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Maternal health and social outcomes after having a child taken into care: population-based longitudinal cohort study using linkable administrative data
  1. Elizabeth Wall-Wieler1,
  2. Leslie L Roos1,2,
  3. James Bolton3,
  4. Marni Brownell1,2,
  5. Nathan C Nickel1,2,
  6. Dan Chateau1,2
  1. 1 Department of Community Health Sciences, University of Manitoba, Manitoba, Canada
  2. 2 Manitoba Centre for Health Policy, University of Manitoba, Manitoba, Canada
  3. 3 Department of Psychiatry, University of Manitoba, Manitoba, Canada
  1. Correspondence to Elizabeth Wall-Wieler, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 3P5, Canada; wallwiee{at}


Background We investigated whether mothers experience changes to their health and social situation after having a child taken into care by child protection services, then compared these outcomes with those found in mothers whose children were not taken into care.

Methods The cohort includes mothers whose first child was born in Manitoba between 1 April 1998 and 31 March 2011. Mothers whose children were taken into care after age 2 (n=1591) were compared with a matched group of women whose children were not taken into care (n=1591).

Results The rates of mental illness diagnoses, treatment use and social factors were significantly higher for mother whose children were taken into care, both in the 2 years before and in the 2 years after the index date. These adjusted relative rates (ARRs) increased significantly for anxiety (before ARR=2.71, after ARR=3.55), substance use disorder (3.77–5.95), physician visits for mental illness (2.83–3.66), number of prescriptions (psychotropic: 4.35–5.86; overall: 2.34–2.94), number of different prescriptions (psychotropic: 2.70-3.27; overall: 1.62–1.70), residential mobility (1.40–1.63) and welfare use (2.07–2.30).

Conclusion The health and social situation of mothers involved with child protection services deteriorates after their child is taken into care. Mothers would benefit from supports during this time period to ensure that the outcomes they experience after the loss of their child do not become another barrier to reunification.

  • cohort studies
  • health inequalities
  • maternal health
  • mental health

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  • Contributors The study was conceived and drafted by EW-W; EW-W also acquired and analysed the data. All authors contributed to the design of the study and the interpretation of the data. Drs LLR, JB, MB, NCN and DC provided critical revision of the manuscript for important intellectual content. Dr LLR provided supervision. Drs DC and NCN provided statistical support.

  • Funding Preparation of this manuscript was supported by a Social Sciences and Humanities Research Council of Canada Joseph-Armand Bombardier Canada Doctoral Scholarship, a Graduate Enhancement of Tri-Council Stipend, and a Women’s Health Research Foundation of Canada Full Time Scholarship.

  • Competing interests None declared.

  • Ethics approval This study was approved by the Health Research Ethics Board at the University of Manitoba (#H2016:182) and the Health Information Privacy Commission at Manitoba Health, Seniors and Active Living (#2016/2017-09). Using deidentified administrative data files did not require informed consent from participants.

  • Provenance and peer review Not commissioned; externally peer reviewed.