Group singing as an effective intervention for postnatal depression
- Rebecca Bind
- Oct 15
- 4 min read
Updated: Oct 16
The SHAPER-PND study
I am Dr Rebecca Bind, a Postdoctoral Research Associate working in the Perinatal section of the Stress, Psychiatry and Immunology Lab at The Institute of Psychiatry, Psychology and Neuroscience. Most recently I managed a clinical trial for mothers with postnatal depression called SHAPER-PND, the exciting results from which have just been published and I will discuss below.
Postnatal depression
Postnatal depression has become more common in recent years, thought to affect up to 1 in 4 mothers. Symptoms—which include low mood and sadness, loss of interest and motivation, tearfulness, fatigue, and feelings of guilt— can begin in pregnancy and carry on into the postpartum period or appear after the baby is born. While conventional treatments, like antidepressants and talking therapy, show to be beneficial, many mothers still face difficulties in accessing standard care.
In light of this, it has become increasingly necessary for alternative or complementary interventions to be made available, like community-based arts activities. In fact, studies show that group singing help mothers with a sense of social support, stress reduction and relaxation, and a stronger bond with their babies.
Our study
To understand whether community singing sessions are an effective intervention for postnatal depression, the SHAPER research team, myself included, set up a clinical trial, led by Professor Carmine Pariante of King’s College London. Our trial had three main aims (more detail of which can be read in our protocol paper and in our recently published findings):
1) To evaluate whether 10 weeks of singing sessions can reduce symptoms of postnatal depression
2) To understand whether mothers who participated in the singing sessions found it to be a useful intervention
3) To assess whether the intervention is affordable for the NHS to incorporate into standard care for postnatal depression.
Study design
For the SHAPER-PND study, we recruited 199 mothers across South London who were experiencing symptoms of postnatal depression and their babies. Mothers were recruited from social media, their GP surgery, perinatal mental health services, word-of-mouth, and community centres.
Eligible mothers enrolled and completed a baseline assessment for demographic information and to evaluate their mental health. Mothers were then randomly (that is, by chance) allocated to either our 10-week singing intervention (intervention group), called Breathe Melodies for Mums (described below), or to already-existing mother-baby groups at local children’s centres, like baby sensory and messy play (control group).
They filled in questionnaires at baseline, week 6 (mid-intervention), week 10 (end-of-intervention), and weeks 20 and 36 (post-intervention follow-ups) so we could track their symptoms and whether they were finding their assigned activity to be helpful for their mental health.
We also filmed mothers interacting with their babies at baseline, week 10, and week 36, to look for changes in their relationship and we collected biological samples (saliva) at baseline and week 10 to look at mothers’ and babies’ levels of stress hormones, including cortisol. Results from these two aspects of the trial are still being analysed.
Breathe Melodies for Mums
Breathe Melodies for Mums (M4M) is a singing programme that was developed by Breathe Arts Health Research as a bespoke intervention for postnatal depression and piloted in a previous research study.
For M4M, mothers and their babies attended 10 weekly, in-person, hour-long singing sessions, led by a specialist Breathe-trained music lead. Mothers and babies sat in a circle on the floor and classes began with welcome songs to introduce everyone. Songs were from around the world in different languages and from different cultures, were sung in rounds with multiple parts and harmonies, and sometimes included instruments.
What did we find?
We found that mothers in both groups experienced a significant decrease in their symptoms of postnatal depression by the end of the intervention (week 10). However, once the intervention period ended, mothers in the singing group maintained lower levels of depression than mothers in the control group, seen at weeks 20 and 36, that is up to six months after the end of the singing sessions. This was a very important finding as it showed us that not only is M4M effective at reducing symptoms of depression during the intervention period itself, but that its effects are long-lasting.
Secondly, we looked at participant retention, meaning whether mothers remained in the study. We found a difference between the intervention and control groups, such that mothers in the intervention group were likelier to remain in the study and attend their sessions. This suggested that the intervention group was finding their activity to be more helpful and motivating. We next found that mothers who participated in M4M found it to be a more useful and valuable intervention than the mothers who attended community mother-baby activities found their sessions to be.
Finally, M4M was found to be affordable, with the cost of a 10-week intervention falling within the range that NICE recommends the NHS pay for an intervention. This was very encouraging, given that M4M is clinically effective for postnatal depression and mothers enjoy and greatly benefit from the sessions.
Why does M4M work?
The Breathe M4M singing intervention is a promising intervention for postnatal depression and we believe there are numerous reasons why it works. Firstly, it is possible that the skills mothers learn during the sessions help them care for and bond with their babies, leading to increased feelings of competency and reduced depression. Additionally, previous studies have found that singing to one’s baby decreases cortisol, a stress hormone closely tied to depression. Furthermore, the singing sessions have been specifically tailored to mothers experiencing postnatal depression, providing mothers with social support that they likely wouldn’t receive in standard mother-baby activity groups. In fact, mothers in the intervention group told us in interviews conducted that they greatly valued the opportunity to build social connections in a group setting with other mothers going through similar mental health difficulties.
Going forward
Overall, the SHAPER-PND trial provides exciting novel evidence that the Breathe M4M singing intervention is clinically effective, highly-rated by mothers, and cost-effective. Given this, in addition to the fact that mothers in the intervention group had longer-lasting relief from their depressive symptoms, and were more likely to attend their sessions, we believe there is great value in our health and social care systems investing in this intervention.
