Objective To evaluate the efficacy of mindfulness-based behavioral intervention (MBBI) combined with intrapartum nursing for vaginal delivery in primiparous women. Methods A total of 118 primiparous women admitted to Shangqiu Municipal Hospital from October 2023 to October 2025 were enrolled and divided into an observation group and a control group with 59 cases in each group according to different nursing protocols. The control group received routine obstetric care, while the observation group received MBBI combined with intrapartum nursing. Labor duration, delivery mode, postpartum blood loss, neonatal Apgar score, visual analogue scale (VAS), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were compared between the two groups. Results The duration of each labor stage and total labor time in the observation group were significantly shorter than those in the control group (all P＜0.05); the cesarean section rate, VAS, SAS and SDS scores were significantly lower than those in the control group (all P＜0.05); the 2-hour postpartum blood loss was significantly less than that of the control group (P＜0.05); and the 1-minute neonatal Apgar score was significantly higher than that of the control group (P＜0.05). Conclusion MBBI combined with intrapartum nursing can effectively shorten the labor course of primiparous women, reduce the cesarean section rate and postpartum blood loss, improve neonatal outcomes, and significantly relieve maternal pain perception and negative emotions.