Objective: To assess the effects of a health and nutrition educational intervention on maternal knowledge, attitudes and practices.

Design: Pre- and post-test design using structured interviews of pregnant women.

Setting: Thirty-nine villages in Central Java Province, Indonesia.

Method: Pregnant women (N = 252) at 12–20 weeks of gestation were randomly allocated at the village level into education intervention and control groups. Women in the intervention group received health and nutrition education, while those in control group did not. Educational sessions were provided monthly until delivery.

Results: After the intervention, women in the education group had better knowledge about the risks and consequences of getting worm infection and the causes, consequences and prevention of anaemia during pregnancy; expressed stronger intentions to feed colostrum (91.9% vs. 78.2%, P = 0.003); to breastfeed within one hour of birth (80.4% vs. 68.9%, P = 0.004); to breastfeed exclusively for six months (77.2% vs. 62.7%, P = 0.014); to breastfeed for 24 months (P = 0.06); and also had better knowledge of practices related to the early initiation of breastfeeding (0.5 hour [25th–75th 0.5–6] vs. two hour [0.5–17.5], P = 0.052); of 24-hour exclusive breastfeeding (51.2% vs. 31.1%, P = 0.006); of giving birth at health facilities (71.9% vs. 58%, P = 0.024); and of birth assisted by skilled birth attendants (90.1% vs. 81.5%, P = 0.057) than their control counterparts.

Conclusion: The reported change in knowledge, attitudes and reported practices may be attributable to the health and nutrition education provided during pregnancy.