivery room between 37 0/7 and 42 0/7 weeks of gestation for active phase of labor were eligible, and were randomized in a 1:1 ratio to receive music during labor or no music during labor. Music in labor was defined listening to music from the randomization until the delivery of the baby. The primary endpoint was the pain level during the active phase of labor, recorded using the visual analogue scale (VAS) for pain, ranging from 0 (no pain) to 10 (unbearable pain). The effect of music use during labor on each outcome was quantified as the mean difference (MD) with 95% confidence interval (CI).

Results: During the study period, 30 women agree to take part in the study, underwent randomization, and were enrolled and followed up. 15 women were randomized in the music group, and 15 in the control group. No patients were lost to follow up for the primary outcome. Pain level during the active phase of labor was scored 8.8 ± 0.9 in the music group, and 9.8 ± 0.3 in the control group (MD - 1.00 point, 95% CI - 1.48 to - 0.52; P < 0.01). Music during labor and delivery was also associated with a decreased pain at 1 h postpartum (MD - 2.40 points, 95% CI - 4.30 to - 0.50), and decreased anxiety level during active phase of labor (MD - 19.90 points, 95% CI - 38.72 to - 1.08), second stage of labor (MD - 49.40 points, 95% CI - 69.44 to - 29.36), and at 1 h postpartum (MD - 27.00 points, 95% CI - 47.37 to - 6.63).

Conclusion: In nulliparous women with singleton pregnancies at term, listening to music reduces the pain level, and the anxiety level during labor.

Trial registration: Clinicaltrials.gov NCT03779386.

Keywords: Birth; Delivery; Labor; Neonatal; Pregnancy; RCT; Women’s health.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anxiety / therapy*
  • Female
  • Humans
  • Italy
  • Labor Pain / therapy*
  • Labor, Obstetric* / psychology
  • Music Therapy*
  • Music*
  • Pain Management / methods
  • Parity
  • Postpartum Period
  • Pregnancy
  • Pregnancy Outcome
  • Treatment Outcome
  • Visual Analog Scale
  • Women's Health

Associated data

  • ClinicalTrials.gov/NCT03779386