Objective: To explore parents' experiences of immediate skin-to-skin contact after the birth of their very preterm neonates and their perceptions regarding care and support from staff.

Design: A descriptive qualitative study.

Setting: Birth and neonatal units within a university hospital in Sweden.

Participants: Six parent couples who co-cared for their very preterm neonates with skin-to-skin contact throughout the first 6 hours after birth.

Methods: We analyzed individual interviews using reflexive thematic analysis as described by Braun and Clarke.

Results: The parents' experiences of immediate skin-to-skin contact with their very preterm neonates were represented by the following three themes: A Pathway to Connectedness, Just Being in a Vulnerable State, and Creating a Safe Haven in an Unknown Terrain. Skin-to-skin contact helped the parents attain their roles as essential caregivers and provided a calming physical sensation that promoted parents' feelings of connectedness with their newborns. When parents provide skin-to-skin contact at birth, staff members need to recognize and address their vulnerability. A good relationship with nursing staff, which was mediated through staff behaviors and availability, facilitated skin-to-skin contact.

Conclusion: Skin-to-skin contact initiated at birth with very preterm neonates was a valuable and empowering experience for parents and enhanced early bonding between parents and their newborns. Staff members should recognize that skin-to-skin contact between parents and neonates is an interactive process that has challenges and requires adequate support. Future research is warranted to understand the needs of nursing staff who provide initial care in the postpartum period. Furthermore, we recommend the implementation of maternal-neonatal couplet care.

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