Caesarean section is a surgical procedure for delivering a baby. It involves making surgical incisions into the mother's abdominal wall and uterus. These operations are performed if there is a serious medical concern for the mother or baby. Caesarean sections are generally done with regional anaesthesia, either a spinal or epidural block with anaesthetic injected into the area around the spine in the lower back, which makes the mother feel numb from the waist down. Women have increased risks associated with anaesthesia and surgery, and the baby may be more likely to be admitted to a neonatal unit or separated from the mother.
Women having a caesarean section under regional anaesthesia are often highly anxious during the operation and may feel some discomfort. Listening to relaxing music of the woman's choice may lead to better outcomes and less need for treatment.
The review findings indicate that listening to music during planned caesarean section under regional anaesthesia may improve pulse rates and birth satisfaction scores, although the effect sizes were not large enough to indicate a clinically beneficial effect. The review authors identified one controlled trial that randomly assigned 76 women who listened to their preferred music through earphones, or to standard care, but data were available for only 64 women. The music was provided from the beginning of anaesthesia to the end of surgery. The women's heart rates were reduced by some seven beats/minute when measured at the end of contact with the newborn during the intra-operative period and after the surgeon had completed skin suture. Birth satisfaction scores were increased by a mean of 3.4 points on a 35-point scale when women listened to music. Respiration rates were no different for the two groups and neither were levels of anxiety, which decreased at the end of contact with the newborn and again after closing the skin, with no clear difference with or without music. The trial was from Taiwan and reporting of trial methodology was poor.
The findings indicate that music during planned caesarean section under regional anaesthesia may improve pulse rate and birth satisfaction score. However, the magnitude of these benefits is small and the methodological quality of the one included trial is questionable. Therefore, the clinical significance of music is unclear. More research is needed to investigate the effects of music during caesarean section under regional anaesthesia on both maternal and infant outcomes, in various ethnic pregnant women, and with adequate sample sizes.
Evidence on the benefits of music during caesarean section under regional anaesthesia to improve clinical and psychological outcomes for mothers and infants has not been established.
To evaluate the effectiveness of music during caesarean section under regional anaesthesia for improving clinical and psychological outcomes for mothers and infants.
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 September 2008).
We included randomised controlled trials comparing music added to standard care during caesarean section under regional anaesthesia to standard care alone.
Two review authors, Malinee Laopaiboon and Ruth Martis, independently assessed eligibility, risk of bias in included trials and extracted data. We analysed continuous outcomes using a mean difference (MD) with a 95% confidence interval (CI).
One trial involving 76 women who planned to have their babies delivered by caesarean section met the inclusion criteria, but data were available for only 64 women. This trial was of low quality with unclear allocation concealment and only a few main clinical outcomes reported for the women. The trial did not report any infant outcomes. It appears that music added to standard care during caesarean section under regional anaesthesia had some impact on pulse rate at the end of maternal contact with the neonate in the intra-operative period (MD -7.50 fewer beats per minute, 95% CI -14.08 to -0.92) and after completion of skin suture for the caesarean section (MD -7.37 fewer beats per minute, 95% CI -13.37 to -1.37). There was also an improvement in the birth satisfaction score (maximum possible score of 35) (MD of 3.38, 95%CI 1.59 to 5.17). Effects on other outcomes were either not significant or not reported in the one included trial.