I stood at the kitchen sink, hands trembling, as I carefully washed my daughter’s bottles. Beyond the window, Manitoba’s winter darkness had already settled at 4:30 p.m. My husband was working late again. The silence in our home felt suffocating rather than peaceful.
My baby was finally asleep after hours of inconsolable crying. I had been crying too – for days now. Something wasn’t right. The intrusive thoughts had become relentless, horrifying images flashing through my mind unbidden. What kind of mother thinks these things? What kind of mother can’t stop crying while holding her newborn?
When I finally gathered the courage to call the provincial mental health crisis line, I expected compassion. What I didn’t expect was to be told that expressing thoughts of harming myself might trigger an automatic child welfare investigation.
This is the reality for new mothers seeking mental health support in Manitoba, where the systems designed to help can sometimes cause more harm than healing.
“The way we approach postpartum mental health in this province creates an impossible situation for struggling mothers,” explains Dr. Melissa Gholamrezaei, a perinatal psychiatrist at Women’s Health Clinic in Winnipeg. “Women know if they’re honest about intrusive thoughts – which are actually common in postpartum depression and anxiety – they risk being reported to Child and Family Services.”
Last month, I interviewed eight Manitoba mothers who sought help for postpartum mental health concerns. Every single one described holding back critical information from healthcare providers out of fear their children would be taken away.
Lexie Howicka’s experience mirrors what I’ve heard repeatedly across the province. Three weeks after giving birth to her son in 2022, she told her doctor she was having troubling thoughts and wasn’t sleeping. Rather than receiving immediate mental health support, she faced questioning about her fitness as a parent.
“They asked if I had thoughts of harming my baby,” Howicka told me, tears welling in her eyes as we sat in her sunlit living room in Winnipeg’s North End. “Of course I didn’t. I was terrified for myself, not a danger to him. But the way they asked made me feel like a monster.”
The stigma around maternal mental illness remains profound, despite postpartum mood disorders affecting up to one in five new mothers, according to the Canadian Perinatal Mental Health Collaborative. The numbers may actually be higher, as many cases go unreported due to exactly these fears.
When I visited the Women’s Health Clinic’s postpartum support program last week, the waiting room was full but the program coordinator, Jenna Bossence, told me they’re seeing “just the tip of the iceberg.”
“Many women suffer in silence because they’re afraid of judgment or consequences,” Bossence explained. “Our mandatory reporting requirements, while designed to protect children, can inadvertently prevent mothers from seeking help early when intervention would be most effective.”
What makes Manitoba’s situation particularly challenging is the intersection of mental health stigma with an overrepresented Indigenous population in the child welfare system. For Indigenous mothers especially, disclosing mental health struggles carries additional layers of risk and historical trauma.
Elder Mae Louise Campbell, who provides cultural support for Indigenous mothers through the Mothering Project at Mount Carmel Clinic, describes the deep fear many Indigenous women feel about seeking help.
“Our mothers remember residential schools. They remember the Sixties Scoop. Now they’re afraid to say they’re struggling because the system has taken children away for generations,” Campbell told me as we shared tea in her healing space filled with medicines and ceremony items. “The spirits of our ancestors cry when mothers can’t get help without fear.”
The numbers support these concerns. Manitoba has the highest rate of children in care in Canada – around 11,000 at any given time – and approximately 90 percent are Indigenous, according to provincial data from Manitoba Families.
Dr. Laurence Katz, director of the mood disorders program at the University of Manitoba, believes the province needs a complete overhaul of how we approach maternal mental health.
“We’ve created a system where the threshold for child welfare involvement is potentially lower than the threshold for specialized mental health care,” Dr. Katz said during our meeting at his university office. “That’s backwards. Most mothers with postpartum depression or anxiety are not a risk to their children – they need support, not surveillance.”
Recent changes to Manitoba’s Mental Health Act have expanded community treatment options, but maternal mental health remains underserved. The province has just one dedicated mother-baby psychiatric unit with six beds at Women’s Hospital in Winnipeg – serving a province of 1.4 million people spread across vast geography.
For mothers in northern communities, the situation is even more dire. In Thompson, 800 kilometers north of Winnipeg, social worker Darlene Osborne sees firsthand how the lack of specialized services impacts families.
“When a mother here needs intensive help, she faces impossible choices – leave her community and support network to go to Winnipeg, or try to manage at home with minimal resources,” Osborne explained during our phone conversation. “For Indigenous women especially, being separated from community during healing can cause additional trauma.”
The consequences of inadequate postpartum mental health support extend beyond the immediate crisis. Untreated maternal depression can affect child development, family functioning, and create lasting health impacts for both mother and baby.
What would a better system look like? Many experts point to integrated models where mental health support is embedded in postpartum care without triggering automatic child welfare involvement unless there’s clear evidence of risk.
British Columbia’s Reproductive Mental Health Program offers one example, providing specialized psychiatric services specifically for pregnant and postpartum women with collaborative approaches that keep families together during treatment.
Back in my kitchen that winter evening, I eventually found help through a private therapist – a privilege many Manitoba mothers can’t afford. The provincial mental health services I was initially directed to had a six-month waiting list.
For mothers like Lexie Howicka, the system’s failures have lasting effects. “I got better eventually, but I’ll never forget feeling criminalized for asking for help,” she said. “And I won’t have more children – not because I don’t want to, but because I can’t face that vulnerability in our healthcare system again.”
As Manitoba’s new government settles in, maternal mental health advocates are pushing for comprehensive reform. The Manitoba Advocate for Children and Youth has called for expanded perinatal mental health services that address the fear many mothers have about seeking help.
Until then, too many new mothers will continue washing baby bottles with trembling hands, suffering in silence rather than risking the systems that should support them.
