Introduction: Pregnancy is associated with various physical and psychological changes. Pregnant women may experience a lot of anxiety. The present study aimed to determine the effectiveness of cognitive-behavioral education on anxiety during pregnancy and delivery method in Primiparous women. Methods: This was a semi-experimental study using a pre-test post-test control-group design. The study population included all primiparous women admitted to Asalian Hospital in Khorramabad, Iran, in 2014. 24 women were selected via convenience sampling based on certain inclusion and exclusion criteria and were randomly divided into experimental and control groups. In addition to providing both groups with normal medical care during pregnancy, only the experimental group received twelve 90 minute sessions of cognitive-behavioral education. Data were collected using a researcher-made demographic questionnaire and the Van den Berg Questionnaire Pregnancy Related Anxiety. Data were analyzed by descriptive statistics, analysis of covariance, and chi-square tests using SPSS (v. 20). Results: Mean scores of anxiety during pregnancy in the experimental group decreased significantly as opposed to the control group (P < 0.001). Additionally, there was a significant difference between the experimental and the control group in terms of delivery method (P < 0.05). Conclusions: Prenatal cognitive-behavioral education was effective in reducing the anxiety of pregnant women and in referring them for vaginal delivery method. Therefore, establishing and promoting various methods for low pain childbirth and training pregnant women for choosing the vaginal delivery method is recommended.