Fetal loss is emotionally traumatic. To make matters worse, women who have a miscarriage or stillbirth also must deal with the stress of procedures necessary to remove the deceased fetus. So the UAB Department of Obstetrics and Gynecology (OB/GYN) developed a music therapy program to comfort mothers in this situation.
For the safety of infants and mothers, the anesthesia used in most obstetric procedures allows the mother to be awake. This usually means that the mother can see and hear what is going on in the delivery room. The sights and sounds of medical procedures can cause anxiety even in normal cases, but they often cause great emotional stress for mothers who are delivering a deceased baby.
To make that experience less difficult, UAB Medicine now offers patients the opportunity to listen to music during some of the OB/GYN operative procedures used to manage fetal loss. Laura Money, MSN, nurse manager for UAB Women & Infants Services, says the program is based on feedback the department received from patients and on research in the area of music therapy.
“We already have a comprehensive bereavement program for our families who experience the loss of a child, but we wanted to make what goes on in the operating room less stressful and more compassionate,” Money says. “In follow-up calls with patients, we’ve learned that the sounds of some equipment we use can range from somewhat distressing to traumatic. Also, mothers are sometimes upset by communications between members of the care team during procedures. In creating a way to alleviate stress, we looked at research that shows how listening to music during certain procedures has improved the experience of mothers.”
In various hospital settings, music therapy has been shown to promote positive mood changes while reducing pain, anxiety, stress, and depression. Studies of how delivering mothers can benefit from listening to music show specific results, such as lowering anxiety before and during procedures, slowing the heart rate, and decreasing the amount of sedation needed. The same research also indicates that listening to music can improve a mother’s experience during recovery.
A Success by Several Measures
Creating the program involved certain practical and technical issues, such as selecting a music streaming service, creating playlists, providing mobile devices for patient use, and obtaining disposable headphone covers to meet COVID-19 safety guidelines. The process was a joint effort among care providers from nursing, anesthesia, obstetrics, and Health Services Information Services (HSIS). Money says the program gives patients several options.
“The idea was to make this service an individualized one,” she says. “By including mothers in the preparation, we let them engage in decisions about their operative environment, and that relieves some anxiety. They can call us the day before surgery to choose from playlists created by our staff, or they can bring their own playlists. The music has well-documented benefits, of course, but some patients have said they just like the fact that the headphones block out all the sounds and conversation in the delivery room. One patient chose to listen to a podcast as a distraction. Our team is in favor of whatever works, and we want to meet our mothers wherever they are in the bereavement process.”
The program has been running for less than a year, but already it is viewed as a success by several measures. Feedback from patients shows 100% satisfaction with the music program, which requires only the monthly cost of a streaming service, noise-blocking headphones, and tablet computers. Money says the program also offers other opportunities for improving patient experience.
“We’re happy that the program has had a 100% success rate in making the care process less stressful,” Money says. “We can see its potential now, too. Obviously, there isn’t a more emotionally difficult situation in our area than a mother facing fetal loss, so this was the right point to initiate the program. But the improvement of outcomes that music therapy offers can be expanded across other areas of OB/GYN, and we anticipate doing that as soon as it’s feasible. We believe success in improving the patient experience and outcomes will lead to more success.”
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