Objective To investigate the status of maternal health literacy in Henan Province and analyze the existing problems, so as to provide evidence for promoting health education, health intervention and improve women’s health.

Methods Stratified sampling method was used to recruit pregnant women as study subjects in Henan provincial health literacy improvement project units. National Residents’ Health Literacy Monitoring Questionnaire was used to investigate their status of health literacy.

Results The overall maternal health literacy in Henan Province was 43.3%, among which the basic knowledge and concept, healthy lifestyle and behavior, and health skills were 51.7%, 45.2% and 35.7%, respectively. The six types of health literacy were basic medical literacy 22.5%, health information literacy 34.3%, infectious disease prevention and control literacy 40.2%, chronic disease prevention and control literacy 41.6%, scientific health concept literacy 58.0%, and safety and first aid literacy 65.9%. There were statistically significant differences when comparing age, education level, and occupation in health literacy in terms of general health, three aspects and six kinds of health problems (all P < 0.05). Various marital status showed different level of health literacy in terms of basic knowledge and concept, scientific health concept, and chronic disease prevention (all P < 0.05).

Conclusion The level of maternal health literacy in Henan Province is relatively high, but it is unbalanced in different social demographic characteristics and various dimensions. Under the leadership of the government, multi-sectoral cooperation and the participation of whole society, attention should be paid on improving the level of health literacy of pregnant women with low education background, strengthening health skill guidance and basic medical care advocacy, guiding pregnant women and female groups to develop healthy behaviors and lifestyles, so as to promote the construction of a healthy China.