Most couples eagerly anticipate the birth of their first child. However, the transition to parenthood is also associated with significant lifestyle changes and approximately 50% of couples report a moderate to severe decline in relationship satisfaction and quality. Low relationship satisfaction is associated with increased couple conflict, individual psychological distress, negative parent-child relationships and poor child outcomes. Despite our increasing knowledge of the factors that predict enhanced couple adjustment, few evidence-based programs are available to assist couples' adjustment to parenthood. In this first randomized controlled trial evaluating the effectiveness of a flexible delivery psycho-education program, entitled 'Couple CARE for Parents', 71 pregnant couples were assessed on self-report and observational measures of couple relationship and individual functioning and then randomized into either the Couple CARE for Parents program (n = 35) or a comparison program (n = 36). Couple CARE for Parents was a six unit program, comprising of an antenatal workshop, two home visits and three telephone support calls, and included skill-training in key relationship processes that are predictive of couple relationship quality, with the addition of parenting and baby care information. Among intervention couples the typical decline in female relationship satisfaction was prevented, with only 13% of intervention females reporting a decline in relationship satisfaction from pregnancy to 5 months postpartum, compared to 42% of females in the comparison program. Observed couple communication also improved as a result of the intervention, with Couple CARE for Parents couples showing reliably lower rates of negative speaker and listener skills at post-intervention relative to comparison couples. Couples were highly engaged in Couple CARE for Parents and there was a low drop out rate across the 7 month intervention period. These findings are promising and add to the early intervention studies showing positive effects of couple-focused psycho-education during the transition to parenthood by demonstrating that flexible delivery programs are feasible and attractive to couples. Providing cost-effective couple relationship education to expectant and new parent couples opens another window of opportunity for health professionals and governments to minimize the rates of relationship distress and divorce and their associated negative effects on individual, couple and family functioning.