Background: Pregnancy is one of the most important and sensitive stages in a woman's life. Objectives: The present study was conducted to investigate the effect of midwife-oriented group counseling, based on Orem's model on self-care and empowerment, in primiparous women presenting to select health centers. Methods: The present parallel randomized controlled trial was conducted on 74 pregnant women presenting to select health centers in Talesh, Iran, in 2017. The eligible candidates were selected using convenience sampling and were then divided into an intervention (37) as well as a control group (37) in randomized blocks of four. The participants completed the pregnancy-related empowerment and pregnant women's self-care questionnaires before, immediately after, and three weeks after the intervention. Data were analyzed by using SPSS-24. Results: The results showed that the intervention increased the mean total score of empowerment before, immediately after, and three weeks after the intervention in both groups, however, the effect was more sustained in the intervention compared to the control group (P < 0.001). The results also showed that the intervention increased the mean total score of self-care before, immediately after, and three weeks after the intervention in both groups, however the effect was more sustained in the intervention compared to the control group (P < 0.001). Conclusions: Midwife-oriented group counseling affected pregnant women's empowerment and self-care. Furthermore, the importance of maternal health and midwives' role as health counselors suggests the need for a greater attention to this issue.