Prenatal stress is the mechanism through which poor welfare of pregnant sows has detrimental effects on the health and resilience of their piglets. We compared two gestation housing systems (IMPROVED versus [conventional] CONTROL) in terms of sow stress and welfare indicators and sought to determine whether potential benefits to the sows would translate into improved offspring health. Sows were mixed into 12 stable groups (six groups per treatment, 20 sows per group) 29 days post-service in pens with free-access, full-length individual feeding/lying-stalls. CONTROL pens had fully slatted concrete floors, with two blocks of wood and two chains suspended in the group area. IMPROVED pens were the same but with rubber mats and manila rope in each stall, and straw provided in three racks in the group area. Saliva was collected from each sow on day 80 of pregnancy and analysed for haptoglobin. Hair cortisol was measured in late gestation. Sows' right and left eyes were scored for tear staining in mid lactation and at weaning. Numbers of piglets born alive, dead, mummified, and total born were recorded. Piglets were weighed and scored for vitality and intra-uterine growth restriction (IUGR) at birth. Presence of diarrhoea in farrowing pens was scored every second day throughout the suckling period. IMPROVED sows had lower haptoglobin levels and tear-stain scores during lactation. IMPROVED sows produced fewer mummified piglets, and these had significantly lower IUGR scores, and scored lower for diarrhoea than piglets of CONTROL sows. Hence, improving sow welfare during gestation improved the health and performance of their offspring.