The orchestral music is late-Romantic in style, rejecting avant-garde techniques and influenced by composers like Wagner, Strauss, Ravel, and early Stravinsky. The vocal music generally resembles recitative or Sprechgesang, though the mother's and child's parts are sometimes more expressive. In general, the score is lyrical and musically conservative, with few innovations and frequent use of clichés. The opera's overture opens with an unaccompanied female nonet. The first act is dominated by the orchestra, while vocal music predominates in the act. In the fourth and final act, the female nonet provides the voices of the dead children.