* Corresponding author: Faegheh Golalizadeh Bibalan, MSc in Midwifery, Department of Midwifery, Faculty of Nursing and Midwifery, Hamedan University of Medical Sciences, Hamedan, Iran. Email: golalizadeh2010@gmail.com Impact of a Counseling Program on Depression, Anxiety, Stress, and Spiritual Intelligence in Pregnant Women Batul Khodakarami (MSc) 1,2 , Faegheh Golalizadeh Bibalan (MSc) 3* , Farzaneh Soltani (PhD) 4,2 , Alireza Soltanian (PhD) 5,6 , Hussein Mohagheghi (PhD) 7 1 MSc in Midwifery Education, Mother and Child Care Research Center, Hamedan University of Medical Sciences, Hamedan, Iran 2 Department of Midwifery, Faculty of Nursing and Midwifery, Hamedan University of Medical Sciences, Hamedan, Iran 3 MSc in Midwifery, Department of Midwifery, Faculty of Nursing and Midwifery, Hamedan University of Medical Sciences, Hamedan, Iran 4 Assistant Professor, Mother and Child Care Research Center, Hamedan University of Medical Sciences, Hamedan, Iran 5 Associate Professor, Modeling of Noncommunicable Diseases Research Center, Hamedan University of Medical Sciences, Hamedan, Iran 6 Department of Biostatistics and Epidemiology, School of Public Health, Hamedan University of Medical Sciences, Hamedan, Iran 7 Assistant Professor, Department of Psychology, Faculty of Economics and Social Sciences, Bu-Ali Sina University, Hamedan, Iran A R T I C L E I N F O A B S T R A C T Article type: Original article Background & aim: Recent studies showed that spirituality and spiritual intelligence in pregnant women are associated with mental reactions. The purpose of this study was to evaluate the effects of spiritual counseling on pregnant women's spiritual intelligence and common mental reactions during pregnancy. Methods: In this quasi-experimental study, 80 multiparous and nulliparous pregnant women were randomly selected from among pregnant women referring to our clinic. The patients were screened and then randomly assigned to intervention (n=40) and control (n=40) groups. The intervention group was divided into four groups of ten and then received spiritual counseling during eight sessions. The control group only received the routine care. The data was collected by using a demographic form, Depression, Anxiety, Stress Scale-21 (DASS-21), and King spiritual intelligence scale. Both groups were followed immediately and two months after the intervention. To analyze the data, descriptive and analytical statistics were used in SPSS, version 16. Results: Before the intervention, there was no significant difference in mean scores of depression, anxiety, stress, spiritual intelligence, and its components between the two groups (P>0.05). However, immediately and two month after the intervention, the results showed a significant difference between the two groups in terms of mean scores of depression, anxiety, stress, spiritual intelligence, and its components (P<0.05). There was a non-significant difference in the mean scores of depression, anxiety, and stress over time (before, immediately after, and two months after the intervention) in the intervention group (P>0.05). The mean scores of spiritual intelligence and its components significantly increased over time (before, immediately, and two months after the intervention) in the intervention group (P<0.05). Conclusion: Spiritual counseling was effective in enhancing spiritual intelligence and controlling depression, anxiety, and stress in pregnant women. Article History: Received: 26- Jan -2016 Accepted: 25- Feb -2017 Key words: Anxiety Depression Pregnancy Spiritual intelligence Stress Please cite this paper as: Khodakarami B, Golalizadeh Bibalan F, Soltani F, Soltanian A, Mohagheghi H. Impact of a Counseling Program on Depression, Anxiety, Stress, and Spiritual Intelligence in Pregnant Women. Journal of Midwifery and Reproductive Health. 2017; 5(2): 858-866. DOI: 10.22038/jmrh.2016.7755 Introduction In recent decades, psychiatry and other related disciplines have been concerned about pregnant women's mental reactions such as anxiety and depression (1). Globally, some of the stressors that commonly affect mental reactions of women during pregnancy are pregnancy complications, low material resources, unfavorable employment conditions, heavy family and household responsibilities, and strain in intimate relationship (2). Several studies found that elevated depression (3), anxiety (4), and stress (5) levels predicted an