Rethinking support for early motherhood: a multi-level ecological analysis of mothers’ experiences in Urban China

Early motherhood is a critical yet vulnerable life stage shaped by intersecting individual, familial, societal and structural challenges. Existing research often overlooks the multiple everyday stressors mothers experience across ecological domains. This study explores the lived experiences of mothers in urban China, using an ecological framework to examine the multi-level challenges they face during the first three years after childbirth. In-depth interviews were conducted with 50 mothers of children aged 0–3 years recruited from nine community and township health centers and one childcare program for a migrant community in Shanghai, China, during well-child visits. Interviews were guided by an ecological framework and analyzed using thematic analysis. Challenges clustered across ecological levels, including postpartum physical health problems, caregiving burden, limited family and social support, work–childcare tension and constrained services, and information and financial constraints. These challenges manifested as common themes that negatively affected maternal wellbeing and the child nurturing environment. These findings highlight that the challenges mothers experience extend beyond the individual level to family and institutional contexts, underscoring the need for coordinated interventions from individual support to family- and system-level services.