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Guided Imagery and Music for Labor Pain, Anxiety, and Birth Experience: A Randomized Trial
Betül Uncu1, Tülay Yılmaz1, Nursena Sarıkaya1
1Department of Midwifery, Faculty of Health Science, Istanbul University-Cerrahpaşa, Avcılar, Turkey.
Introduction:
Labor pain and childbirth-related anxiety are significant factors that influence women's physiological and psychological well-being during delivery. Nonpharmacological interventions such as guided imagery and music have been increasingly been used to support comfort and positive birth experiences. This randomized controlled trial aimed to determine the effects of guided imagery combined with music on labor pain, anxiety, and birth experience among primiparous pregnant women.
Methods:
A total of 123 primiparous women were randomly assigned to three groups: guided imagery with music, music-only, and control. The intervention groups received their respective practices in addition to routine intrapartum care, whereas the control group received only usual care. Labor pain was measured using the Visual Analog Scale (VAS), anxiety using the State Anxiety Inventory, and birth experience using the Childbirth Expectations and Experiences Scale-II. Birth experience was considered a secondary outcome in this study. Data were analyzed using repeated-measures analysis of covariance (ANCOVA) and one-way ANCOVA. Baseline pain, baseline anxiety, and planned pregnancy status were included as covariates in the adjusted models. Statistical significance was set at p < 0.05.
Results:
A significant group × time interaction was observed for labor pain, indicating that the trajectory of pain differed across the three groups over time (p < 0.05). Post-test anxiety scores were significantly higher in the music-only group compared to the other groups (p < 0.05). Birth experience scores were significantly higher in the music-only group compared to the control group (p < 0.05), with a small effect size. No adverse events were reported in any group.
Conclusion:
Both guided imagery combined with music and music-only interventions were associated with reductions in labor pain, although the pattern of change differed across time. However, neither intervention improved anxiety levels, and the findings for birth experience were limited. These results suggest that while nonpharmacological interventions may support certain aspects of childbirth, additional strategies may be needed to effectively address perinatal anxiety.
