Differential effects therapy of Javanese-traditional (Karawitan instrumental) music and classical music in the first stage and second stage of childbirth

Mina Yumei Santi, Dyah Noviawati Setya Arum, Atik Ismiyati, Siswati Siswati, Mudayah Devit Wulansari

Abstract


Background: Labor pain may induce maternal anxiety, interfere with uterine contractions, and prolong the birthing process. Music therapy is a non-pharmacological intervention known to mitigate both labor pain and anxiety.

Objective: This study aimed to compare the effects of Javanese-traditional (Karawitan instrumental) and classical music therapies on anxiety, labor pain, and the duration of the first and second stages of labor.

Methods: A randomized controlled trial was conducted involving 201 mothers undergoing normal labor at primary healthcare centers. Participants were assigned into three groups: Javanese-traditional music (Karawitan instrumental), classical music, and a control group practicing deep breathing. Interventions lasted 40 minutes. Anxiety was measured using the Spielberger State-Trait Anxiety Inventory, pain intensity with a visual analog scale, and labor duration through partograph analysis. Statistical tests included paired t-test, Wilcoxon signed-rank, Kruskal-Wallis, one-way ANOVA, and Mann-Whitney U tests

Results: Both music interventions significantly reduced anxiety and pain within groups (p-value< 0.001). No significant difference in pain reduction was found between the two music groups during the first active phase (p-value= 0.108). Similarly, anxiety scores did not differ significantly between the music groups post-intervention (p-value= 0.956), though classical music showed a slightly greater reduction. Regarding labor duration, Javanese-traditional music was associated with a shorter first stage, while classical music significantly reduced the duration of the second stage (p-value= 0.000 and p-value= 0.035, respectively).

Conclusions: Javanese-traditional (Karawitan instrumental) and classical music therapies are both effective in reducing maternal anxiety and labor pain while supporting labor progress. Javanese-traditional (Karawitan instrumental) music demonstrated greater effectiveness during the first stage, whereas classical music offered benefits in anxiety reduction and second-stage labor duration

Keywords


classical music; childbirth; labor pain; therapy; karawitan instrumental

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References


Sulisyowati N. Music therapy reduces pain. Jurnal Eduhealth 2023; 14(02):940-943. https://doi.org/10.54209/jurnaleduhealth.v14i02.2310.

Gokyildiz S, Ozturk M, Vurgec BA, Alan S, Akbas M. The effect of music on pain and anxiety of women during labor on first-time pregnancy: a study from Turkey. Complementary Therapies in Clinical Practice 2018;30:96-102. https://doi.org/10.1016/j.ctcp.2017.12.015.

Bobak IM, Jensen MD, Lowdermilk DL. Maternity Nursing. Jakarta: CV EGC; 2012.

Shetti AN, Badhe V, Ravindran R. Pharmacological and non-pharmacological modes of labour analgesia: Recent updates and literature review. International Journal of Pharmaceutical Chemistry and Analysis 2024;11(4):270-273. https://doi.org/10.18231/j.ijpca.2024.039.

Oxorn DC. Intraoperative Echocardiography. Elsevier Health Sciences; 2011.

Santiváñez-Acosta R, Tapia-López EN, Santero, M. Music Therapy in Pain and Anxiety Management during Labor: A Systematic Review and Meta-Analysis. Medicina 2020;56: 526. https://doi.org/10.3390/medicina56100526.

Vaid R, Fareed A, Farhat S. Sounds of comfort: the impact of music therapy on labor pain and anxiety in primigravida women during vaginal delivery: a systematic review and meta-analysis. Reproductive Health 2025;22:67. https://doi.org/10.1186/s12978-025-02023-z.

Hassanzadeh R, Abbas-Alizadeh F, Meedya S. Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes. BMC Women's Health 2020;20:180 https://doi.org/10.1186/s12905-020-01048-9.

Tan HS, Agarthesh T, Tan CW, Sultana R, Chen HY, Chua T, Sng BL. Perceived Stress During Labor and Its Association With Depressive Symptomatology, Anxiety, and Pain Catastrophizing. Scientific Report 2021;11:17005. https://doi.org/10.1038/s41598-021-96620-0.

Pietrzak J, Mędrzycka-Dąbrowska W, Tomaszek L, Grzybowska ME. A Cross-Sectional Survey of Labor Pain Control and Women's Satisfaction. International Journal of Environmental Research and Public Health 2022;19(3):1741. https://doi.org/10.3390/ijerph19031741.

Abbasi P, Charandabi SMA, Mirghafourvand M. Comparison of the effect of educational software and booklet on anxiety and pain during labor: a randomized controlled clinical trial. Journal of Obstetrics and Gynaecology 2021;41(2):234-241. https://doi.org/10.1080/01443615.2020.1736017.

Mujiyani SA, Latifah L. Pain management in the first stage of labour using sensory stimulation. The British Journal of Midwifery 2022;30(7):396-404. https://doi.org/10.12968/bjom.2022.30.7.396.

Vaid R, Fareed A, Farhat S, Hammoud Z, Asif MI, Ochani S, Jaber MH. Sounds of comfort: the impact of music therapy on labor pain and anxiety in primigravida women during vaginal delivery: a systematic review and meta-analysis. Reproductive Health 2025;22(1): 67. https://doi.org/10.1186/s12978-025-02023-z.

Ji C, Zhao J, Nie Q, Wang S. The role and outcomes of music therapy during pregnancy: a systematic review of randomized controlled trials. Journal of Psychosomatic Obstetrics & Gynecology 2023;45(1):1-10. https://doi.org/10.1080/0167482X.2023.2291635.

McCaffrey T, Cheung PS, Barry M. The role andoutcomes of music listening for women in childbirth:an integrative review. Midwifery. 2020;83:102627. https://doi.org/10.1016/j.midw.2020.102627.

Lin H, Chang YC, Chou HH, Chang CP, Huang MY, Liu SJ, Tsai CH, Lei WT, Yeh TL. Effect of music interventions on anxiety during labor: a systematic review and meta-analysis of randomized controlled trials. PeerJ 2019;7(e6945). https://doi.org/10.7717/peerj.6945.

Chen D, Zeng Y, Tang H, Chen L, Yang N. Effect of music interventions on maternal and child outcomes in obstetric settings: an update systematic review and meta-analysis. International Journal of Gynecology, Obstetrics, Reproduction, and Medical Research 2020;8(1):45-59. https://doi.org/10.31907/2309-4400.2020.08.10.

Ergin E, Kahriman F, Coşan-Ay H, Yücel ŞC. Effect of classical Turkish Music on pain and anxiety of patients undergoing bone marrow aspiration and biopsy: a randomized controlled clinical trial. Journal of Holistic Nursing and Midwifery 2022;32(3):227-233. https://doi.org/10.32598/jhnm.32.3.2259.

Suryani E, Sari LP, Ardhila INS. The Impact Langgam's Music Instrumental of Javanese style to reduce anxiety and labor pain. Jurnal Kesehatan Masyarakat 2021;16(3):377-384. https://doi.org/10.15294/kesmas.v16i3.23876.

Family Health Data Communication Information System Special Region of Yogyakarta Province. Data per Indicator January-December 2020. 2021. Available from: http://kesgadiy.web.id/.

Althubaiti A. Sample size determination: A practical guide for health researchers. Journal of General and Family Medicine 2022;24(2):72-78. https://doi.org/10.1002/jgf2.600.

Saputra MRA, Chalid FI, Budianto H. Metode Ilmiah dan Penelitian: Kuantitatif, Kualitatif, dan Kepustakaan (Bahan Ajar Madrasah Riset. Sidoarjo: Nizamia Learning Center; 2023.

Ilardi CR, Gamboz N, Iavarone A, Chieffi S, Brandimonte MA. Psychometric properties of the STAI-Y scales and normative data in an Italian elderly population. Aging Clinical and Experimental Research 2021;33(10):2759-2766. https://doi.org/10.1007/s40520-021-01815-0.

Begum MR, Hossain MA. Validity and Reliability of Visual Analogue Scale (VAS) for Pain Measurement. Journal of Medical Case Reports and Reviews 2019;2(11):394-402. https://www.researchgate.net/publication/370776477.

Guo H, Que M, Shen J, Nie Q, Chen Y, Huang Q, Jin A. Effect of music therapy combined with free position delivery on labor pain and birth outcomes. Applied Bionics and Biomechanics. 2022;2022(8963656). https://doi.org/10.1155/2022/8963656.

Liu YJ, Sun J, Gao GL, et al. Effects of training prior to music therapy-assisted childbirth on labor pain and delivery outcomes in parturients. European Journal of Medical Research 2025;460. https://doi.org/10.1186/s40001-025-02713-1.

Colak MB, Akin B, Kalkan SC, Yuvaci HU. Effects of labor support on pregnant women's childbirth comfort, satisfaction and postpartum comfort levels: a randomized controlled trial. BMC Pregnancy and Childbirth 2025;25(1):789. https://doi.org/10.1186/s12884-025-07904-6.

McCaffrey T, Cheung PS, Barry M, Punch P, Dore L. The role and outcomes of music listening for women in childbirth: an integrative review. Midwifery 2020;83(102627). https://doi.org/10.1016/j.midw.2020.102627.

Guo H, Que M, Shen J, Nie Q, Chen Y, Huang Q, Jin A. Effect of Music Therapy Combined with Free Position Delivery on Labor Pain and Birth Outcomes. Applied bionics and Biomechanics 2022;8963656. https://doi.org/10.1155/2022/8963656 (Retraction published Appl Bionics Biomech 2023;29:9808013. https://doi.org/10.1155/2023/9808013

Van der Valk-Bouman ES, Becker AS, Schaap J, Berghman M, Oude Groeniger J, Van-Groeningen M, Vandenberg F, Geensen R, Jeekel J, Klimek M. The impact of different music genres on pain tolerance: emphasizing the significance of individual music genre preferences. Scientific Report. 2024;14(1):21798. https://doi.org/10.1038/s41598-024-72882-2.

Widiyono. Buku Referensi: Betapa Menakjubkannya Terapi Musik Bagi Kesehatan. Jombang: Lima Aksara; 2021.

An SY, Park EJ, Moon YR, Lee BY, Lee E, Kim DY, Jeong SH, Kim JK. The effects of music therapy on labor pain, childbirth experience, and self-esteem during epidural labor analgesia in primiparas: a non-randomized experimental study. Korean Journal of Women Health Nursing 2023;29(2):137-145. https://doi.org/10.4069/kjwhn.2023.06.21.

Saskovets M, Saponkova I, Liang Z. Effects of Sound Interventions on the Mental Stress Response in Adults: Scoping Review JMIR Mental Health 2025;12:e69120. https://doi.org/10.2196/69120.

Hunter AR, Heiderscheit A, Galbally M, Gravina D, Mutwalli H, Himmerich H. The Effects of Music-Based Interventions for Pain and Anxiety Management during Vaginal Labour and Caesarean Delivery: A Systematic Review and Narrative Synthesis of Randomised Controlled Trials. International Journal of Environmental Research and Public Health. 2023; 20(23):7120. https://doi.org/10.3390/ijerph20237120.

Setiaji, D. Model Komposisi Musik Terapi Relaksasi untuk Ibu Hamil Berbasis Idiom Musikal Karawitan. Acintya: Jurnal Penelitian Seni Budaya, Institut Seni Indonesia Surakarta 2021;13(1):15-27. https://jurnal.isi-ska.ac.id/index.php/acintya/article/download/3818/2918.

Lu G, Jia R, Liang D, Yu J, Wu Z, Chen C. Effects of Music Therapy on Anxiety: A Meta-analysis of randomized Controlled Trials. Psychiatry Research 2021;304:114137. https://doi.org/10.1016/j.psychres.2021.114137.

Zhao J, Yang J, Huang C, Chen Y, Pan L, Han W. Effects of Short-Term Music Therapy on Negative Emotions and Quality of Life in Primiparas. Noise & Health 2025;27(124):1-6. https://doi.org/10.4103/nah.nah_93_24.

Tambunan MB, Suwarni L, Selviana S. Effect of emotional freedom techniques on anxiety, depression and insomnia among COVID-19 patients. International Journal of Public Health Science 2023;12(2):545-553. https://doi.org/10.11591/ijphs.v12i2.22403.

Nuryana D, Viwattanakulvanid P, Romadlona NA. Maternal health services utilization and its contributing factors among adolescent mothers. International Journal of Public Health Science (IJPHS) 2022;11(1):77-87. https://doi.org/10.11591/ijphs.v11i1.21041.

Şolt-Kırca A, Kanza-Gül D. The effect of music and skin contact with the newborn on pain and anxiety during episiotomy repair in primiparous women: a double-blind randomized controlled study. Journal Explore 2022;18(2):210-216. https://doi.org/10.1016/j.explore.2020.11.007.

Ji C, Li J, Nie Q, Wang S. Effect of Music Therapy on Axiety in Full-term Pregnant Women. Frontiers in Psychiatry 2024;15:1-7. https://doi.org/10.3389/fpsyt.2024.1429999.

Riyanti R, Wahyuni NI. Pengaruh Terapi Musik Terhadap Lama Persalinan Kala 1 Fase Aktif di Puskesmas Maja Desa Maja Kecamatan Maja Kabupaten Lebak Banten. Manuju 2024;6(5):1837-1849. https://doi.org/10.33024/mnj.v6i5.11228.

Çelebi D, Yılmaz E, Şahin ST, Baydur H. The effect of music therapy during colonoscopy on pain, anxiety and patient comfort: a randomized controlled trial. Complementary Therapies in Clinical Practice 2020;38:101084. https://doi.org/10.1016/j.ctcp.2019.10108.

Naibili MJE, Hamranani H, Wahyuningsih M. Relationship between knowledge level and anxiety facing childbirth in primiparous mothers at Panembahan Senopati Hospital Bantul. Journal of Nursing Science Update 2022;10(2):116-125. https://doi.org/10.21776/ub.jik.2022.010.02.5.

Uvnäs-Moberg K, Ekström-Bergström A, Berg M. Maternal plasma levels of oxytocin during physiological childbirth-a systematic review with implications for uterine contractions and central actions of oxytocin. BMC Pregnancy Childbirth 2019;19:285. https://doi.org/10.1186/s12884-019-2365-9.

Indahwati L, Rahmawati DR, Ulfah M. Literature Review: The Effect of Music Therapy on the Duration of the First Stage of Labor in the Active Phase. Jurnal Ilmiah Kebidanan (The Journal of Midwifery) 2023;11(2):216-221. https://doi.org/10.33992/jik.v11i2.2477.

Boz İ, Kumru S, Buldum A, Firat MZ. Reassessing the length of labor in healthy Turkish women: a retrospective and descriptive study. Journal of Obstetry and Gynaecology 2019;39(4):468-473. https://doi.org/10.1080/01443615.2018.1534811.


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