What is the evidence on the role of the arts in improving health and well-being? A scoping review

2.2 Management and treatment 2.2.1 How the arts help people experiencing mental illness 2.2.1.1 Perinatal mental illness In pregnancy, arts programmes for mothers and fathers ahead of the birth may help to support their psychological readiness for becoming parents (483). Weekly art therapy in the final trimester has been found to reduce the fear of childbirth, as well as depression and anxiety (484). Listening to music has been found to reduce anxiety during specific procedures such as amniocentesis (485–487), reduce stress in the later stages of pregnancy (488) and improve sleep quality in pregnant women experiencing poor sleep (487). For women with pre-eclampsia, listening to music or receiving music therapy can decrease the maternal blood pressure and increase the fetal heart rate (489,490). Music listening during pregnancy can also reduce the chance of developing low well-being or postnatal depression after giving birth (491), while singing during pregnancy has been associated with greater mother–infant bonding, fewer neonatal crying episodes, less colic and neonatal nightly awakening, and reduced perceived maternal stress (108).

Listening to music during pregnancy has also been associated with a better experience of labour, including reduced anxiety, blood pressure and heart rate; increased basal fetal heart rate; higher fetal reactivity; a shorter first-stage of labour; a greater likelihood of delivery beginning naturally; and a lower need for medication (492–494). During labour, listening to calming music can lower anxiety levels and has also been linked with lower levels of pain (495,496), faster dilation and effacement, faster progression of labour and lower arterial tension (496). Listening to music can increase positive emotions and patient satisfaction and decrease negative emotions and perceived threat for women undergoing a caesarean section (497). It also decreases the associated anxiety (498–500), pain and opioid need (498,500–502), as well as decreasing the heart rate and systolic blood pressure and preventing increases in the diastolic blood pressure and respiratory rate (497). However, there is little evidence of benefit if a woman has a general anaesthetic while the music is played (503). The design of spaces such as the birth room has also been associated with health outcomes, including the number of caesarean sections, maternal pain ratings, satisfaction with care and the ability of staff to perform their duties (504).

Listening to music after giving birth has been associated with fewer symptoms of depression and greater well-being (110), but there is less evidence on benefits 29