The purposes of this study were to determine factors affecting the use of music by women during childbirth and to compare the frequency of actual music use during childbirth by women who heard music during prenatal labor rehearsal vs those who did not hear music in rehearsal. Fifty-four women attending Lamaze childbirth classes were randomly assigned to music-rehearsal or nonmusic-rehearsal groups. After delivery, all subjects completed questionnaires about music use and subjective responses to music. Eleven factors involved in determination of actual music use were identified. No significant differences in music use by rehearsal group assignment were found. Results demonstrate that music provides an adjunct to childbirth that is highly desirable for some women, while unappealing or inconvenient for others. Suggestions for utilization of findings by maternity care providers are presented.