Postpartum Counselling in Canada: How to Get It, What It Costs, Who to Call

Postpartum counselling in Canada is available, free in several forms, and still hard to reach, because the free route needs a referral and the fast route costs money. Statistics Canada found that 23 percent of mothers who recently gave birth reported feelings consistent with postpartum depression or an anxiety disorder, and that only 32 percent of them received any treatment since the birth. The gap is rarely a lack of services. It is navigation: knowing which door to knock on, in which order, while running on no sleep.

This article is part of our guide to postpartum support, and it covers the three ways to get postpartum counselling in Canada, what each one costs, how long it takes, and what to do tonight while you wait. For the wider map of what provincial health care covers after birth, read postpartum support in Canada.

What Counts as Postpartum Counselling in Canada?

Postpartum counselling means talk therapy for the mood and anxiety changes that follow birth, delivered by a trained professional: a registered psychologist, a registered psychotherapist or counsellor, a registered social worker, or a psychiatrist. In Canada the title matters for cost. Psychiatrists are medical doctors, so their visits are covered by your provincial health card. Psychologists, psychotherapists and social workers are not covered by provincial plans outside hospital and community programs, so you pay privately or through benefits.

The therapy itself is usually cognitive behavioral therapy or interpersonal therapy, both of which have evidence for perinatal depression and anxiety, delivered in weekly sessions for a set number of weeks. Group programs run on the same models and are often the fastest free option.

How Do You Get Free Postpartum Counselling in Canada?

The free route starts with one honest conversation with a family doctor, midwife, nurse practitioner or obstetrician. They screen you, usually with the Edinburgh Postnatal Depression Scale, and they refer you. Three kinds of free program sit behind that referral:

• Hospital reproductive mental health programs. Most large cities have a perinatal or reproductive mental health clinic attached to a hospital, offering assessment, short term counselling, group therapy and medication review. These need a referral from a doctor or midwife and wait times vary by region, from a couple of weeks to a few months.
• Public health and community programs. Public health nurses in most provinces run postpartum calls, home visits and perinatal depression screening, and can connect you to free community counselling. In Quebec the CLSC is the entry point.
• Community mental health agencies. Canadian Mental Health Association branches and similar agencies offer free or sliding scale counselling, sometimes with perinatal specific groups, and usually accept self referral.

If your symptoms are severe, say so plainly. Severity moves you up the list. "I am not functioning" is a complete sentence and it changes what the referral form says.

What Does Private Postpartum Counselling Cost?

Private therapy is the fast route and the expensive one. Session fees vary by province and by the professional's title, and registered psychologists charge more than registered psychotherapists or social workers for the same hour. The practical questions to ask before you book are whether the therapist offers a sliding scale, whether they bill your extended health plan directly, and whether they have perinatal training, which you can ask for by name.

Three ways to bring the cost down:

• Extended health benefits through your own or your partner's employer typically cover a set amount of psychology or counselling per year. Check the plan for which titles it covers, because some cover psychologists only and others include social workers and psychotherapists.
• Sliding scale and training clinics. University training clinics and many community agencies charge by income.
• Perinatal peer support through Postpartum Support International is free and runs while you wait for anything else.

Who Can You Call for Postpartum Counselling Today?

Keep these on your phone:

| Support | What it is for | Contact | | --- | --- | --- | | PSI HelpLine | Information, support and local perinatal counsellors, not a crisis line | Call 1-800-944-4773 or text Help to 800-944-4773 | | PSI Canada volunteers | A person who helps you find a perinatal therapist or prescriber near you | Request through postpartum.net/canada, reply in 1 to 2 business days | | Provincial health line | Symptom questions and local referrals, 24 hours in most provinces | Call 811 in most provinces | | 988 Suicide Crisis Helpline | Thoughts of harming yourself, Canada wide | Call or text 988 any time |

If you have thoughts of harming yourself or your baby, that is the 988 line or your nearest emergency department tonight, not a waitlist.

What Helps While You Wait for Counselling?

Waitlists are real, so use the time. Tell one professional, even by phone, so the referral is documented. Join one free peer group, in person or online, because talking to people who are in the same month as you is support that does not need a referral. Keep one short daily check on how you are, because it is what gets a doctor to act faster when you say it has been three weeks.

AlphaMa is an AI companion for mothers that uses cognitive behavioral techniques to help you untangle 3am thoughts, rehearse what you want to say at your appointment, and take the lists and follow ups out of your head. It is available on the App Store and Google Play in Canada and it is free right now. It supports you between appointments, and it does not diagnose, treat or replace counselling.

If what you are feeling is less sadness and more a depletion that lifts when the load drops, read the signs of postpartum burnout and our guide to postpartum burnout, because that changes what helps.

Related reading:

• Postpartum Support Canada: What Is Covered and Who to Call
• Postpartum Anxiety vs Postpartum Depression
• What Does Postpartum Depression Feel Like?