ObjectivesPregnancy is a vulnerable period for women’s health, and health practices play an essential role in this period. This study aimed to determine the relationship between health practices with attitudes toward pregnancy and motherhood and pregnancy symptoms.DesignIt was a cross-sectional study using cluster sampling conducted on 351 pregnant women in 2021–2022. Data were collected using questionnaires of socio-demographic characteristics, health practices in pregnancy (Health Practices Questionnaire-II), attitude towards motherhood and pregnancy (Prenatal Attitudes Towards motherhood and Pregnancy) and pregnancy symptoms (Pregnancy Symptoms Inventory). The general linear model (GLM), with the adjustment of socio-demographic characteristics, was used to determine the relationship of the health practices with attitudes towards motherhood and pregnancy and pregnancy symptoms.SettingHealth centres in Tabriz city, Iran.ParticipantsWomen were eligible if living in the Tabriz city, Iran, were pregnant and had a personal health record at the health centre.ResultsThe mean (SD) of the total health practices score was 117.9 (20.5) out of 34–170. The mean (SD) of the attitudes towards motherhood and pregnancy was 33.4 (4.5) out of 11–44. The mean (SD) of the pregnancy symptoms was 28.0 (12.1) out of 0–123. According to the Pearson correlation test, there was a significant direct correlation between health practices with attitudes towards motherhood and pregnancy (r=0.39; p<0.001) and a significant inverse correlation with pregnancy symptoms (r=−0.29; p<0.001). Based on the GLM with an increase in the score of health practices, the mean score of the attitude towards motherhood and pregnancy increased (B=0.07; 95% CI: 0.05 to 0.1), and the mean score of pregnancy symptoms decreased (B=−0.1; 95% CI: −0.2 to −0.05).ConclusionConsidering the relationship between health practices with the attitude towards motherhood and pregnancy symptoms, healthcare providers better use educational and counselling strategies to promote health practices in pregnant women.