Pregnancy and postpartum: a guide for singers

The trained singer utilizes an awareness of her body as an instrument. When she becomes pregnant, her body changes in numerous ways to support the pregnancy. Many of these changes have great impact on her ability to sing during the pregnancy and postpartum periods. The voice may be altered positively or negatively by the release of hormones. The body undergoes many changes that affect the posture and breathing required for singing. Most notably, the abdominal muscles are greatly impacted by the pregnancy. They are stretched by the growing uterus, and this affects their function. In addition, the linea alba (the connective tissue between the halves of the rectus abdominis) is softened by hormonal increases and subject to stretching as the uterus grows, predisposing it to weakness. Since the other abdominal muscles attach to the linea alba via connective tissue, maintaining the integrity of the linea alba during pregnancy and postpartum is vital to the operational function of the abdominal muscles. Protecting the vulnerable linea alba must be deliberately undertaken in two parts. First, conscious exercise is needed to preserve the linea alba during pregnancy and to rehabilitate it after pregnancy. Targeted exercises strengthen the transverse abdominis and shorten and approximate the two halves of the rectus abdominis. Second, modifications in daily movement are necessary to protect the linea alba while performing routine activities. Cesarean sections present additional surgical concerns for singers, including abdominal incisions, use of medication, and the rare need for general anesthesia via intubation. Recovery from a cesarean can be difficult due to abdominal pain, yet steps may be taken to speed healing at the hospital and at home. This paper provides an overview of how pregnancy affects the singer, discusses the effects of pregnancy and cesarean section, and provides a plan to protect the abdominal muscles during pregnancy and rehabilitate them in the postpartum period. It combines information from the fields of physical therapy, medicine, and surgery into a guide for the singer and voice teacher.