Objective To explore the application effect of 3H-4A-5S nursing service in the repair and treatment of postpartum striae gravidarum. Methods From October 2021 to September 2023, 100 patients who received postpartum striae gravidarum repair in Jinan Second Maternal and Child Health Hospital were selected as the research objects. According to the random number table method, they were divided into control group and experimental group, with 50 patients in each group. The control group was given routine nursing, and the experimental group was given 3H-4A-5S nursing. The pregnancy striae gravidarum cognition, psychological state, coping style, self-efficacy and nursing satisfaction were compared between the two groups. Results The cognitive scores of clinical symptoms, treatment methods, natural prognosis and nursing content in the experimental group were higher than those in the control group (P <0.05). The scores of each dimension of CD-RISC in the experimental group were higher than those in the control group (P <0.05). The confrontation score of the experimental group was higher than that of the control group, and the avoidance and yield scores were lower than those of the control group (P <0.05). The scores of daily life, compliance behavior, medication behavior and health behavior in the experimental group were better than those in the control group (P <0.05). The nursing satisfaction of the experimental group was 96.00%, which was higher than 84.00% of the control group (P <0.05). Conclusion 3H-4A-5S nursing is effective in the repair of postpartum striae gravidarum. It can not only effectively improve the patient's awareness of striae gravidarum and improve the patient's self-efficacy, but also play an important role in improving the psychological state, satisfaction and patient's coping level. It is worthy of application.