Objective To explore the application value of graded responsibility system holistic service in the perioperative period of cesarean section women. Methods 82 puerperae with cesarean section in department of obstetrics of the hospital from January 2023 to January 2025 were prospectively selected as research subjects, and were randomly divided into observation group and control group by randomization ranking method, with 41 cases in each group. The control group received routine nursing, while the observation group was given graded responsibility system holistic service nursing. The postoperative rehabilitation indicators (first exhaust time, first ambulation time, hospital stay), breastfeeding status (success rate of breastfeeding) and occurrence of complications (incision infection, postpartum hemorrhage, lower extremity venous thrombosis) were recorded in the two groups. The pain degree[visual analogue scale (VAS) ]at 4, 8, 12 and 24 hours after delivery and psychological status[brief profile of mood states (bPOMS) ]before intervention and before discharge were compared. Results The first exhaust time and first ambulation time in observation group were significantly lower than those in the control group, and the success rate of breastfeeding was significantly higher than that in control group. At 24 hours after delivery, the SF-MPQ scores in observation group were significantly lower than those in control group. The scores of fatigue, depression, tension, anger and confusion of bPOMS in observation group before discharge were significantly lower than those in control group while the score of vitality dimension of bPOMS was significantly higher. There were no significant differences in the hospital stay and incidence of complications between groups. Conclusion Graded responsibility system holistic service nursing model can significantly improve the perinatal psychological status of cesarean section women, help to promote the success of breastfeeding, and accelerate the postoperative rehabilitation process.