Therapeutic art in its own right, musical care...what place should perinatal music therapy have in the obstetric field, and more particularly in preparation for childbirth ? How can collaborations be envisaged for comprehensive care of the pregnant woman and her child ?
Pregnancy is a significant and often emotionally complex phase for women. In this context, music therapy emerges as a valuable therapeutic approach, offering a space for expression, relaxation and connection between mother and child. This article explores the benefits of music therapy in preparing for birth and motherhood, while highlighting the importance of interprofessional collaboration between perinatal music therapists and the entire medical profession. I also invite you to discover concrete ways to integrate this approach within healthcare establishments or in the context of liberal activities.
Perinatal music therapy: special care for motherhood music & obstetrics
Music therapy is an integrative and relational approach in the paramedical field, characterized by the use of music in care, and care through music, to support the mental, emotional and physical health of patients. In the context of preparation for childbirth, it has proven to be a considerable asset in helping women manage stress, promote the nesting process, strengthen the connection with their body and their baby, and cultivate confidence in their abilities. Midwives, as maternal health professionals, can benefit from the integration of clinical music therapy with their patients, in order to promote rich and complementary care. music & obstetrics
The benefits of music therapy
The benefits of music therapy in preparing for motherhood are as follows :
Reduced Anxiety and Stress : Music has a calming effect on the nervous system, helping to alleviate anxiety associated with childbirth. Scientific studies have shown that listening to music can lower levels of the stress hormone cortisol in pregnant women .
Creating or strengthening the attachment bond : Music therapy also promotes the establishment of an emotional bond between mother and child. Through singing or listening to music together, mothers can begin to build an emotional connection with their baby even before birth.
Emotional Expression : In a safe setting, each woman has the opportunity to explore her feelings and concerns, thus promoting a process of introspection and healing.
Stimulating fetal cognitive development : Some research suggests that exposure to music during pregnancy may promote fetal neurodevelopment, contributing to positive outcomes for the child after birth.
Self-Induced Sound Analgesia by Vocalization (SAAV)
A central aspect of music therapy in preparation for motherhood lies in the use of vocalization. Whether sung or spoken, the latter can act as a form of self-induced sound analgesia, an approach initiated and developed within the practice Les Sons Naissances .
Mechanism of vocalization analgesia
My research and experiments with several patients have led me to consider the voice as a complementary and effective tool to reduce anxiety and pain during labor, and facilitate childbirth. Indeed, the process of vocalization — whether through singing, whispering, or specific sounds — seems to offer more autonomous and active pain management. Beckett (2012) also emphasizes that music is increasingly perceived as a valuable alternative or complement to reduce stress and pain. In the same spirit, Alain Carré, in his experiment at the Grenoble maternity ward, reports a 30% reduction in the doses administered of epidural anesthetic thanks to the musicalization of the delivery rooms ( Music in the hospital: Living better thanks to music, 2009). However, my practice leads me to rethink these experiments in the form of a joint proposal, where musical listening and vocalization come together to create a sound bubble around the woman in labor. This could lead to a randomized study to assess the number of women interested in this combination, but this is not the subject of this discussion. The focus remains on ASAV (Self-induced Sound Analgesia by Vocalization).
The woman's ability to actively control pain sensation and motor processes seems to be more adequate than a singular application of music during labor and delivery.
In this sense, vocalization appears to offer more adequate control over pain and bodily processes than passive listening to music alone. This approach allows women to regain some control over their childbirth experience by directly influencing their physical and emotional state, thus making vocalization valuable for pain self-management.
When women vocalize, they stimulate the release of endorphins and oxytocin, hormones known for their analgesic properties and their role in creating emotional bonds. This natural process does not only modulate the perception of pain: it induces a general relaxation of the body that facilitates the opening of the cervix, illustrated by the well-known adage "soft mouth - soft cervix" . Deep and regular sounds, by relaxing the facial muscles, contribute to the relaxation of the other muscles of the body, thus facilitating the physical processes of childbirth. Unlike simple diffusion of music, the active capacity of the woman to modulate her pain and influence her physical state through vocalization seems particularly effective.
Empirically, it also appears that the co-parent's voice in a state of vocalization, as learned during perinatal music therapy sessions, has an analgesic effect, especially during the despair phase. An intense period when the woman can feel suddenly overwhelmed by pain, uncertainty, and fear of not being able to continue the birthing process. According to some researchers, this phase of despair is associated with a deep emotional vulnerability, where contractions can seem insurmountable and the feeling of discouragement can translate into crying or cries for help. In these moments, coping mechanisms, such as vocalization and the reassuring presence of the co-parent, can play a key role in restoring a sense of security and control.
Vocalization is an ancient vertebrate trait, not exclusive to humans, that is crucial for many types of communication.
-- "Vocalization is an ancient trait of vertebrates, not exclusive to humans, that is crucial to many types of communication."
That being said, vocalization, or vocal work, cannot be considered as a simple technique to be applied in isolation, but must be accompanied by in-depth psychological support for the pregnant woman, particularly during complex situations (bereavement, etc.). Hence the interest in perinatal music therapy. Unlike prenatal singing, which focuses mainly on harmonic and rhythmic expression, vocalization in perinatal music therapy, as part of preparation for childbirth, must be approached as a comprehensive treatment. It aims to promote the emotional and physiological integration of sensations of pain, by allowing the woman to release and process her emotions, while working in depth on supporting maternal mental health.
This support must focus on attentive listening and emotional pain management, in order to avoid vocalization being used simply as a temporary "band-aid" or a hobby. On the contrary, it must be part of a psychotherapeutic process where the woman can fully explore and express her feelings, blockages, and psychological pain, in order to support her in her ability to cope with the intensity of the transformations induced by the experience of birth and motherhood.
Recommended practices
Collaboration between midwives and music therapists specializing in perinatal care could encourage women to explore various forms of vocalization, including free singing, traditional songs or instinctive sounds. These practices initiated as part of therapeutic monitoring would encourage parturients to feel more comfortable and in control during childbirth, thus promoting a positive birth experience.
Towards an alliance between midwives and music therapists
The synergy between midwives and music therapists represents a significant advance in perinatal care. Together, these professionals can create an optimal support environment for pregnant women, including:
Setting up joint workshops : Workshops co-facilitated by midwives and music therapists could be organised to raise women's awareness of music therapy practices, thereby strengthening their confidence and preparation for childbirth.
Education and awareness : This collaboration would also educate women about the importance of music, perinatal health and vocalization in the birth process, contributing to supporting early motherhood and preventing certain psychopathologies.
Feedback
Testimonials from women who benefited from perinatal music therapy at the Les Sons Naissances practice during their pregnancy highlight the positive impact of this approach. Many of these women were pregnant with their second or even third child at the time, and came following parental/maternal bereavement. We will see in a future article how the situation of bereavement before, during or after childbirth involves a complex pattern, variable in intensity, of becoming a mother , from the beginning of the pregnancy, and the role of music therapy in supporting the different phases of these maternities.
C. , 35, having given birth to her second child, says:
❝ I would not have believed that I could let my body express itself in this way. [...] It allowed me to feel free, detached from all the preconceptions that I could have about the need to "sing in tune" and allowed me to listen to my voice. ❞
M., 37 years old , grieving mother, for her second childbirth:
❝ Lucile puts at our service her very fine knowledge on birth and her sensitivity to the perinatal world. During a circle for future mothers, I learned vocalization and relaxation techniques to help me during childbirth, participated in a singing circle ... all with the adapted advice of Lucile. A big thank you for the transmission of all your knowledge, as well as your listening and your sense of pedagogy. ❞
A., 34 years old (mother in maternal mourning, second pregnancy) :
❝ [...] I. was born this morning, after only a few hours of labor. He is doing well and is breastfeeding a lot. Thank you from the bottom of my heart for everything, this birth was possible thanks to you. I vocalized a lot, the A's and the OU's were my allies and I visualized the arrow a lot while breathing. Thank you for helping me to have confidence in myself and to believe in all of this. ❞
M., 42 years old (mother in parental mourning, third birth) :
❝ Thank you, delivery without epidural, and the ao or ui é accompanied me all the time and the a helped me a lot during the last pushes. [...] and when I had the impression that I was not going to bear the pain any longer, she was there . ❞
A., 34 years old (second birth)
❝ Lucile is very gentle, attentive and close to what vibrates deep inside us. She helped me let go, especially during my childbirth. I thank her infinitely for accompanying me to fully live my aspirations. ❞
In addition, scientific studies confirm that women who have integrated music into their preparation for childbirth report a reduction in pain during childbirth and a decrease in anxiety. These results reinforce the legitimacy of music therapy in this context.
Practical Tools
To facilitate the integration of music therapy into prenatal care, several practical tools can be considered:
Music playlists : Creating appropriate playlists, including soothing music and traditional songs, can help women mentally prepare for childbirth.
Vocalization exercises : Offering simple vocalization exercises, such as free singing or instinctive sounds, can encourage women to use their voice as a tool for sound analgesia.
Body exercises with music: Music therapy being a psycho-corporeal practice, moments of setting up from the practices of musicians and singers can be integrated, thus allowing future mothers to relax physically and free their minds.
Cultural Perspectives
It is worth noting that music therapy in pregnancy is not just a modern practice; it is part of a diverse cultural tradition across the world. For example, in some African cultures, ritual songs are used to celebrate motherhood and strengthen the bond between mother and child. These cultural and artistic approaches are at least important in understanding the history and experience of pregnancy, but also a way to enrich the practices of music therapists and better meet the needs of pregnant women.
Conclusion
Music therapy is an invaluable support in preparing for childbirth, helping women manage anxiety, strengthen the bond with their baby and use their voice as a primary tool to soothe labor pains. The first perinatal music therapy school will soon open for professionals and perinatal companions. The creation of this branch of music therapy focused primarily on maternal mental health and supporting the mother-child bond, paves the way for innovative practices, thus improving the well-being of pregnant women. The envisaged alliance between midwives and music therapists, and more generally with the medical profession, could offer a global approach, meeting the emotional and physical needs of future mothers, while promoting a positive and enriching childbirth experience.
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