Investigating the effect of acceptance and commitment therapy on changing the decision of pregnant women seeking abortion to continue their pregnancy, acceptance of the maternal role and adaptation to pregnancy

To determine the effect of Acceptance and Commitment Therapy on changing the decision of pregnant women seeking abortion to continue their pregnancy, acceptance of the maternal role, and adaptation to pregnancy.

This is a randomized controlled clinical trial with two parallel groups and no blinding, with an anticipated sample size of 112 participants (56 per group). Participants will be allocated using block randomization with blocks of six and a 1:1 allocation ratio. The randomization sequence will be generated by an independent individual, and allocation will be concealed using opaque, sealed, sequentially numbered envelopes. Study phase: Not applicable.

This randomized controlled clinical trial will be conducted at the Nafas Center in Ahvaz. After obtaining informed consent, participants will be randomly allocated to the intervention and control groups. The intervention group will receive 8 weekly 90-minute sessions of acceptance and commitment therapy (ACT)-based education, while the control group will receive routine services provided by the center. This study will be conducted without blinding.

Inclusion: Women 18–48y, 4–20wks gestation, intrauterine pregnancy, Persian literacy, consent; Exclusion: acute psych/med/obstetric conditions, pregnancy/fetal complications, substance abuse, major stressors, concurrent psychotherapy, incomplete data.

Intervention group: Group-based acceptance and commitment therapy (ACT) education will be provided in 8 weekly 90-minute sessions, delivered in 6 groups. The control group will receive routine services at the Nafas Center in Ahvaz, including routine prenatal care and psychosocial support, and will not receive the ACT intervention.

Change in the decision to continue pregnancy; acceptance of the maternal role; adaptation to pregnancy

Due to a technical issue with the IRCT system, the registration and approval process of the study was delayed. As a result, the participant recruitment start date entered when initially completing the registration form does not correspond to the final approval date of the study. Since participant recruitment has not yet started, I would like to correct the participant recruitment start date registered in the system so that it accurately reflects the actual status of the study and is consistent with the approval date of the clinical trial.

Participants will be allocated to two groups using block randomization with blocks of six and a 1:1 allocation ratio: an acceptance and commitment therapy-based counseling group (n = 56) and a control group (n = 56). The randomization sequence will be generated using blocks of six by an individual independent of the research team. To ensure allocation concealment, each allocation will be placed separately in an opaque, sealed, light-proof, sequentially numbered envelope, with only one allocation code (A or B) inside each envelope. After eligibility criteria have been confirmed and informed consent has been obtained, the next envelope will be opened in sequential numerical order, and the participant will be assigned to either the intervention or control group according to the allocation code contained in the envelope.

Due to the need to maintain the confidentiality of participants' information and the limitations arising from informed consent and ethical considerations of the study, de-identified individual participant data will not be shared with other researchers.