Tom Jackson's Academy of Live Music

Singing While Pregnant

Some women wonder if it is safe to continue performing while they are expecting babies. Many wonder how pregnancy will affect their tone, breathing and vocal stamina, and whether or not it’s possible to still produce quality vocals while pregnant. They are also curious to know if there are any special considerations to take at this time in their lives. They are often faced with numerous concerns about how an enlarging abdomen will affect their image, or the image of their band, including how they look, how they dress, and how energetically (and gracefully) they are able to move around on stage.

As a mother of four young children, a singer and a vocal technique instructor, this topic is near and dear to my heart. I definitely understand some of the unique challenges that female singers face while pregnant, and so I have chosen to share a little bit of advice with my readers who may be asking how pregnancy is going to affect their singing, or why it is presenting them with so many new challenges.

While you may find that you’ll need to make some adjustments to your repertoire or to your performance schedule, it is both safe and healthy to continue singing during pregnancy. (It may not be a good time to begin any intense training in vocal technique, though, as the pregnant body will pose some restrictions and breathing will feel different during pregnancy than it will afterwards.) Furthermore, it seems illogical to stop singing altogether, as this will leave you with a voice that is woefully out of shape at the end of the nine or so months, and then you will have to start redeveloping your vocal skills in order to get back to your previous level.

Despite the challenges, there are many benefits to continuing to sing while pregnant. Singing increases oxygen circulation – it’s good for your circulatory system, which is, in turn, good for your baby’s – lowers heart rate and decreases blood pressure, and may help boost the immune system. It also releases endorphins, which are natural mood boosters and stress relievers. Since the fetus is comforted by the musical sounds of his or her mother’s voice, singing will also have a soothing affect on him or her, both during pregnancy and after the baby is born.

Breathing Challenges

While I was pregnant with my eldest son, I was rehearsing and performing with my two bands a few times per week. (I did so up until my due date.) Earlier in the pregnancy, I had begun to become concerned that I wouldn’t be able to find the vocal endurance to conquer intense phrases because I had heard many stories of women who had difficulties breathing – not just while singing, either - because of their pregnancy bellies.

Depending on how a woman is carrying, pregnancy may affect how a female singer 'supports' her voice, both in speech and in singing. In fact, pregnancy may present the only legitimate ‘excuse’ for reverting to thoracic (chest) breathing because the size and height of the womb and unborn baby may make it difficult, if not impossible, to allow for free movement of the diaphragm and expansion of the lungs and abdomen. This is a common complaint of women who are ‘carrying high’, as the top of the uterus places pressure on and crowds the diaphragm, lungs, ribs and stomach.

A woman who is ‘carrying low’, on the other hand, may find that she is able to continue employing diaphragmatic breathing or appoggio technique throughout her pregnancy, and may notice few, if any, changes in her breathing technique over the months. Since I carried very low with all of my pregnancies, I found that my growing belly never significantly interfered with my ability to breathe correctly during singing tasks, (nor with my ability to eat a very large meal!).

Additionally, the muscles that support breathing, most specifically the abdominal muscles, gradually lose their tonicity and become increasingly separated and lax as the belly increases in size. It is common for this muscle laxity to become worse with each subsequent pregnancy, as well. This may make it more difficult for the pregnant singer to tackle more challenging singing tasks that require greater stamina and support, such as longer vocal phrases in higher-lying tessituras or 'belting'. This does not mean that a woman should stop singing once she is ‘showing’. In fact, using the support muscles during pregnancy may keep them stronger and make them more prepared to handle vocal challenges postpartum. Being in good physical condition and having a strong core before becoming pregnant, as well as getting the muscles back into shape relatively soon after delivery, may help.

Of course, pregnancy hormones stimulate the respiratory centre to increase the frequency and depth of the breaths, which may give the woman a feeling that she is breathing hard and is frequently breathless, or even lightheaded and dizzy. These hormones also swell the capillaries of the respiratory tract and other capillaries in the body, and relax the muscles of the lungs, bronchial tubes, and other muscles that may affect breath support. (Shortness of breath is not a sign that the woman and her baby are lacking in oxygen.) Relief of this breathlessness often comes when the baby drops lower into the pelvis. This 'engagement' usually occurs two or three weeks before delivery in first pregnancies, but not typically until labour begins in subsequent pregnancies. In the meantime, adequate hydration and physical exercise may help to alleviate some of this shortness of breath.

Many pregnant women complain about excess mucous leading to nasal or sinus congestion, a runny nose, sneezing, coughing or a post-nasal drip. This condition, which occurs in about twenty to thirty percent of pregnant women, is believed to be brought on by the hormones of pregnancy, and is called pregnancy rhinitis. Pregnancy rhinitis occurs when the nasal passageways become irritated and inflamed during pregnancy, and is not due to environmental allergens or toxins or the common cold. This copious mucous can make breathing difficult, especially during sleep, but also during singing tasks. Symptoms of pregnancy rhinitis usually resolve on their own within two weeks of labour and delivery as the hormone balance of the body begins to reestablish itself. In the meantime, the pregnant singer can try relieving some of her symptoms. She may try nasal saline irrigation, antihistamines (if approved by her physician), or oral decongestants (with doctor’s consent). Other non-medicinal remedies include maintaining good hydration (i.e., by drinking plenty of water and avoiding caffeine) and adequate humidity levels in the home to prevent the mucous from becoming overly thick, avoiding environmental irritants such as cigarette smoke, sleeping with the head propped up and exercising (when approved by a physician).

Exposure To Noise

While it is true that a fetus is relatively protected from much of the noise outside the womb, (muffled) sounds do penetrate the amniotic fluid and reach the baby’s developing ears. The human cochlea and peripheral sensory end organs complete their normal development by twenty-four weeks of gestation. Indications of the maturation of the auditory pathways of the central nervous system are consistently present in ultrasonographic observations of blink-startle responses to vibroacoustic stimulation after twenty-eight weeks. Most female singers, musicians and avid music listeners believe this phenomenon to be a positive thing, as their unborn babies are being exposed to music early on whenever they sing and rehearse or perform with their bands. (My eldest son came out of the womb practically able to play the drums already!)

However, recent studies have shown that fetuses who are regularly or repeatedly exposed to excessively high levels of noise – continuous noises louder than eighty decibels, such as heavy traffic, on an ongoing basis (e.g., eight hours a day) or one hundred and fifteen decibels, such as that produced by very loud music, for periods of fifteen continuous minutes or longer - can actually suffer hearing damage (high-frequency hearing loss), which may be associated with an increased risk of prematurity, intrauterine growth retardation or restriction, and low birth weight. (Band practice typically reaches levels of about one hundred and twenty decibels.)

Appropriate sound levels may be difficult to determine simply by listening. If the singer is not in the habit of wearing hearing protection and is unbothered by sound levels that others would find excessive, she has likely already suffered damage and acquired some permanent noise induced hearing loss. (Noise induced hearing loss is usually gradual and painless, but, unfortunately, it is also permanent. Once destroyed, the hearing nerve and its sensory nerve cells do not regenerate, so it’s always a good idea to wear earplugs, at least while rehearsing.) Consider investing in a decibel metre, which measures the true loudness of a sound wave, and will provide you with an accurate and objective measurement of the noise levels in your rehearsal space. These levels may be more pronounced if the rehearsal space is small and enclosed.

If you rehearse with a band that typically plays at higher volume levels, it would be in your baby’s best interest for you to request that the musicians lower their sound levels for a few months just during rehearsals. Understanding band mates will likely be accommodating to your request. Considering the length and frequency of rehearsals and performances will help you determine just what adjustments need to be made to the sound levels. Some exposure to loud noises is safe, so the occasional gig or concert shouldn’t pose a problem, but that exposure should be infrequent and relatively short in duration.

Exposure To Cigarette Smoke

Another very valid concern is that of the effects of the smoke that singers inhale during gigs on their unborn babies. Some singers don't think much about their exposure to secondhand smoke until they are pregnant, and the fumes remain little more than a nuisance with which they feel they must contend because of their career of choice. Others simply don't care, as they may be smokers themselves.

For those who reside and perform in states or provinces that have enacted a statewide or province-wide ban on smoking in all enclosed public places, including bars and restaurants, they likely haven't really had to give it much consideration. Not every state in the U.S. or province in Canada - and certainly not every country in the world - however, has the same laws in place.

Regular exposure to secondhand smoke can have just as significant an impact on a person's health as actually smoking the cigarettes, pipes or cigars directly can (e.g., asthma, chronic bronchitis and other respiratory problems, and even lung cancer, can result). It's estimated that if a person spends more than two hours in a room where someone is smoking, the nonsmoker inhales the equivalent of four cigarettes. There are actually higher levels of the dangerous chemicals in secondhand smoke than the smoker himself inhales directly with each puff.

Ideally, no singer should be exposed to either firsthand of secondhand smoke, but it's especially concerning to those who are pregnant because it is no longer just their own health that they are responsible for. One study suggests that cancer-causing chemicals in cigarette smoke pass from mother to unborn baby, whether the mother smokes or not. Pregnant women exposed to the secondhand smoke of co-workers, family members or fans pass some of the blood-borne chemicals to their unborn babies, though babies of smokers have much higher levels of the chemicals. Pregnant mothers who smoke regularly or who are regularly exposed to high levels of secondhand smoke risk complications such as miscarriage, stillbirth, low birth weight, premature birth, babies born with decreased lung function and a higher rate of Sudden Infant Death Syndrome. Their children are also at higher risk of developing asthma, bronchitis, colds, pneumonia, other lung diseases, middle ear infections and sinus infections.

Knowing what to do about the smoke that female singers are exposed to during gigs is a tough call, especially when their careers are gaining momentum and when they thoroughly enjoy what they do. It can certainly be assumed that periodic and limited exposure is not going to significantly impact the long-term health of a woman's unborn baby. However, it's really hard to know for certain. A pregnant singer needs to consider how well (or how poorly) she tolerates the smoke, how often she is being exposed to it, for how long the exposure lasts each time, and what risks she is willing to take with both her own health and that of her fetus. For some singers, it is a simple decision; for others, it is not.

If the pregnant singer who sings in venues where smoking is permitted feels as though she is not ready or is unwilling to stop performing, she may have to consider revising her gigging schedule or find different locations for her to perform. For example, she can attempt to book fewer gigs in smoky clubs until after she has given birth. (She should keep in mind, though, that the dangerous chemicals from both first and secondhand smoke may also pass to her infant through her breast milk, and she should continue to make these schedule adjustments until after she has weaned her baby, or choose to bottle feed instead, at least for a while after she has been exposed to cigarette smoke.) She may actively seek out more outdoor performance opportunities (e.g., festivals, parks, streets, patios) during the spring, summer and fall months, if possible. She may also ask club owners to open up windows and doors for better ventilation while she is performing. (This may not be possible due to the city's noise ordinances or bi-laws, but it would certainly be worth asking.)

If she is singing in a smoky environment, she should take her breaks outside so that she can get some fresh air and reduce the amount of time that she must inhale the smoke. She should also leave the venue as soon after she has finished performing as possible, rather than continue to hang out with her band in a smoke-filled club or bar. She can suggest a change of venue - such as a patio or a different restaurant where smoking is not permitted - if her bandmates would like to eat or have some drinks. (Of course, she should never drink alcoholic beverages herself while pregnant or nursing.)

Safety Considerations

Most singers perform on elevated stages. Climbing stairs - sometimes temporary and thus less sturdy ones, and possibly while carrying equipment - is part of the life of singers and musicians.

Furthermore, performance stages are typically cluttered with instrument cables, instruments, microphone stands, guitar stands, monitors, amplifiers and speakers, as well as other people, all of whom are trying to claim their particular piece of the platform.

Because of the pregnant woman’s shifting centre of gravity, the extra weight that she is carrying, her tendency to tire easily, the looseness and instability of her joints due to relaxing hormones and the lack of concentration, preoccupation and predisposition to daydreaming (known as “scatterbrain syndrome”), her balance is often negatively affected. Pregnant women, in fact, are especially prone to clumsiness that may lead to a loss of balance and to minor falls. The pregnant singer needs to take extra care when using the stairs and when moving around on crowded stages. I suggest carving out a reasonable space on the stage that can be designated as one’s very own, where no other musician or singer will invade and potentially knock her off balance and where she is not likely to trip on patch chords, DI boxes, music stands or any other sound equipment.

Also, pregnant women are particularly prone to back injuries due to the loosening effect of hormones on the joints. They should avoid carrying heavy sound equipment, and ask a member of the band or sound crew to assist them, instead.

Vocal Health

Hydration is always important for singers, but especially so for those who are pregnant. Due to increases in blood volume and amniotic fluid, a woman’s need for water is even greater during pregnancy. Additionally, the hormones of pregnancy, particularly the high levels of progesterone that are required to sustain the pregnancy, can have a diuretic effect on the mucous membrane (cover) of the vocal folds, inhibiting their ability to remain moist and lubricated and to function optimally.

If the expectant singer is performing outdoors in the heat of summer, she should seek out shade and increase her fluid intake even more. As always, caffeinated drinks that have a diuretic effect on the body – essentially, they cause fluid to be retained in the digestive tract rather than allowing it to be reabsorbed by the body - should be avoided. (Excessive intake of caffeine may also affect your baby’s developing respiratory system, and that can affect his or her future as a singer, too!)

Also, she should be sure to rest between sound checks and performances, as well as between sets. Elevating her feet, and grabbing a light snack if there is time are both good ideas.

How Does Pregnancy Affect Tone?

The hormones of pregnancy may have similar effects on the vocal instrument that they do during a woman’s menstrual cycle. The cyclical hormonal changes can cause a drying out of the vocal fold mucosa (cover) with a reduction in secretions of the glandular epithelium that may explain why some women notice subtle changes in their voice quality, (including a deepening of the tone or a slightly lower than usual range), during their menstrual cycles. Some professional female opera singers even schedule performances around their cycles so that they can offer their audiences the best performance possible and so that they don’t risk damaging their vocal instruments when there is insufficient moisture or lubrication for the folds to function optimally.

When a pregnant women experiences a separation of the recti (main abdominal) muscles, and when her core is weakened and her muscular balance is thrown out of alignment because of her shifting centre of gravity, she may also experience difficulties with breath management. When breath management is negatively impacted, so too is the tone of the voice. A singer who belts may have difficulties getting the 'torso anchoring' that she accustomed to using for 'support' and may not be able to sustain 'money notes'. An opera singer may find that she now lacks the stamina to sing longer phrases or can't move her voice with as much agility (especially when pregnancy hormones are causing edema on the capillaries of the vocal folds, weighing them down a bit).

Pregnancy hormones can temporarily affect a singer’s range. Oftenimes, the singer will lose some of her upper range and gain a few lower notes, which may require her to transpose her songs a key or two lower during pregnancy or to avoid singing certain songs for a while. Her voice may sound dull or be lacking in its usual brilliance, and she may struggle with control, especially when ineffective breathing technique is an issue. Of course, some women find that pregnancy doesn’t seem to affect their tone significantly, and notice no changes in voice quality at any given point during the month, nor during pregnancy.

Additionally, as if growing another life isn’t exhausting enough, an inability to get sufficient rest due to discomfort, frequent trips to the restroom at night or traveling to gigs during sleeping hours may decrease the amount of energy that a singer can give to a vocal phrase. For many women, fatigue leads to breathiness (caused by inadequate vocal fold closure) and an inability to energize the vocal phrase sufficiently. Although some tone and technique problems are hormone-induced and won’t disappear until after the baby is born and is weaned, some of them can be eliminated simply by getting more rest. Tapering off the consumption of water in the evening and before bed can decrease the need for bathroom trips, and propping up the belly, legs and hips with pillows can help to reduce some of the discomforts. Napping whenever possible may help, as well. Also, the pregnant singer shouldn't push herself to keep rehearsing long after she has started feeling tired.

After Delivery

It takes a while after the baby is born for the hormonal balance of the body to be restored to its pre-pregnancy levels. Breastfeeding will prolong this return, (but please don’t avoid it, as it has so many benefits for both baby and mother). If a woman has noticed that her voice quality has changed during pregnancy, it may take her a while before she feels as though she has her old voice back. Be assured, however, that it will return in time.

Life with a newborn can be extremely exhausting due to consistently interrupted sleep cycles long after recovery from a marathon pregnancy, labour and delivery. As mentioned earlier, physical fatigue can lead to a lack of energy to give to vocal tasks. Until the baby is sleeping better – for longer stretches at a time – the new mother may find that her singing tone continues to be breathy and her onsets less than precise. (I have always found that co-sleeping with my babies, right in my own bed, has allowed me to get much better rest because I can nurse them before they completely awaken, and I don't have to get out of bed to do so. I can simply nod back off to sleep while the baby is still eating, and the baby remains, essentially, asleep for the entire night.)

It may also take some time for the abdominal muscles to recover from having been stretched for many months, which means that some of the muscles that support breathing for singing will lack their previous strength and tone. The rectus abdominus – the main abdominal muscles that meet in the middle of the abdomen, covering the belly and running from the rib cage down to the pubic bone - tend to separate during later pregnancy in order to accommodate the growing uterus and baby. For some women – those who lack core abdominal tone to begin with, those who carry ‘big’, those who are pregnant with multiples, those who have become pregnant again very soon after having given birth, those who are genetically pre-disposed, etc. - this separation is more pronounced than it is for other women. Weak abdominal muscles, such as in diastasis recti (separation of the main abdominal muscles), contribute to poor posture, which in turn cause joint misalignments, nervous system interference, and lower back pain and inflammation. Poor posture and misalignments can negatively affect breath support.

For singers especially, every effort should be made to encourage the abdominal muscles to come back together so that breath support can be what it was before pregnancy.

In many cases, the two sides of the muscle come back together on their own after a couple months, or with some exercises that are designed specifically for drawing them back together. Note that recent research has shown that regular abdominal crunches and sit-ups, including those which require twisting the torso or flexion and extension of the spine (e.g., crisscross, jackknife, roll-up, roll-over, etc.), that are typically recommended for firming up the stomach will actually make the separation worse, so they should be avoided during pregnancy and the first few postpartum months. The most effective and safest method of drawing the abdominal muscles back together and tightening them involves sitting or standing isometric exercises during which the woman would sit or stand straight, suck her belly button inward (as if she were attempting to pull it up and toward her spine) and hold that position for ten to fifteen seconds several times a day. This exercise can even be performed earlier in pregnancy (as long as it is comfortable) to help maintain abdominal tone for as long as possible. Multiple contractions of the transverse muscles - activated when 'sucking in' the stomach - are encouraged.

It is sometimes recommended that singing tasks that require strenuous use of the abdominal support muscles be avoided in the first few weeks postpartum, until the separation disappears. Binding of the abdomen from below the pubic bone to just below the sternum within the first day or two after giving birth, then continuing to bind twenty-four hours a day for a few months after delivery may help to draw these muscles closer, and will stabilize the pelvis and the lower back (which are dependent on the strength and alignment of the abdominal muscles to provide good postural support).

However, for some of us, the separation of this main abdominal muscle - the dreaded 'mommy tummy' - will remain a permanent part of our postpartum figures, despite our most persistent efforts to improve or regain muscle tone. Physical therapy, or plastic surgery (i.e., a 'tummy tuck' that will repair the abdominal wall) for severe cases, may be required. Singing can still be well-supported, even with permanently separated abdominal muscles, so don’t panic if your muscles do not come back together without taking extreme measures.

Finally, sing to your baby as often as you can. This will not only help calm your baby and encourage bonding, but you will also be beginning the process of regaining your pre-pregnancy vocal skills, and your baby will begin to develop an ear for music and rhythm.

Last updated on Tue Apr 23 23:52:24 2013