« The pulverisation of Indigenous property: Jessica A. Shoemaker, ‘Fractionation by Design: Remedy Without Repair in Indigenous-Owned Trust Allotments’, Tulsa Law Review, 61, 1, 2025, pp. 63-90

Stealing mothers: Kathleen S. Kenny et al, ‘The association of child removal by child protective services and mortality among First Nations and non-First Nations mothers in Canada: a retrospective cohort study’, The Lancet Public Health, 20/01/26

26Jan26

Abstract: Background: Links between maternal exposure to child removal by child protective services and increased mortality have been identified in the general population. However, this association has not been examined in First Nations mothers, who are disproportionately intervened upon by this system. Our study aimed to quantify the relationship between child removal and mortality in First Nations and non-First Nations mothers. Methods: In this retrospective analysis, we used whole population, matched, and sibling cohorts to compare mortality in First Nations and non-First Nations mothers with and without a child removed by child protective services between April 1, 1998, and March 31, 2022, in Manitoba, Canada. First Nations mothers were identified through the First Nations Research File; non-registered or self-identified First Nations mothers, along with Inuit, Métis, and non-Indigenous mothers, were categorised as non-First Nations mothers. We excluded mothers not residing in Manitoba for 2 years before the birth or first removal date of their oldest child. In the whole population cohort, we compared First Nations mothers with a child removed, First Nation mothers without a child removed, non-First Nations mothers with a child removed, and non-First Nations mothers without a child removed. For the matched cohort, First Nations and non-First Nations mothers with a child removed were matched 1:2 with mothers without a child removed based on First Nations status, urbanicity, and maternal age at first birth. For the sibling cohort, we compared First Nations mothers who had a child removed with a sister (with the same biological mother) who did not have a child removed. We extracted individual-level data from Manitoba’s Population Research Data Repository for each contact a person had with health care and social services. We estimated absolute rates and rate ratios of all-cause, unavoidable, and avoidable mortality. Findings: The whole-population cohort included 16 211 First Nations mothers and 77 841 non-First Nations mothers. The prevalence of child removal was 27·3% (4429/16 211) for First Nations mothers versus 4·3% (3353/77 841) for non-First Nations mothers. Compared with unexposed non-First Nations mothers, adjusted mortality rates due to all causes in mothers with a child removed was highest for First Nations mothers (64 deaths per 10 000 person-years [95% CI 57–72]; rate difference 51·65 per 10 000 person-years [95% CI 49·15–54·14]; rate ratio 5·20 [95% CI 3·98–6·78]) followed by non-First Nations mothers (48 deaths per 10 000 person-years [40–56]; 35·28 per 10 000 person-years [32·81–37·74]; 3·87 [2·90–5·15]). Associations persisted in the matched and sibling cohorts. Avoidable causes accounted for the majority of all deaths, and in the sibling cohort in First Nations mothers, child removal was only associated with avoidable mortality. Interpretation: Child removal was associated with preventable deaths in mothers, with the highest risk of death observed in First Nations mothers. Our findings call for recognition of the potential extent of health harm to mothers attributable to child removal and should accelerate action for First Nations-led interventions to support and preserve families.


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