‘Fathers’ world in words': First-time fathers' expressions of their paternal role to preterm infants: A critical discourse analysis

AIM: To explore how first-time fathers articulated their caregiving roles for preterm infants following admission to neonatal intensive care units (NICUs) and to identify the dominant discourses shaping their caregiving identities.

DESIGN: A qualitative study informed by Fairclough's three-dimensional framework for critical discourse analysis, grounded in social constructivist and poststructuralist perspectives.

METHODS: Four focus group interviews were conducted with 17 Danish first-time fathers of preterm infants between October 2022 and January 2023. Transcripts were coded and thematized using an emic, data-driven approach. Fairclough's framework guided analysis at the textual, discursive, and social levels. Butler's theory of performativity informed interpretation of how fathers reproduced, reinforced, and challenged gender norms through caregiving practices and language use.

RESULTS: Three themes were identified in the textual analysis: (1) first-time fathers' practical and emotional involvement in caregiving; (2) first-time fathers' expressions of protection and responsibility; and (3) shared parenting practices and negotiations of caregiving roles. These themes intersected with broader discourses: paternity leave, caregiving, the father's role, and gender roles. Fathers expressed strong emotional and practical engagement but were sometimes positioned as secondary caregivers by organizational routines.

CONCLUSION AND IMPLICATIONS FOR PRACTICE: First-time fathers actively constructed identities as competent and involved caregivers while negotiating institutional and societal expectations. Findings highlight opportunities for neonatal nurses to foster father-inclusive, family-centered care by actively involving fathers in caregiving tasks and addressing implicit gender assumptions. Promoting inclusive caregiving cultures that recognize both parents as competent caregivers may advance gender equity and improve outcomes for preterm infants.