The purpose of this study was to investigate the effects of antenatal education on birth fear, depression, anxiety, stress, childbirth self-efficacy, and mode of delivery in primiparous pregnant women. This is a single-blind, prospective, randomized controlled trial, in which we applied the Consolidated Standards of Reporting Trials (CONSORT) statement. The study was conducted in a city in Turkey’s Central Anatolia region, and the data collection process was made between April and September 2019. One hundred and twenty primiparous pregnant women were assigned to either the antenatal education group (n = 60) or the control group (n = 60) via randomized block assignment. A total of 112 women were evaluated at the end of the study. Pregnant women in the antenatal education group were given two 2-hr sessions (240 min) twice a week for 4 weeks. It was found that those in the antenatal education group had less birth fear, depression, anxiety, and stress symptoms and increased childbirth self-efficacy compared to controls (p < 0.05). Those in the antenatal education group had significantly lower postnatal birth fear, depression, anxiety, and stress symptoms compared to controls (p < 0.001). More vaginal births occurred in the antenatal education group compared to controls (p = 0.043). According to the outcome of this evidence-based study: antenatal education has important clinical benefits for women both during pregnancy and in the postpartum period and all pregnant women should receive this education.