Abstract
Objectives This study examines whether mothers involved with child protection services (CPS) at the birth of their first child had higher rates of postpartum depression and anxiety. Methods A retrospective cohort of mothers whose first child was born in Manitoba, Canada between April 1, 1995 and March 31, 2015 is used. Postpartum depression and anxiety among mothers whose first child was placed in care at birth (n = 776) was compared with mothers who received services from CPS (but whose children were not placed in care) (n = 4,270), and a 3:1 matched group of mothers who had no involvement with CPS in the first year of their firstborn’s life (n = 2,328). Adjusted odds ratios (AOR) of depression and anxiety diagnoses in the first year postpartum were obtained from logistic regression models. Adjusted rate ratios (ARR) of antidepressant use obtained using Poisson models. Results Mothers whose children were taken into care have greater odds of having a postpartum depression or anxiety diagnosis than mothers receiving services (AOR = 1.31; 95% CI 1.08–1.59) and those not involved with CPS (AOR = 2.13; 95% CI 1.67–2.73). Among mothers who had a postpartum depression or anxiety diagnosis, mothers whose children were placed in care had significantly higher rates of antidepressant use than mothers receiving services only (ARR = 2.00; 1.82, 2.19) and mothers who were not involved with CPS (ARR = 2.42; 95% CI 1.94–3.51). Conclusions for Practice Targeted programs should be implemented to address postpartum mental illness among mothers who are involved with CPS at the birth of their child.
References
Abrahams, R., Kelly, S., Payne, S., Thiessen, P., Mackintosh, J., & Janssen, P. (2007). Rooming-in compared with standard care for newborns of mothers using methadone or heroin. Canadian Family Physician, 53(10), 1722–1730.
Andersson, L., Sundstrom-Poromaa, I., Wulff, M., Astrom, M., & Bixo, M. (2006). Depression and anxiety during pregnancy and six months postpartum: A follow-up study. Acta Obstetricia et Gynecologica Scandinavica, 85(8), 937–944.
Brownell, M., Chartier, M., Au, W., MacWilliam, L., Schultz, J., Guenette, W., & Valdiva, J. (2015). The educational outcomes of children in care in Manitoba. Winnipeg. Retrieved from http://mchp-appserv.cpe.umanitoba.ca/reference/CIC_report_web.pdf.
De Tychey, C., Briançon, S., Lighezzolo, J., Spitz, E., Kabuth, B., De Luigi, V., Messembourg, C., Girvan, F., Rosati, A., Thockler, A., & Vincent, S. (2008). Quality of life, postnatal depression and baby gender. Journal of Clinical Nursing, 17(3), 312–322. https://doi.org/10.1111/j.1365-2702.2006.01911.x.
Family Services and Housing. (2009). Child protection services. Retrieved February 16, 2016, from http://www.gov.mb.ca/fs/cfsmanual/pubs/pdf/1.3.1_enp.pdf.
Feldman, R., Weller, A., Leckman, J., Kuint, J., & Eidelman, I. (1999). The nature of the mother’s tie to her infant: Maternal bonding under conditions of proximity, separation, and potential loss. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 40(6), 929–939. https://doi.org/10.1111/1469-7610.00510.
Fernandez, E. (2012). Accomplishing permanancy: Reunification pathways and outcomes for foster children. New London: Springer.
Fong, K. (2016). Child welfare involvement and contexts of poverty: The role of parental adversities, social networks, and social services. Children and Youth Services Review, 72, 5–13. https://doi.org/10.1016/j.childyouth.2016.10.011.
Gilbert, R., Fluke, J., O’Donnell, M., Gonzalez-Izquierdo, A., Brownell, M., Gulliver, P., Janson, S., Sidebotham, P. (2012). Child maltreatment: Variation in trends and policies in six developed countries. The Lancet, 379(9817), 758–772. https://doi.org/10.1016/S0140-6736(11)61087-8.
Gold, K., Leon, I., Boggs, M., & Sen, S. (2016). Depression and posttraumatic stress symptoms after perinatal loss in a population-based sample. Journal of Womens Health, 25(3), 263–269.
Gough, P., Trocme, N., Brown, I., Knoke, D., & Blackstock, C. (2005). Pathways to the overrepresentation of Aboriginal children in care. Toronto. Retrieved from http://cwrp.ca/sites/default/files/publications/en/AboriginalChildren23E.pdf.
Kenny, K. (2017). Mental health harm to mothers when a child is taken by child protective services: Health equity considerations. The Canadian Journal of Psychiatry, 70674371774888. https://doi.org/10.1177/0706743717748885.
Kenny, K., Barrington, C., & Green, S. (2015). “I felt for a long time like everything beautiful in me had been taken out”: Women’s suffering, remembering, and survival following the loss of child custody. International Journal of Drug Policy, 26, 1158–1166. https://doi.org/10.1016/j.drugpo.2015.05.024.
Kinser, P., & Lyon, D. (2014). A conceptual framework of stress vulnerability, depression, and health outcomes in women: Potential uses in research on complementary therapies for depression. Brain and Behavior, 4(5), 665–674. https://doi.org/10.1002/brb3.249.
Leigh, B., & Milgrom, J. (2008). Risk factors for antenatal depression, postnatal depression and parenting stress. BMC Psychiatry, 8, 24. https://doi.org/10.1186/1471-244X-8-24.
Manitoba Centre for Health Policy. (2007). Term: Protection services. Retrieved December 15, 2016, from http://mchp-appserv.cpe.umanitoba.ca/viewDefinition.php?definitionID=103841.
Nickel, N., Chateau, D., Martens, P., Brownell, M., Katz, A., Burland, E., Walld, R., Hu, M., Taylor, C.R., Sarkar, J. and Goh, C.Y., (2014). Data resource profile: Pathways to health and social equity for children (PATHS Equity for Children). International Journal of Epidemiology, 43(5), 1438–1449.
Novac, S., Paradis, E., Brown, J., & Morton, H. (2009). Supporting young homeless mothers who have lost child custody. In J. D. Hulchanski, P. Campsie, S. B. Chau, S. W. Hwang & E. Paradis (Eds.), Finding home: Policy options for addressing homelessness in Canada. Toronto: Cities Centre, University of Toronto.
O’Donnell, M., Maclean, M., Sims, S., Morgan, V., Leonard, H., & Stanley, F. (2015). Maternal mental health and risk of child protection involvement: Mental health diagnoses associated with increased risk. Journal of Epidemiology and Community Health, 69, 1175–1183. https://doi.org/10.1136/jech-2014-205240.
Pajulo, M., Suchman, N., Kalland, M., & Mayes, L. (2006). Enhancing the effectiveness of residential treatment for substance abusing pregnant and parenting women: Focus on maternal reflective functioning and mother-child relationship. Infant Mental Health Journal, 27, 448–465. https://doi.org/10.1002/imhj.
Pelton, L. (2015). The continuing role of material factors in child maltreatment and placement. Child Abuse and Neglect, 41, 30–39. https://doi.org/10.1016/j.chiabu.2014.08.001.
Priest, S., Austin, M., Barnett, B., & Buist, A. (2008). A psychosocial risk assessment model (PRAM) for use with pregnant and postpartum women in primary care settings. Archives of Women’s Mental Health, 11(5–6), 307–317.
Putnam-Hornstein, E., & Needell, B. (2011). Predictors of child protective services contact between birth and age five: An examination of California’s 2002 birth cohort. Children and Youth Services Review, 33, 2400–2407.
Roos, L., Gupta, S., Soodeen, R., & Jebamani, R. (2005). Data quality in an information-rich environment: Canada as an example. Canadian Journal on Aging, 24, 153–170. https://doi.org/10.1353/cja.2005.0055.
Statistics Canada. (2014). Focus on geography series, 2011. Retrieved from http://www12.statcan.gc.ca/census-recensement/2011/as-sa/fogs-spg/Facts-pr-eng.cfm?Lang=Eng&GK=PR&GC=46.
Vigod, S., Villegas, L., Dennis, C., & Ross, L. (2010). Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review. BJOG, 117(5), 540–550. https://doi.org/10.1111/j.1471-0528.2009.02493.x.
Watkins, S., Meltzer-Brody, S., Zolnoun, D., & Stuebe, A. (2011). Early breastfeeding experiences and postpartum depression. Obstetrics & Gynecology, 118(2), 214–221. https://doi.org/10.1097/AOG.0b013e3182260a2d.
Yim, I., Stapleton, T., Guardino, L., Hahn-Holbrook, J., & Schetter, C.D. (2015). Biological and psychosocial predictors of postpartum depression: Systematic review and call for integration. Annual Review of Clinical Psychology, 11, 99–137. https://doi.org/10.1146/annurev-clinpsy-101414-020426.
Acknowledgements
Data used in this study are from the Population Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba and were derived from data provided by Manitoba Health, Seniors and Active Living, Manitoba Families, Healthy Child Manitoba, Manitoba Education and Training, Manitoba Justice, and Vital Statistics under Project #2016/2017-09. The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy, Manitoba Health, Seniors and Active Living or other data providers is intended or should be inferred. This work was supported by a Social Sciences and Humanities Research Council of Canada Joseph-Armand Bombardier Canada Doctoral Scholarship, at Graduate Enhancement of Tri-Council Stipend, and a Women’s Health Research Foundation of Canada Full Time Scholarship.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Wall-Wieler, E., Roos, L.L., Brownell, M. et al. Postpartum Depression and Anxiety Among Mothers Whose Child was Placed in Care of Child Protection Services at Birth: A Retrospective Cohort Study Using Linkable Administrative Data. Matern Child Health J 22, 1393–1399 (2018). https://doi.org/10.1007/s10995-018-2607-x
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10995-018-2607-x