To explore the influences of midwife-led group maternal and infant health education during pregnancy of primiparas on their psychological status, labor analgesia, and pregnancy outcomes. Methods: A total of 120 primiparas who underwent prenatal examination and delivery in hospital were selected as the study subjects and were randomly divided into two groups (60 cases in each group) from January 2021 to October 2022. The primiparas in the study group received midwife-led group maternal and infant health education, while the primiparas in the control group received routine maternal and infant health education. The scores of the self-rating anxiety scale (SAS) and self-rating depression scale (SDS), the satisfaction for delivery analgesia, and the pregnancy outcomes of the primiparas were compared between two groups. Results: The scores of postpartum SAS (34.63±6.83 points) and SDS (39.56±7.86 points) of the primiparas in the study group were significantly lower than those (38.75±7.11 points and 43.49±6.97 points) of the primiparas in the control group. The satisfaction score of labor analgesia (4.13± 0.56 points) of the primiparas in the study group was significantly higher than that (3.23±0.74 points) of the primiparas in the control group. The cesarean section rate (11.7%), the postpartum blood loss (261.3±66.1ml), and the birth weight (3.27±0.48kg) of the primiparas in the study group were significantly lower than those (26.7%, 297.3±60.7ml, and 3.49±0.53kg) of the primiparas in the control group. The Apgar score (9.5±0.6 points) and the exclusive breastfeeding rate (85.0%) of the neonates in the study group were significantly higher than those (9.0±0.7 and 60.0%) of the neonates in the control group (all P＜0.05). Conclusion: Midwife-led group maternal and infant health education during pregnancy of the primiparas can effectively alleviate their postpartum depression and anxiety, increase their satisfaction for labor analgesia. and improve pregnancy outcomes.