Background: Given the prevalence and outcomes of gestational depression and anxiety and the important role of midwives in psychological support of pregnant women, alternative treatments like spiritual counseling can play an important role. This study investigated the effect of spiritual counseling on depression, anxiety and stress in pregnant women.

Methods: This randomized clinical trial recruited 80 pregnant women in antenatal preparation courses for physiologic delivery in Fatimah Hospital, Hamadan (2015). Participants were selected based on inclusion criteria and clinical interviews, and were randomly assigned to intervention (n=40) and control (n=40) groups. Data were collected through a demographic questionnaire and DASS-21. Both groups were followed immediately after and two months after the intervention. Data were analyzed by descriptive and analytical statistic in SPSS/16.

Results: Before the intervention, no significant difference was observed in the mean score of depression, anxiety, stress and spiritual intelligence between intervention and control groups (p>0.05). After the intervention and two months later, the results showed a significant difference between the two groups on depression, anxiety, and stress, so the intervention was effective (p<0.05). The mean score of depression, anxiety and stress in the intervention group did not significantly change over time (p>0.05).

Conclusion: Spiritual counseling can control depression, anxiety and stress in pregnant women; therefore, it is recommended that spiritual counseling be used as a complementary, effective and non-invasive intervention to control psychological problems of pregnant women.