Gender perspectives on experiences of kangaroo mother care for preterm infants in neonatal intensive care unit in China: A qualitative study

Background

In China, preterm infants are commonly cared for in neonatal intensive care units, where parent-infant separation disrupts bonding and causes parental distress. Kangaroo mother care can restore this bond, but its adoption in Chinese neonatal intensive care units remains limited. Although cultural norms and institutional practices are shown to influence its implementation, little is known about how these factors shape parents' gendered experiences.

Objective

This study integrated the views of healthcare professionals, fathers, and mothers to explore: (1) The influence of sociocultural norms and gender roles on kangaroo mother care practices; (2) Parents' perceptions of gendered responsibilities and roles in kangaroo mother care; (3) Gender-specific barriers and facilitators to participation; and (4) The transformative effects of kangaroo mother care on parents and infants.

Methods

A qualitative descriptive design was adopted. Between March and June 2025, purposive sampling was used to recruit 32 participants—including healthcare professionals (n = 11), fathers (n = 9), and mothers (n = 12) of preterm infants—from a tertiary hospital in Sichuan, China. Data were collected through face-to-face semi-structured interviews and analyzed using thematic analysis.

Results

Based on interviews with 32 participants (11 healthcare professionals, 9 fathers, and 12 mothers), four themes were identified: (1) The influence of sociocultural norms and gender roles on participation in kangaroo mother care: Parents experienced tensions between traditional gender expectations and emerging egalitarian ideals of parenting; (2) Parental perceptions of appropriateness and unique contributions in kangaroo mother care: Mothers showed sensitivity in emotional interaction, while fathers fostered bonding and provided support, rendering their roles complementary and irreplaceable; (3) Gendered challenges and facilitators of kangaroo mother care: Fathers were constrained by work and limited paternity leave, while mothers faced postpartum restrictions; however, supportive environments and targeted guidance facilitated participation and individual traits sometimes shaped experiences beyond gender; and (4) The transformative effects of kangaroo mother care on parents and infants: Kangaroo mother care reinforced parental identity and strengthened parent–infant bonding.

Conclusion

Kangaroo mother care participation in Chinese neonatal intensive care units is shaped by gender norms, institutional constraints, and individual factors. To promote equitable parental involvement, policy actions such as more flexible and extended paternity leave are needed, alongside father-inclusive, gender-sensitive clinical support and standardized guidance from healthcare professionals. Strengthening nursing education to build skills in gender-sensitive family-centered care may further facilitate implementation, and these findings may be informative for other neonatal intensive care unit settings.