Can Health Literacy Empower Pregnant Women? Examining Its Role in Self‐Care Practices: A Cross‐Sectional Study

ABSTRACT Background and Aims Health literacy is an important determinant of maternal health and may influence improving pregnancy outcomes. This study aimed to assess the health literacy levels of pregnant women and explore their relationship with empowerment and self‐care practices. Method This cross‐sectional study included 350 pregnant women receiving prenatal care at 12 health service centers in Langroud, northern Iran. Participants were recruited through convenience sampling and provided written informed consent. Data were collected from March to September 2024 using the Health Literacy for Iranian Adults Questionnaire (HELIA), the Pregnancy Empowerment Questionnaire (PEQ), and the Pregnancy Self‐Care Questionnaire (PSCQ). Stepwise multiple linear regression analyses were conducted to identify independent predictors of pregnancy self‐care. The mediating effect of pregnancy empowerment on the association between health literacy and self‐care was examined using PROCESS macro (Model 4) with bootstrap confidence intervals. Results The mean scores of health literacy, pregnancy empowerment, and self‐care were 66.67 ± 13.56, 76.26 ± 9.83, and 118.45 ± 24.54, respectively. Higher health literacy was significantly associated with greater pregnancy empowerment (B = 0.344, p < 0.001) and better self‐care behaviors (B = 1.15, p < 0.001). Family income and planned pregnancy were identified as significant correlates of both empowerment and self‐care. Mediation analysis demonstrated a significant indirect effect of health literacy on self‐care through pregnancy empowerment, indicating partial mediation. Conclusion This study highlights the critical role of health literacy as an independent predictor of both women's empowerment and self‐care during pregnancy. Higher levels of health literacy not only directly contribute to better self‐care practices but also indirectly promotes empowerment. Pregnancy empowerment partially mediated the association between health literacy and self‐care among pregnant women. These findings emphasize the potential value of integrating health literacy and empowerment strategies into prenatal care programs to support maternal self‐care and well‐being.