And Why Not Choirs on Prescription

Following on from my last blog about group-singing helping symptoms of post-natal depression I’ve been talking to various people in related fields, starting with the fantastic Lauren, from The Parenting Chapter, which is a go-to website for people navigating the ups and downs of parenting. Lauren has been gathering a team of professionals to help, support and advise people on that journey, and as someone in the know, she put me in touch with The Parenting Charter’s Consultant Perinatal Psychologist, Julianne Boutaleb.

I was really interested to hear her view on this research and also why and how it could be that group-singing does help mums. And we had a fascinating conversation about the brain, neuroplasticity, emotional regulation and how the post-natal brain is similar to the adolescent brain (might explain a lot!).

So here are some of her comments:


"I think the Pram Chorus singing groups work on so many levels for parents who might be feeling low or socially isolated, or even those potentially suffering from PND. 

Firstly, unlike most other groups they offer a structure for social activity which doesn't necessarily involve talking about the baby or being a new parent. For many of the parents I see with PND this is hugely important as fear of having to talk about their birth or breastfeeding is what puts many of them off attending groups.”

This is really important I think. Nobody wants to be judged, but especially as a new parent, the fear that we are doing a bad job or that others are judging us is a huge pressure. Especially as a new parent, when you really don’t have a clue what you’re doing. Is your baby’s crying normal? How do you know if it isn’t? This also relates to the gaping loneliness that so many of us feel after having a baby and losing our usual social and work-communities. Personally I think this is a massive cause of PND and my aim with Pram Chorus (and my other choirs) is to build supportive, friendly and non-judgemental communities for parents at a very vulnerable time.


“Secondly, there is a focus on the parent and their needs...and the songs they want to sing! For many new parents feeling a bit lost in their new role as mum or dad, I imagine that all the positive associations with a song from their pre-parenting life might also reconnect them with strengths they have forgotten about, and act as an important bridge between their pre-baby self and who they are now.”

Julianne is essentially talking about identity here, and the identity crisis of parenthood. We have so many preconceptions about what being a parent is, and importantly, what a GOOD parent is. Then when it happens to us, it can be traumatic, bewildering, painful, lonely, confusing. And amongst all of this is the awareness of the huge responsibility of caring for a tiny vulnerable person. Where do I and my mass of emotions fit into this? Who am I now and does anyone notice or care? And where can I go if I’m feeling like this? I love seeing the groups I work with literally growing in stature, as we focus on our posture, finding their voices and connecting their bodies and breath with their voices and emotions. We learn a wide variety of songs, some familiar, some entirely new, but each voice and person is valued for their unique contribution.


“Finally, the act of collective singing has been proven to have positive neurological benefits which may lift mood (dopamine) and improve bonding (oxytocin). In addition we access the right side of our brains when singing -the side of the brain linked to emotions and early memory. For parents suffering from depression or anxiety (where left brain processes such as rumination are dominant) hanging out in the right brain may provide welcome relief and neurochemical balance so they feel calmer and less anxious.”

And the chemical-science-bit! This is really fascinating and where group-singing really comes into its own, especially for parents (and everyone) suffering from mental illness who would like a drug-free treatment with no side effects. I am astounded that with the NHS broke and at breaking point, and with more and more research demonstrating the therapeutic effects of choirs in a variety of health contexts, that there aren’t choirs on prescription.

Many thanks to….

Julianne Boutaleb CPsychol AFBPsS Consultant Perinatal Psychologist

Founder & Clinical Director of Parenthood In Mind

 *Blog title taken from a lecture of the same title by Grenville Hancox at Morley College, 15th January 2018 in which he was advocating singing on prescription.


New Research Shows that Singing in Groups Helps Reduce Symptoms of Post-Natal-Depression. But how?

I am thrilled that what I have been hearing anecdotally from my members over the last 6 years has been demonstrated in new research published in the British Journal of Psychiatrists this week. A study of 134 mothers experiencing symptoms of post-natal-depression were split into three groups: one doing group singing; one doing creative play and one following their usual treatment. The results are astounding. For those experiencing mild to moderate symptoms there was an improvement in their symptoms, but for those experiencing moderate to severe symptoms of PND there was an even faster improvement in their symptoms. Put simply, singing in a choir with your baby works over a matter of weeks to reduce symptoms of post-natal depression.

I have written before about how founding Pram Chorus came out of my own experience of depression and loneliness after the birth of my daughter 7 years ago. I had the idea of setting up a choir for parents, where they could bring their babies/toddlers too. Pram Chorus is a place where the focus is YOU, the parent, rather than the baby (like so many other activities); somewhere to go and do something, which actually works with your baby there, so there is no guilt about leaving them either. What continually inspires me are the frequent reports from members that Pram Chorus is their "saviour", or "the one activity that gets me through the week".

So now we know that group singing works, but do we have any idea how or why?

I have direct experience of this and have thought about it, talked to and tried things out with my choir members, so here are some of my thoughts.

There is something very different to singing in a group from singing on your own in the shower for example. Obviously, in the shower you are alone to let rip, but in a group there is another very important factor: you are also listening and being heard. I think this is a profound aspect of choir-singing and a big clue to its benefits. Our deepest feelings and emotions can be hard to articulate, especially when they are negative, and then there is the problem of having someone to listen, even if we can articulate them. Singing is a means of expression, which somehow seems to express deep emotions in a cathartic way, without you even having to consciously articulate them. I also incorporate active listening exercises into my sessions, so that the singers are really listening and responding to each other; enhancing their interaction, making them more connected to each other. This connection goes further than being emotional and psychological, to being a physical connection, with choir singers' breath being consciously synchronised, whilst unconsciously their heartbeats become synchronised.

This aspect of connection is important to PND. Women who live in close-knit communities are less likely to experience postnatal depression. So when singing together, you are engaging in a unifying activity, which has largely been lost in our society, where on becoming a parent your usual work and social networks are no longer there for you on a day-to-day basis. The loneliness can be excruciating, with it being no surprise that rates of postnatal depression are suggested to be 1 in 8. Personally, I suspect it is a hidden epidemic with a lot of cases going undiagnosed and the grey landscape between being depressed and feeling low, being largely unknown and ignored. I address this by encouraging everyone to both contribute and take responsibility in a musical and social sense (we take it in turns to bring cake), so that the whole group is working together, listening to each other, talking, singing, laughing and eating together.

Which leads us on to confidence and a sense of achievement. I'm not going to pretend to be an expert on postnatal depression or mental health, but it seems to me that if you are struggling with PND, especially having recently gone through the trauma of birth, breast-feeding, sleepless nights etc, you are not going to be feeling at your most confident. I have observed that working together with others to "achieve" a song, where each voice counts and is valued, gives a sense of achievement and over time builds confidence in other areas: personally, socially, and professionally. This improvement in self-esteem has a knock-on positive effect on mental health.

My final point about PND is that I think there is a real crisis of identity on becoming a parent, especially as a mother, after the physical and emotional trauma of birth. I for one, was completely unprepared, so when the reality hit of being alone with a baby that cried a lot for long stretches of time, without anyone to tell me what to do and an unstructured 24-hour existence, I was really at a loss. Everything, from health professionals to family and other activities, seemed so baby-focussed, which I found boring and jarring, compounding the sense of inadequacy and loneliness I felt. In contrast, I very consciously focus on the parents in my choir sessions. I love seeing the babies and getting to know them over time, but my focus is the adults and asking them individually "how are YOU?". I weave exercises into my warm-ups so everyone learns each other’s names and to help members get to know each other. And we don't sing nursery rhymes - we sing a wide variety of songs with members regularly being asked for song suggestions.

What all of this amounts to is building a supportive community, which, through the experience of singing and making music together, creates deep connections between people.

This research is so exciting and hopefully for those suffering from PND, (and potentially many other mental illnesses) could pave a way for cost-effective and drug-free treatments. There are many more questions (I have as many as I have ideas!) but the most pressing for me, is how to improve access to choirs like Pram Chorus for vulnerable women so that they are not too terrified to come. So how about it NHS, GPs, Midwives and Health Visitors.  Prescribe a choir? Choir-therapy? Feel free to comment below.

Ruth Routledge - Pram ChorusChoir Community


Watch a video below about the research....

The Black-hole of Loneliness

One of the many things I really wasn't prepared for when becoming a parent, was the gaping, black-hole of loneliness which sucked me in. After the initial terror/euphoria of birth, getting our new daughter home and settling into the 4 hourly marathon of existence (feed, sleep, change, repeat), I was completely left to my own devices with minutes, hours, days and whole weeks to fill.

Yes, we did NCT classes (National Childbirth Trust antenatal classes largely focused around birth) so I had a group of other local mums to meet up with. And nice as they were, they weren't really my friends. We barely knew each other and aside from having given birth and living in roughly the same part of London, we didn't have much in common. Our weekly meet-ups in a local cafe were seriously marred by the fact that my baby went completely nuts for the 15 minutes or so in which I managed to inhale a coffee and scoff a cake before retreating (of course she calmed down as soon as I left). The baby-massage course I embarked on, more for something to do than anything else, was yet another trauma as, of course, mine was the only baby who detested having her clothes off and screamed blue-murder for the duration of the class, whilst I sweatily, tried to feed her, calm her - anything so that the poor teacher could be heard and the rest of the class could get some benefit or enjoyment! 

Like many people, I also don't have close family around, as well as being one of the first of my local friends to have a baby, so no-one I knew was kicking around in the day, looking for baby-friendly company. I tried coffee mornings and baby-groups, but when you're tired, vulnerable, hormonal and finding life a real challenge, the last thing you feel able to do is, firstly, just go to an activity with a bunch of strangers and introduce them to you and your (screaming) child. Secondly, even if you do pluck up the courage to go, you then have to take an extra step and speak to groups of people who all seem to know each other and have nailed the parenting-thing so that their child doesn't scream whenever they are in a social situation (I have since discovered they didn't really feel like that - but they seemed like that to me.)

The supermarket became my go-to, as there would be some minimal but low-pressure human interaction and even... (drum-roll!!)...the possibility of a chat with someone I bumped into, knowing I could quickly skidaddle if bubba decided to exercise her lungs. I also took to travelling to meet my partner after his working day to kill another couple of hours and bring the time when my solo-parenting was over. Braving rush-hour with a small baby wasn't a patch on that ever-threatening black-hole  - actually it was quite an effective antidote being crammed into a confined space with a load of people with a "purpose".

But what really saved me was two things: an exercise class where I could take my baby. It was outside on Tooting Common, and wasn't just new mums, but a bunch of down-to-earth people with children of varying ages and stages. So the perspective they had on a screaming newborn, was one I was seriously lacking, and helped me so much. They didn't mind that my baby cried a lot, they didn't think that meant I was a bad mother or doing something terribly wrong - they knew that lots of young babies are unsettled and "colic-y" (don't get me started on that nonsense-term!!) and it being outside also meant that by baby's cries didn't have the stressful impact on me or anyone around me. Tess, the teacher was so helpful too, rocking the buggy so I could finish whatever exercise we were doing, without worrying that my baby crying for 20 seconds was going to scar her for life. Obviously the exercise itself also helped.

And that in turn was the inspiration for Pram Chorus, my second saviour - so that I could combine my previous professional life as a choir-director, with my newfound existence as a parent. A choir for parents: not just mums but dads too (a subject for another blog-post, but poor Dad-carers are implicitly and explicitly excluded from so many baby-activities) - ANYONE looking after a pre-school child, to come and take part themselves in a stimulating and fun activity. You don't have to talk to anyone, or be able to sing or even especially like singing. But you and your baby/toddler, screaming or not, are welcome to come and take part in something. I won't promise you friends (although there's a strong chance you'll make some) but I will promise you an hour of pure, healthy escapism; where you and your voice are valued and appreciated. You will come away with some new songs to sing, having exercised your grey-matter, having had a laugh and with a spring in your step, to keep you going for the week between classes. 

So if you are struggling and doing your best to dodge that black-hole, please take that first step and come along.

Starting back after a loooong break!

This is my first ever blog post, so welcome! You will have to forgive any stumblings as I feel as though I'm slowly grinding my brain back into work mode after what feels like a very long time. I have been keeping busy feeding, entertaining, disciplining, washing, clearing-up-after and, very occasionally of course, losing-my-temper-with my sprogs, little of which comes naturally to me. I have had barely 5 minutes in which to gather my thoughts without interruption in the last 4 weeks and even snuck into the loo and surreptitiously locked the door yesterday so I could do an internet supermarket order. Honestly! The lengths I have to go to! I do go to the supermarket at least once a day yet somehow don't succeed in buying all the things we actually need. I would blame myself, but it's really not my fault - it's the fault of the constant interruptions by small people "really needing" the brightly packaged things in small individual packets, or winding each other up or tripping up other unsuspecting shoppers. A supermarket trip with my kids truly is a mental, emotional and physical assault course of gargantuan proportions (hence my sneaky toilet-stop yesterday!)

Anyway, I digress (sorry). There is lots going on this term, namely in the form of not having our Tuesday session anymore, but having new sessions starting on different days and places. These will be starting after half term, with the idea being to spread the PC-love beyond Balham and Tooting and also to give you more options in terms of days/locations.

I am also sending out a survey for you to honestly tell me what you think works and what doesn't - please don't hold back!!

We are also hitting the ground running with two local events in our first three weeks of term: firstly a Macmillan coffee morning in Balham on Friday 15th September straight after our Friday session. This will be a workshop-style session teaching a couple of simple songs to everyone before having lovely cakes - so please let me know if you can donate a cake and also invite friends/neighbours. All donations will go to Macmillan nurses. Secondly we are performing with Night Chorus as part of Tootopia on Saturday 23rd September 2:30pm at the Graveney and Meadow. It's a lovely festival at different venues in and around Tooting.

After that we will be knuckling down to learning.....wait for it.....CHRISTMAS SONGS! A diverse selection of carols and other festive songs. I have chosen the songs but if you have a cracking idea do let me know and hopefully we can add it in....

Onwards and upwards Pram Choristers :-)