Abstract: Objective To investigate the effects of midwife-led video teaching and delivery simulation on the delivery pain and outcomes of primiparas.Methods A total of 106 primiparas in our hospital were selected as subjects. They were randomly divided into the observation group and the control group by random number table method,with 53 cases in each group. The control group was given routine prenatal examination and health education,while the observation group was given midwife-led video teaching and delivery simulation. The stress level during delivery using self-rating anxiety scale (SAS),self-rating depression scale (SDS) ,time of first stage of labor,second stage of labor,and third stage of labor,pain degree in active first stage of labor and delivery outcomes were observed and compared between the two groups.Results The degree of anxiety and depression during delivery in the observation group were significantly lighter than those in the control group (P< 0. 05). The time first stage of labor and second stage of labor in the observation group were shorter than those in the control group (P< 0. 05),and there was no significant difference in the time of third stage of labor (P > 0. 05). The pain degree in active first stage of labor in the observation group was lower than that in the control group (P< 0. 05). The proportions of vaginal midwifery,voluntary cesarean section and involuntary cesarean section in observation group were lower than those in the control group while the proportion of normal vaginal delivery was higher than that in control group (P< 0. 05).Conclusion Midwife-led video teaching and delivery for primiparas can shorten the labor process,reduce physical and mental pain,and improve the delivery outcomes.