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Introduction Significant biological, psychological, and physical changes during pregnancy can affect sexual performance in women (1,2). Hormonal changes during pregnancy cause vomiting, diarrhea, breast sensitivity, and fatigue, leading to decreased sexual desire (1). However, several studies have reported that these problems are not the only causes of sexual dysfunction (3). Many non-hormonal factors (e.g., social, economic, and cultural factors) can also change the sexual behaviors of women during pregnancy. The sexual behaviors of the couples during pregnancy are affected by their value systems, traditional and religious beliefs, and fear of hurting the fetus and mother (4). According to the literature, culture plays an important role in the frequency of sexual intercourse during pregnancy, which ultimately leads to sexual dysfunction (5, 6). In addition, several studies conducted on the Iranian women indicated that the most common causes of sexual dysfunction were physical problems (e.g., backache, pain during intercourse, dyspnea, and weight gain) (7,8) and false beliefs about intercourse during pregnancy. These misbeliefs include injury to the fetus, premature delivery, or lack of attractiveness for the spouse (7). Sexual function is still regarded as a taboo subject in some societies due to the lack of sufficient knowledge as well as cultural and religious prejudices (9,10). Sexual dysfunction intervenes with women's reproductive health. This disorder is regarded as a major health problem, the negative effects of which include the reduction of self-confidence, emotional changes, stress, significant distress between spouses, and reduced quality of life (11). Different statistics have been reported about the rate of sexual dysfunction, varying from 40% (12) to 63% (8) and 79% (12). It is noteworthy that more than half of the women receive no information about sexual intercourse during pregnancy (8). This could be either due to not asking about sexual coition during pregnancy on the part of the patient or the negligence of the healthcare providers. The lack of appropriate interaction between the patients and midwives leads to receiving inadequate information related to sexual function, which is a critical issue in communities (13,14). The lack of knowledge about intercourse during

Background and Aim: Pregnancy due to physiological and psychological changes can affect the mental health of mothers. This study aims to investigate the Approach of acceptance and commitment based on the fear of delivery pain. Materials and Methods: This study was a randomized educational trial with a commitment-based treatment approach that was performed on pregnant women in Arak in 2016-2017. After obtaining written consent forms, 42 subjects were selected through the available sampling method. Subjects were grouped in the intervention group (ACT) and in the control group. Eight 90-minute sessions were held for 8 consecutive weeks of counseling Fear of delivery pain at 10 and one month after the intervention was measured in 2 groups by the Likert scale of pain (1-7) score. Data analysis was performed through repeated measure ANOVA by using SPSS (Version 18). Results: Results showed that the mean pain immediately after the intervention was 2.52±2.20 in the intervention group and 4.66±1.80 in the control group. Which is a month later in the intervention group compared to the control group had a significant decrease (3.52±1.81 vs. 4.52±2.30) (P=0.001). Conclusion: In this study, counseling with the approach of acceptance and commitment reduction the fear of delivery pain, which is the most important reason for choosing cesarean section in women, Therefore, it seems that empowering midwives to counseling approaches can be useful to improve maternal care during pregnancy, especially in the administration of delivery preparation classes.

Objectives: The present study aimed to investigate the effect of acceptance and commitment therapy (ACT) on the quality of life of infertile women during the treatment. Materials and Methods: This study was a randomized clinical trial that was conducted on 40 infertile women admitted to the clinics of Arak, Iran. They were selected through a convenience sampling technique and were randomly assigned to intervention (n=20) and control (n=20) groups. The Fertility Quality of Life (FertiQoL) Questionnaire was used as a data collection tool, which was completed before and one month after the intervention. The counseling group was provided with eleven 90-minute sessions of ACT twice a week. Then, the data were analyzed using SPSS 23 through the chi-square test and independent samples test. Results: Based on the results, there was a statistically significant difference between the mean scores of the quality of life in ACT and control groups before and one month after the intervention (P<0.05). Conclusions: In general, it seems that ACT improves the infertile women’s quality of life and this treatment can be used for alleviating the quality of life of these women taking into account the high incidence of infertility.