More Than a Checklist: Women’s Mental Health and Postpartum Depression Screening in Canada
Author: Tashi Stampp, PhD Student in Population Health; School of Interdisciplinary Health Sciences, University of Ottawa | Editors: Emily Anne Opala and Romina Garcia de leon (blog coordinator) Reviewer: Dr. Anne TM Konkle
Published: November 27th, 2026
Note to the readers: This includes content relating to anxious or depressive thoughts after delivery. The following quotes are experts from research papers that have either interviewed or collected data from real parents in Canada. Identity remains anonymous.
The Hidden Mental Load of New Motherhood
When a person’s identity transitions to that of a parent or caregiver, an assortment of new responsibilities is demanded of them. Some of this might stem from social circles sharing tips or expectations of parenthood, or from internal beliefs about what being a “good parent” might mean to them. Often what is overlooked, is the internal shift that occurs in this transitional period. The emotional and mental changes that emerge after delivery. Something hidden beneath the celebration of a child entering the world.
Postpartum depression (PPD) is a growing public health concern for Canadian women. Around 23% of new mothers report symptoms of depression (e.g., sadness or low mood) from pregnancy and up to one year after delivery. The Canadian health care system continues to fall short in addressing postpartum mental health needs. Failing to recognize or treat PPD can affect both parents and their families. Only a small number of women who require care receive it, and even fewer receive evidence-based treatment.
Why Postpartum Depression Screening Looks Different in Canada
In Canada, screening for PPD is not routinely done and is often left up to individual healthcare providers. This approach was informed by the Canadian Task Force on Preventative Health Care in 2022, who recommended against routine screening for PPD in primary care settings. Choosing not to implement universal screening is not just a lack of action; it is a policy decision that shapes whether PPD is identified and treated.
In contrast, the United States Preventative Services Task Force emphasized the importance of implementing screening recommendations that maintain diagnostic accuracy, sound treatment, and efficient follow-up. The United States implemented routine screening for PPD in 2016.
When “Usual Care” Isn’t Enough
Across Canada, approaches to PPD screening remain inconsistent. Rather than routinely screening all new mothers, healthcare providers are encouraged to use their own judgment when identifying mental health concerns during prenatal and postpartum care, referred to as usual care.
But what does “usual care” actually look like for parents from racialized or marginalized backgrounds, who are often underrepresented in research and may already face systemic barriers within healthcare settings? And how much evidence is considered “enough” before action is taken.
What Often Goes Unseen After Birth
Research suggests that after childbirth, healthcare providers often focus primarily on the baby’s wellbeing while the emotional needs of the parents receive less consideration. This lack of visibility can reinforce a system where parents are left with feelings of isolation, guilt or shame as their feelings remain hidden beneath the surface.
A Canadian mother expressed their experience with PPD “[…] most of us are sobbing in our homes, you know, thinking that this sucks. And we have nobody to tell, and there’s guilt and shame and all this stuff that comes with it. And it’s actually really common [laughter], um, but […] it’s supposed to be positive, right?”
Canadian mothers reported “needing medical attention for self”. In practice, support for postpartum mental health relies heavily on provider judgment, available time, available financial resources, and mental health literacy, all of which could vary across settings.
When Policy Meets Real Life
Public health decisions often involve difficult choices about balancing potential risks and benefits for communities. Deciding whether an intervention is worth implementing means asking questions like: Who may be left out? Or, who is benefiting? Canada’s current approach to PPD screening reflects more than a clinical recommendation, it reflects a broader system that determines which forms of evidence are strong enough to justify action.
In evidence-based medicine, Randomized Controlled Trials (RCTs) are often treated as the gold standard for evaluating interventions, because they are designed to isolate cause-and-effect relationships. However, RCTs require researchers to control many factors, which can result in study populations that don’t fully reflect the diversity of real-world experiences.
This tension is evident in Canada’s approach to PPD screening. The Task Force based its recommendation on a systematic review that found low certainty of evidence that routine screening improves maternal health outcomes. Because the available RCT evidence was limited, the Task Force determined that there was not enough evidence to support universal screening, and called for more high quality trials.
The Value of Research That Captures Lived Experience
For parents living with PPD, the consequences of these decisions are often found in everyday life, not clinical trials. An Afro-Canadian woman described being perceived as “strong” by health professionals as a barrier to receiving mental health services after delivery, stating, “[t]hey think maybe we are immune to depression”.
This sentiment reveals something that does not fit within the hierarchy of evidence that is used in policy-making. Yet, it does provide clear insight to the challenges that Canadian Black mothers may face navigating the mental health system after delivery.
Questions to Consider
If PPD is considered a growing public health concern for Canadian women and is associated with long-term consequences, what happens when healthcare systems rely on an approach that does not consistently identify those at risk? More importantly, how should decisions about implementing, or not implementing routine PPD screening be made? Should these decisions be based primarily on the “gold standard” of evidence, or should they consider the realities of clinical practice and the diverse experiences of Canadian parents? These questions require us to assess whose evidence is prioritized in policy-making and whose experiences may be overlooked in the process.
Canadian parents are experiencing the consequences in the meantime.
Mental Health Resources: Postpartum depression looks different for everyone, if you or someone you know is experiencing emotional discomfort, persistent sadness, anxiety, difficulties bonding with your baby, or other mental health concerns, resources are available. While conversations around screening continue, recognition and support remain important for parents and families navigating this transitional period.
Bounce Back – 1-866-345-0224
Connex Ontario Helpline – 1-866-531-2600
For emergencies, call 911 or visit your nearest hospital’s emergency department.
