Vocal communication and perception of pain in childbirth vocalizations

Nonlinear acoustic phenomena (NLP) likely facilitate the expression of distress in animal vocalizations, making calls perceptually rough and hard to ignore. Yet, their function in adult human vocal communication remains poorly understood. Here, to examine the production and perception of acoustic correlates of pain in spontaneous human nonverbal vocalizations, we take advantage of childbirth-a natural context in which labouring women typically produce a range of highly evocative loud vocalizations, including moans and screams-as they experience excruciating pain. We combine acoustic analyses of these real-life pain vocalizations with psychoacoustic experiments involving the playback of natural and synthetic calls to both naïve and expert listeners. We show that vocalizations become acoustically rougher, higher in fundamental frequency (pitch), less stable, louder and longer as child labour progresses, paralleling a rise in women's self-assessed pain. In perception experiments, we show that both naïve listeners and obstetric professionals assign the highest pain ratings to vocalizations produced in the final expulsion phase of labour. Experiments with synthetic vocal stimuli confirm that listeners rely largely on nonlinear phenomena to assess pain. Our study confirms that nonlinear phenomena communicate intense, pain-induced distress in humans, consistent with their widespread function to signal distress and arousal in vertebrate vocal signals.