The Effect of Cognitive Behavioral Counseling on Stress and Quality of Life of Pregnant Women with a History of Spontaneous Abortion: A Randomized Controlled Trial

Background: Spontaneous abortion is a physically and psychologically distressing event, often necessitating psychological support in subsequent pregnancies to mitigate adverse mental health outcomes. Objectives: This study aimed to evaluate the effectiveness of individual cognitive-behavioral therapy (CBT) counseling in reducing stress and improving the quality of life among pregnant women with a history of spontaneous abortion. Methods: A parallel-group randomized controlled trial was conducted with 72 pregnant women at 6–10 weeks of gestation, all of whom had a prior spontaneous abortion and exhibited stress symptoms. Participants were randomly assigned to an intervention group (n=36) receiving 10 individual CBT sessions or a control group (n=36) receiving routine prenatal care. Stress and quality of life were assessed at baseline, post-intervention, and two-month follow-up. Nonparametric statistical analyses were performed, with significance set at p < 0.05. Results: Post-intervention, the CBT group showed a significant reduction in stress levels compared to controls (from 28.3 to 19.9 post-intervention and 19.7 at follow-up; p < 0.001). Significant improvements were also observed in psychological, social, environmental, and general health domains of quality of life (e.g., overall QoL increased from 60.4 to 70.8; p < 0.001). These benefits were largely maintained at the two-month follow-up, though no significant change occurred in the physical domain. Conclusion: Individual CBT counseling is an effective intervention for reducing stress and enhancing quality of life in pregnant women with a history of spontaneous abortion, supporting its integration into prenatal mental health care for this vulnerable group.