Objective: Although many children are placed in care of child protection services each year, very little is known about how having a child placed in care affects the health and well-being of biological mothers. This study aims to address this gap in knowledge. Methods: The linkable administrative data housed at the Manitoba Centre for Health Policy were used to create several cohorts of mothers whose children were born in Manitoba, Canada, identified through child protection case files. Maternal health and social outcomes in the years before and after having a child taken into care were compared using generalized estimating equations. Poisson regression models were used to obtain relative rates of mental health-related outcomes for mothers whose children were taken into care and mothers whose children died. Incidence rate ratios of suicide attempts and completions were obtained using fixed-effects Poisson regression models. Finally, Cox proportional hazard regression models determined rates of avoidable and unavoidable mortality among mothers whose children were taken into care.
Results: Compared with mothers whose children were not placed in care, mothers whose children were taken into care have significantly higher rates of anxiety, substance use, physician visits, hospitalizations, prescriptions, and income assistance use in the years before their children were taken into care; rates increased significantly in the years after. These mothers also had significantly higher rates of depression, anxiety, substance use, physician visits for mental illness, hospitalizations for mental illness, and psychotropic medication use in the years after custody loss compared with mothers who experienced the death of a child. Rates of suicide attempts, death by suicide, avoidable mortality and unavoidable mortality were also higher among mothers whose child was taken into care. Conclusion: Mothers whose children are taken into care often face many challenges in the years leading up to custody loss; the loss of custody often creates new challenges or exacerbates existing challenges. To address these outcomes, more preventative services should be implemented to keep families together and more supports should be in place to ensure timely family reunification. Meaningful supports need to be provided for mothers who are not reunified with their children.