Objectives: Childbirth fear affects 34.2% of Chinese primigravida women, leading to adverse birth outcomes. Family-centered prenatal education (FCPE) may reduce fear through enhanced support systems. Methods: This quasi-experimental study examined the effectiveness of FCPE among 120 primigravida women (14–20 weeks’ gestation) at Yancheng Third People’s Hospital. Participants with elevated Childbirth Fear Questionnaire (CFQ) scores (≥ 81) were assigned to either the experimental group (FCPE + standard care, n = 60) or the control group (standard care only, n = 60). FCPE consisted of five weekly 2-hour sessions involving pregnant women and family members. Results: Both groups showed moderate baseline fear levels (experimental: 85.68 ± 6.30; control: 88.57 ± 6.41, p = 0.112). Post-intervention, the experimental group achieved significantly lower fear scores (80.43 ± 8.53 vs. 87.35 ± 6.91, p = 0.001, Cohen’s d = 0.88). 58.3% of experimental participants transitioned to low fear levels, compared to 16.7% in the control group. Educational level significantly moderated the outcomes within the experimental group (p = 0.031). Conclusion: FCPE effectively reduces anticipatory childbirth fear with a large effect size, supporting implementation in Chinese prenatal care for improving maternal psychological well-being.