The Minangkabau people of West Sumatra in Indonesia are renowned for their matrilineal culture with property and land passing down from mother to daughter. Despite there being a fairly balanced social status for women in the community, the impact of health inequalities is uneven. This study was therefore carried out to explore the relationship between the social, cultural and economic contexts in such a distinctive community with maternal nutrition and pregnancy-related health outcomes, from the perspectives of the mothers, fathers and care providers. Qualitative methods were used to undertake this study in collaboration with partners from the University of Andalas in a suburban area of Padang district. The data collection method was qualitative, semi-structured interviews (n = 19) with women, men, midwives and community health workers. The data were recorded with informed consent, transcribed in the local language and then translated into English prior to being thematically analysed. The major themes which emerged from the data included 'Minangkabau matrilineality and role of women'; 'culture and supportive attitude towards pregnant women'; 'dietary patterns, attitude and access to food'; and 'limited access to information about food and nutrition'. The findings showed healthy dietary patterns such as regular consumption of vegetables and fruit among the participants. However, the issues of poverty, access to food, dietary taboos and inadequate nutritional information remained major challenges for the mothers and the families who participated in the study. The evidence from this study suggests that the matrilineal culture of the Minangkabau promotes the empowerment of women and offers an encouraging environment for enhancing reproductive health. This lends itself to co-developing locally sensitive and sustainable complex interventions incorporating professional support and building on family and community back-up, enhancing knowledge and demystifying dietary misinformation to improve maternal health and nutrition.