Music Therapy Beneficial in Reducing Maternal Stress and Anxiety During Cesarean Section

In recent years, there has been increased attention towards the effects of music intervention and music therapy. Indeed, music has been known to have necessary physical and cognitive performance which affect reducing anxiety and increasing relaxation feelings (Hepp et al., 2016). The evidence for the benefits of music during caesarian section under regional anesthesia to reduce maternal stress and anxiety is yet to be established. However, this research opens the door for more research in the future (Nikpour et al., 2015).

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The search strategy utilized the Cochrane Library where Evidence-Based Medicine (EBM) Reviews are found. The search was conducted principally in the Cochrane Pregnancy and Childbirth Group's Trial Register on 3rd October 2018. The search criteria included randomized controlled trials that put a comparison of music added during the standard care during cesarean section to standard care. An independent assessment on the eligibility, risk of bias and extracted data was conducted. The outcomes were then analyzed using a mean difference with a confidence interval of 95% (Laopaiboon et al., 2009).

Caesarian section is the surgical procedure that is used for delivering babies. It involves the doctor making incisions in the abdomen area of the mother targeting the abdominal wall and the uterus. They are done where a serious medical concern has been noticed that puts either the mother or the baby at risk. It is usually conducted after the mother has been anesthetized. At this point, most mothers are anxious and may feel discomfort with the whole process. It has been noted that having music that the mother likes playing in the background leads to a better outcome and the reduced need for treatment. It improves pulse rates and enhances birth satisfaction scores (Chang & Chen, 2005).

The study was conducted on 76 women although the data was available for 64 of these. It was noted that the heart beats reduced by seven beats per minute when measured at the end. Birth satisfaction went up by a mean of 3.4 on a 35-point scale. The findings were inconclusive and insignificant, or they were not reported in the trial results. It concludes that there is an effect on the pulse rate and birth satisfaction rate although the poor methodological quality affects the conclusions on the effectiveness of music during caesarean section for improving delivery and relieving stress and anxiety in women during cesarean section (Laopaiboon et al., 2009).

The research further identified the need for more research that can evaluate the effects of music during caesarean section. The research in question was limited to some extent, and this affected the results of the study. If future researches ensure better methodologies that take into account randomization procedures will have better results. Assessors that have blinding and concealed outcomes should be undertaken with a proper and important focus on not just one particular type of music, but different genres are also going to have better results. The sample size of pregnant women should also be taken from diverse ethnic groups. With all these in mind, it is clear that the study in question was not conclusive, but it formed an important step and opened the door for more research that is necessary for the subject in question (Chang & Chen, 2005).

Annotated bibliography

Chang, S., & Chen, C. (2005). Effects of music therapy on women's physiologic measures, anxiety, and satisfaction during cesarean delivery. Research in Nursing & Health, 28(6), 453-461

Chang SC and Chen CH from the Nursing Cheng Kung University Medical Center, Tainan, Taiwan, conducted the study with the aim of investigating the effect of music therapy on women's level of anxiety, physiologic measures, and satisfaction when delivering babies through cesarean delivery. It was a review of the study conducted in Taiwan with 64 women divided into two groups; an experimental and a control group. The two groups received different care with the control group being provided with routine care only whereas the experimental group receiving routine care plus music therapy. In the end, the results indicated there was lower anxiety and high satisfaction regarding the whole experience in the experimental group as compared to the control group. However, there was no other noted difference between the two groups based on physiological indexes. The conclusion was that music therapy has the ability to affect anxiety and making the whole process more satisfying for women delivering through cesarean delivery. The study is the main reference for the research discussed above. It was important in offering the necessary information that was necessary for the whole discussion and helped to make the topic have a shape and direction.

Dyson, R. D. (2012). Cesarean Delivery: Surgical Techniques - The Fifteen Minute Cesarean Section. Cesarean Delivery

Robert Dyson provides a comprehensive description of the whole caesarean delivery process. He identifies that it is a process that takes a mere fifteen minutes if done right but explains it using more than ten pages. This shows the detailed nature of the caesarean delivery process. According to a Cochrane review, there are about 20% of post-cesarean febrile morbidity which is most common in repeat cesarean patients. Indeed, the article concludes in identifying that cesarean sections have been on the increase in all parts of the world. It has been identified that it has increased due to reduced tolerance in taking risks with the baby but the safety of the mother has also made it essential to effect cesarean section to the mother. The article was important as it provided more knowledge on the cesarean section that was important in helping get a good understanding of the underlying subject. The whole process is so intimidating because it is basically cutting someone open and then closing them back up. One can understand the level of maternal stress and anxiety that mothers go through before undergoing this surgery.

Hepp, P., Hagenbeck, C., Burghardt, B., Jaeger, B., Wolf, O. T., & Schaal, N. K. (2016). Measuring the course of anxiety in women giving birth by caesarean section: a prospective study. BMC Pregnancy and Childbirth, 16(1).

Philip HeppEmail author, Carsten Hagenbeck, Bettina Burghardt, Bernadette Jaeger, Oliver T. Wolf, Tanja Fehm, Nora K. Schaal and The MAGIC Group came together to study and measure the course of anxiety in women who give birth through caesarean section. It is a common feature among all women going through the caesarean section to experience anxiety; however, the duration and extent of the anxiety have yet to be investigated. The study explored anxiety levels using both objective and subjective methods of measurement. The study reveals that there is a greater level of anxiety before surgery until the skin is closed again. The study identifies interventions that could be relevant for reducing anxiety. They discovered such methods as acupuncture and for the study, music therapy as some ways of reducing anxiety levels in women. By focusing its study on anxiety, the study is helpful as it provides necessary information about anxiety. Getting a better understanding of anxiety will help the study understand better how music therapy is supposed to aid and have an effect on anxiety and stress.

Laopaiboon, M., Lumbiganon, P., Martis, R., Vatanasapt, P., & Somjaivong, B. (2009). Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes. Cochrane Database of Systematic Reviews.

The study in question provided the background of the research. It was a review of earlier research conducted by Chang and Chen in 2005. Having its basis in the Cochrane Database of Systematic Reviews, it provides the necessary information that forms the backbone of the whole study. Indeed, the authors, Malinee Laopaiboon, Pisake Lumbiganon, Ruth Martis, Patravoot Vatanasapt and Busaba Somjaivong all from the Khon Kaen University, Faculty of Medicine, Department of Obstetrics and Gynaecology, Khon Kaen, Thailand reviewed the study and identified important aspects of the study. They concluded that the study identified that the benefits of music therapy were found in improved pulse rate and general satisfaction. However, they were skeptical about the quality of the methodology used to conduct the study and identified the clinical significance to be unclear making them ineffective for nursing and medicine in general. All in all, the review helps bring to focus the whole aspect of music therapy and its effect on maternal stress and anxiety. They also offer recommendations for future research that can provide a better and more clear result that will be of benefit to the subject which they note has not yet been established.

Nikpour, M. A., Firouzbakht, M., Khefri, S., Jamali, B., Kazeminavaee, F., & Didehdar, M. (2015). The effectiveness of prenatal intervention on pain and anxiety during the process of Childbirth-Northern Iran: Clinical trial study. Annals of Medical and Health Sciences Research, 5(5), 348

Another study that has been conducted to identify conditions that are necessary for ensuring that childbirth is handled in a better way that reduces anxiety and pain making it a more relaxing feeling for the mother and child which is essential for promoting health. The six authors, Nikpour, Firouzbakht, Khefri, Jamali, Kazeminavaee, and Didehdar all from Babol University of Medical sciences show the importance of the study. The study was conducted at the Imam Ali Hospital in Amol/Iran from 2012 to 2013. The aim of the study was the assessment of the effects of prenatal training classes on the delivery process at the hospital. It also aimed at evaluating its effectiveness on the process of childbirth. About 90% of prenatal stress is experienced during the process of childbirth. It is essential to help women by whatsoever means possible to reduce these effects as they have an effect of child mortality during childbirth. The study concluded that prenatal education and psychological support was important for mothers during pregnancy and labor. The study offered important information regarding educating mothers on the importance of among issues such as music therapy and its effect in reducing maternal stress and anxiety.

References

Chang, S., & Chen, C. (2005). Effects of music therapy on women's physiologic measures, anxiety, and satisfaction during cesarean delivery. Research in Nursing & Health, 28(6), 453-461

Dyson, R. D. (2012). Cesarean Delivery: Surgical Techniques - The Fifteen Minute Cesarean Section. Cesarean Delivery

Hepp, P., Hagenbeck, C., Burghardt, B., Jaeger, B., Wolf, O. T., & Schaal, N. K. (2016). Measuring the course of anxiety in women giving birth by caesarean section: a prospective study. BMC Pregnancy and Childbirth, 16(1)

Laopaiboon, M., Lumbiganon, P., Martis, R., Vatanasapt, P., & Somjaivong, B. (2009). Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes. Cochrane Database of Systematic Reviews

Nikpour, M. A., Firouzbakht, M., Khefri, S., Jamali, B., Kazeminavaee, F., & Didehdar, M. (2015). The effectiveness of prenatal intervention on pain and anxiety during the process of Childbirth-Northern Iran: Clinical trial study. Annals of Medical and Health Sciences Research, 5(5), 348