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see also: Pregnancy and Musicianship

content created by Abigail Townsend, BS and Ifeanyi Onuh MS (April 2, 2026)

Full session (37 minutes 19 seconds)

Definitions

Postpartum Period: The time following childbirth, typically defined as the first 6–12 weeks, during which significant physiologic, hormonal, and psychological changes occur as the body returns toward a nonpregnant state (Paladine 2019).

Postpartum Musicianship: The experience of returning to or maintaining musical performance after childbirth, influenced by physical recovery, hormonal changes, and caregiving responsibilities (Women in Live Music 2020).

Postpartum Voice Changes: Alterations in vocal quality after childbirth, including decreased pitch, reduced endurance, and increased vocal fatigue, associated with hormonal withdrawal and physiologic stress (Pisanski 2018; Taubenfeld 2025).

Hormonal Withdrawal (Postpartum): The rapid decline in estrogen and progesterone levels after delivery, contributing to changes in vocal fold hydration, fatigue, and mood regulation (Taubenfeld 2025).

Vocal Fold Hydration: The moisture content of the vocal fold mucosa, influenced by systemic hormonal levels and essential for optimal vocal function, endurance, and sound quality (Taubenfeld 2025).

Pregnancy-Related Hearing Changes: Temporary alterations in hearing sensitivity during pregnancy that are typically mild and reversible, with most individuals returning to baseline postpartum (Frosolini 2021). 

Auditory Cortex Adaptation (Postpartum): Structural and functional neuroplastic changes in maternal auditory brain regions after childbirth, enhancing responsiveness to infant vocalizations (Luders 2021). 

Musculoskeletal Strain (Postpartum): Physical stress on muscles and joints following childbirth due to core weakness, altered biomechanics, and recovery from pregnancy and delivery (Selman 2022).

Pelvic Floor Dysfunction: Weakness or impairment of pelvic musculature after childbirth that may affect posture, stability, and physical performance (Selman 2022).

Postural Stability (Musicians): The ability to maintain controlled body alignment during performance, which may be impaired postpartum due to core and pelvic floor changes (Horvath 2019).

Ergonomic Adaptation: Modifications in instrument handling, posture, or performance setup to reduce strain and accommodate postpartum physical changes (Horvath 2019).

Postpartum Fatigue: Persistent physical and mental exhaustion following childbirth, influenced by physiologic recovery, sleep disruption, and caregiving demands (Paladine 2019).

Postpartum Depression (PPD): A mood disorder affecting up to 10% of women within the first year after childbirth, characterized by persistent sadness, anxiety, and impaired functioning (O’Hara 2013). 

Maternal–Infant Bonding: The emotional connection between a mother and her infant, which can be strengthened through vocal interaction such as singing (Halajian 2025).

Oxytocin Release (Postpartum Singing): Hormonal response stimulated by singing or vocal interaction, associated with reduced anxiety, improved mood, and enhanced maternal–infant bonding (Halajian 2025).

Return-to-Performance Timeline: The individualized progression by which postpartum individuals resume professional or physical activities, influenced by recovery, occupational demands, and support systems (Selman 2022).

Background

The postpartum period presents many unique challenges for female musicians, yet it remains a largely underexplored topic in both music and medical literature. The physiological, psychological, and occupational changes that occur after childbirth can significantly affect one's performance. 

Postpartum musicians face a combination of physical adaptations, including recovery from labor and delivery, with changes in core and pelvic musculature, musculoskeletal strain, and fatigue. These physical changes may affect musicians' capacity to perform, particularly for those who require extended reach or precise postural stability, such as those playing cello or percussion instruments. 

The Women in Live Music (WILM) survey highlighted that many women feel compelled to navigate performance expectations alongside childcare responsibilities, often without formal support or accommodations (Women in Live Music, 2020). Decisions about returning to work, scheduling rehearsals, and maintaining performance quality are frequently influenced by these constraints, and some women postpone or modify their professional engagement in the postpartum period to accommodate recovery and caregiving.

Practical strategies have emerged to support postpartum musicianship. Adaptations may include modifications to instrument handling, rehearsal schedules, or ergonomic adjustments to accommodate fatigue and musculoskeletal changes. For example, orchestral performers have used creative approaches such as shared or adapted costumes, modified posture, and supportive equipment to facilitate continued performance in early postpartum stages (Horvath, 2019).

Head and Neck:

Voice: 

Postpartum voice changes are influenced by hormonal withdrawal and fatigue. Involving decreased estrogen due to reduced vocal fold hydration, increased vocal fatigue, and decreased endurance. Progesterone and estrogen fluctuations, including a sharp drop of both of these hormones during the early postpartum period, usually level out within 3 to 6 weeks after delivery, but the demands of new parenthood can continue to impact hormones. Pisanski et al. found that a woman’s voice became significantly lower-pitched during the first year postpartum compared to during pregnancy or before, but reverted after the first year postpartum, approaching pre-pregnancy levels. 

Hearing: 

According to Frosolini et al. (2021), many of the audiometric changes observed during pregnancy are mild and transient, with a tendency for hearing acuity to return to baseline postpartum. In the studies included in their systematic review, five out of seven reported full recovery of hearing after delivery, suggesting that most pregnancy-related auditory changes are reversible and do not result in long-term deficits.

Luders et al. studied how a mother's brain undergoes functional adaptations after birth to respond to the needs of their newborn. Using MRI, the study compared the brains of 14 healthy women between immediate postpartum (1-2 days of childbirth) and late postpartum (4-6 weeks after childbirth), focusing on areas of the primary, secondary, and higher auditory cortex. They found significant volume increases in all auditory regions examined, reflecting the adaptations of the mother's brain in relation to interpreting her newborn's cries. There were also increases within the right-hemispheric regions compared to the left-hemispheric regions that may reflect the ability to discern the sound, pitch, and volume of a baby's crying.  

Smell and Taste:

Postpartum changes in olfaction and gustation are less well characterized than during pregnancy but may persist transiently after delivery due to ongoing hormonal fluctuations. Estrogen and progesterone shifts can influence olfactory receptor sensitivity and central processing, leading to altered perception of odors and flavors. While most changes resolve as hormone levels stabilize, persistent alterations may affect appetite, nutrition, and overall quality of life (Taubenfeld 2025; Paladine 2019).

Swallowing and Upper Aerodigestive Function:

Swallowing function in the postpartum period may be indirectly affected by fatigue, reflux, and musculoskeletal changes. Increased intra-abdominal pressure during pregnancy and delivery can contribute to laryngopharyngeal reflux, which may persist postpartum and impact voice and swallowing comfort. Additionally, generalized fatigue and deconditioning may influence coordination of swallowing musculature, particularly in individuals with high vocal or performance demands (Paladine 2019; Selman 2022).

Management

Up to 10% of women will experience depression in the first year postpartum. Singing during the postpartum period has been shown to provide measurable mental health benefits. Programs such as Breathe Melodies for Mums have found that singing can reduce postnatal depression symptoms by up to 35% within six weeks, promoting faster emotional recovery. Additionally, singing to infants encourages social connection, releases oxytocin, decreases anxiety, and improves the relation between maternal-infant bonding, helping mothers feel more competent and emotionally attuned (Halajian 2025). 
 

References

Horvath J: Pregnancy, Motherhood, and Playing Music  Interlude  July 6th, 2019   https://interlude.hk/pregnancy-motherhood-playing-music/>

Bloom MT: Playing a Rock Gig While Pregnant: Advice from Mamas Who've Done it   Rock Mommy  Sept 23, 2024  https://rockmommy.com/2016/09/playing-a-rock-gig-while-pregnant-advice-from-mamas-whove-done-it/ 

Selman R, Early K, Battles B, Seidenburg M, Wendel E, Westerlund S. Maximizing Recovery in the Postpartum Period: A Timeline for Rehabilitation from Pregnancy through Return to Sport. Int J Sports Phys Ther. 2022 Oct 1;17(6):1170-1183. doi: 10.26603/001c.37863. PMID: 36237644; PMCID: PMC9528725.

Paladine HL, Blenning CE, Strangas Y. Postpartum Care: An Approach to the Fourth Trimester. Am Fam Physician. 2019 Oct 15;100(8):485-491. PMID: 31613576.

Burton A, Bind RH, Davis R, Greenwood L, Lee CY, Estevao C, Hazelgrove K, Miller C, Priestley K, Rebecchini L, Osborn T, Dye H, Dazzan P, Woods A, Crane N, Pariante CM, Fancourt D. A qualitative exploration of active ingredients and mechanisms of action of an online singing programme with mothers experiencing postnatal depression during the COVID-19 pandemic: SHAPER-PNDO study. BMC Psychol. 2024 Nov 30;12(1):714. doi: 10.1186/s40359-024-02213-7. PMID: 39616388; PMCID: PMC11608468.

Halajian C, Honein-Abouhaidar G, El Zein O, Masri S, Charafeddine L. Effects of maternal singing or voice on language and social-emotional development of preterm infants: protocol for a systematic review. BMJ Open. 2025 Sep 18;15(9):e101355. doi: 10.1136/bmjopen-2025-101355. PMID: 40973371; PMCID: PMC12458615.

Benjamin DR, van de Water AT, Peiris CL. Effects of exercise on diastasis of the rectus abdominis muscle in the antenatal and postnatal periods: a systematic review. Physiotherapy. 2014 Mar;100(1):1-8. doi: 10.1016/j.physio.2013.08.005. Epub 2013 Oct 5. PMID: 24268942.

O'Hara MW, McCabe JE. Postpartum depression: current status and future directions. Annu Rev Clin Psychol. 2013;9:379-407. doi: 10.1146/annurev-clinpsy-050212-185612. Epub 2013 Feb 1. PMID: 23394227.

Frosolini A, Marioni G, Gallo C, de Filippis C, Lovato A. Audio-vestibular disorders and pregnancy: A systematic review. Am J Otolaryngol. 2021 Sep-Oct;42(5):103136. doi: 10.1016/j.amjoto.2021.103136. Epub 2021 Jun 19. PMID: 34182351.

Luders E, Gaser C, Gingnell M, Engman J, Sundström Poromaa I, Kurth F. Postpartum Gray Matter Changes in the Auditory Cortex. J Clin Med. 2021 Nov 29;10(23):5616. doi: 10.3390/jcm10235616. PMID: 34884318; PMCID: PMC8658382.

Ford, Anna. “New Mums’ Voices Get Lower after Pregnancy, Shows a University of Sussex Study.” The University of Sussex, 12 July 2018, https://www.sussex.ac.uk/broadcast/read/45029

Taubenfeld, Emma, and Alyssa Dwerk MD. “The Essential Guide to Postpartum Hormones and Their Impact.” Parents, 30 Apr. 2025, www.parents.com/pregnancy/my-body/postpartum/postpartum-hormone-changes/.

Pisanski K, Bhardwaj K, Reby D. Women's voice pitch lowers after pregnancy, Evolution and Human Behavior, Volume 39, Issue 4,
2018, Pages 457-463, ISSN 1090-5138,
https://doi.org/10.1016/j.evolhumbehav.2018.04.002.