<p>Conflicting study outcomes on women undergoing cesarean sections underscore the complex relationship between repeated cesarean deliveries and factors such as sense of coherence, self-efficacy, and anxiety, highlighting the need for empowerment-based interventions to improve mothers’ mental health and parenting outcomes. This randomized controlled trial aimed to evaluate an educational program based on the self-management empowerment model on sense of coherence, self-efficacy, and postpartum anxiety in cesarean mothers. In 2024, 98 women scheduled for cesarean delivery at Shohada-ye-Khalij-e-Fars Hospital, Bushehr, Iran, were selected by convenience sampling and randomly assigned via block randomization to intervention (n = 49) or control (n = 49) groups. The intervention group received a five-step education program over two months. Antonovsky’s Sense of Coherence Questionnaire, Sherer’s Self-Efficacy Scale, and Spielberger Anxiety Questionnaire were administered pre- and post-intervention. Data were analyzed using SPSS version 27 with descriptive/inferential statistics (<i>p</i> &lt; 0.05). Mean changes showed significant intervention effects: self-efficacy − 1.58 ± 7.31 (control) versus 2.79 ± 6.42 (intervention, ŋ² = 0.151, <i>p</i> &lt; 0.001); sense of coherence 2.67 ± 8.36 (control) versus 4.81 ± 6.58 (intervention, ŋ² = 0.073, <i>p</i> = 0.018); anxiety 0.02 ± 15.99 (control) versus − 13.07 ± 13.7 (intervention, ŋ² = 0.224, <i>p</i> &lt; 0.001). The self-management empowerment model significantly improved sense of coherence and self-efficacy while reducing postpartum anxiety, recommending its integration into postpartum care programs.</p><p><i>Trial Registration</i> <a href="http://www.irct.ir/">http://www.irct.ir/</a>, IRCTID: IRCT20130422013092N12 registered July 11, 2024.</p>