Objective. To explore the effects of perinatal cognitive-behavioral therapy on delivery mode, fetal outcome, and postpartum depression and anxiety in women. Methods. The clinical data of 88 perinatal pregnant women who came to our hospital from May 2020 to May 2021 were retrospectively analyzed and grouped into the routine group and the cognitive behavioral intervention group according to different perinatal nursing methods, with 44 cases in the cognitive behavioral intervention group received by cognitive behavioral therapy, and 44 cases in the routine group obtained by routine obstetric care during the perinatal period. The anxiety of pregnant women was evaluated by the Hamilton Anxiety Scale (HAMA). The positive cooperation and negative response of the perinatal pregnant women in two groups were recorded. The trial delivery rate, mode of delivery, amount of intrapartum bleeding, neonatal Apgar score, and visual pain simulation score (VAS) within 48 hours after delivery of the pregnant women in the two groups were also recorded and compared. The incidence of depression of pregnant and lying-in women in the two groups was recorded on the 5th and 42nd day after delivery. Results. After the intervention, the anxiety score of pregnant women in the cognitive behavioral intervention group was significantly lower than that in the routine group (
P
<
0.05
). Following the intervention, the positive cooperation score of pregnant women in the cognitive behavioral intervention group was prominently higher than that in the routine group, and the negative cooperation score was observably lower than that in the routine group (
P
<
0.05
). The rate of spontaneous delivery in the cognitive behavioral intervention group was significantly higher than that in the conventional group (
P
<
0.05
), while the VAS score and blood loss in the cognitive behavioral intervention group were notably lower than those in the routine group (
P
<
0.05
). The proportion of women with EPDS score <9 points, i.e., no postpartum depression both on the 5th and 42nd day after delivery, were significantly higher than those in the routine group (
P
<
0.05
), whereas the proportion of patients with postpartum depression symptoms scored 9–13 points were markedly lower than those of the routine group (
P
<
0.05
). Conclusion. The cognitive behavioral therapy can improve the adverse physiological and psychological reactions of pregnant women with perinatal anxiety disorder, enhance the natural delivery rate and postoperative recovery, reduce the risk of neonatal asphyxia, and ensure the safety of mothers and infants in the perinatal period. Compared with routine nursing, this intervention method is more targeted and scientific, and is worthy of clinical promotion.