Fathers show more stress than mothers when returning home from neonatal intensive care – but they don’t admit it

stress neonatal

43 mothers and 43 fathers of very low-birth-weight infants (< 1500g) were tested for cortisol levels in their saliva around the time of bringing the baby home after neonatal intensive care. Cortisol levels in fathers showed higher stress levels than in mothers, despite fathers not reporting greater stress in a “Perceived Stress Scale” questionnaire.

Earlier research has shown that parents frequently feel unprepared and stressed when finally taking the baby home after intensive care, but previous research has focused on mothers.

A marker of stress is the rate at which cortisol reduces during the day. In normal conditions, cortisol is higher in the morning and gradually decreases during the day. When cortisol decreases less during the day, it is an indicator of stress.

On the day before discharge from the intensive care unit, fathers and mothers showed the same normal cortisol levels and they responded similarly in two measures – the Perceived Stress Scale and the Parental Sense of Competence Scale.

On the day of discharge, the cortisol levels of both mothers and fathers indicated increased stress, but whilst mother recovered during the next two weeks, fathers got worse. As time went on, fathers’ cortisol levels decreased less than mothers’ during the day, indicating higher stress. Unmarried fathers and fathers of families with older siblings were particularly prone to slower decreasing cortisol levels. Fathers whose cortisol readings suggesting higher stress did not report higher stress in the Perceived Stress Scale, whilst mothers did.

The research authors make three recommendations for gender specific support from NICUs:

  • Provide additional support to the father while the baby is still in intensive care.
  • Provide preparation, guidance and troubleshooting support for the transition to home.
  • Identify sources of support for both mothers and fathers once they return home.


Garfield CF, Simon CD, Rutsohn J & Lee YS (2017), Stress from the neonatal intensive care unit to home, Paternal and Maternal Cortisol Rhythms in Parents of Premature Infants,
Journal of Neonatal Nursing

Photo: Penumbra. Creative Commons.