To study the effects of the midwife-led family group pregnancy health care service model for advanced primiparas on their anxiety and delivery modes. Methods: 300 advanced primiparas admitted to the hospital were selected and were divided into control group (n=150) and study group (n=170) from January 2023 to December 2023. The primiparas in the control group received traditional midwifery service model intervention, while the primiparas in the study group receivedthe midwifery led-family group pregnancy health care service model intervention. The weight gain during pregnancy, the anxiety evaluated by pregnancy anxiety scale (PAS), the pregnancy pressure evaluated by pregnancy pressure scale (PPS), the delivery modes and the adverse maternal and infant outcomes of the primiparas were compared between the two groups. Results: The body weight at 28 gestational weeks (60.12±7.03kg) and before delivery (63.44±7.21kg), and the weight gain during the third trimester of pregnancy (3.32±1.60kg) of the primiparas in the study group were significantly lower than those (62.94±6.53kg, 67.80±7.15kg and 4.86±2.91kg) of the primiparas in the control group (all P<0.05). The scores of PAS and PPS of the primiparas in the two groups before delivery were significantly lower than those before intervention, and the PAS score (55.74±5.16 points) and PPS score (1.52±0.35 points) of the primiparas in the study group were significantly lower than those (57.12±6.17 points and 1.64±0.32 points) of the primiparas in the control group (all P<0.05). The natural delivery rate (70.0%) of the primiparas in the study group was significantly higher than that (54.0%) of the primiparas in the control group (P<0.05). The incidence of the adverse maternal and infant outcomes (6.5%) of the primiparas in the study group was similar to that (10.0%) of the primiparas in the control group (P>0.05). Conclusion: Midwife-led family group pregnancy health care service model for the primiparas can effectively control their weight gain during pregnancy, relieve their anxiety and pregnancy pressure and improve their natural delivery rate.