en Midwifery Original Article <div style="text-align: justify;"><span style="font-size:12px;"><span style="font-family:Times New Roman;"><b>Background:</b> Labor pain is a common concern among pregnant women, leading to fear and anxiety. Enhancing self-efficacy can play a crucial role in managing these complications. This study aims to evaluate the effect of mindfulness-based art therapy on the self-efficacy of multiparous and nulliparous women.<br> <b>Methods:</b> The present study was a randomized clinical trial with three parallel intervention arms (multiparous and nulliparous groups) and a control. The statistical population of the study included pregnant women (multiparous and nulliparous groups) referring to health centers (public and private) in Bandar Abbas city for prenatal care. A total sample size of 90 participants was determined, with 30 individuals randomly assigned to each group using a block randomization method. Participants were selected based on inclusion and exclusion criteria. Interventions were conducted in eight sessions, with 3 to 15 people in each group, in a face-to-face and coherent manner. Participants in the intervention and control groups were assessed three times: before the intervention, immediately after the intervention, and four weeks after the intervention using the Iranian Childbirth Self-Efficacy Questionnaire and the Five-Factor Mindfulness Questionnaire. The data were then analyzed using SPSS version 26 software, employing ANOVA and repeated measures tests. A significance level of less than 0.05 was considered.<br> <b>Results:</b> The mean self-efficacy scores for expectations during the active stage of labor immediately after the intervention were 162.07&plusmn;11.28 (nulliparous), 163.07&plusmn;12.02 (multiparous), and 145.77&plusmn;27.50 (control group). Four weeks post-intervention, the scores were 162.07&plusmn;11.98 (nulliparous), 163.07&plusmn;12.02 (multiparous), and 145.77&plusmn;27.50 (control group). The mean self-efficacy scores for expectations during the fourth stage of labor immediately after the intervention were 155.21&plusmn;10.80 (nulliparous), 156.21&plusmn;11.12 (multiparous), and 122.77&plusmn;24.96 (control group). Four weeks after the intervention, these scores were 152.46&plusmn;10.29 (nulliparous), 154.23&plusmn;11.34 (multiparous), and 121.23&plusmn;27.42 (control group). The mean mindfulness scores in both intervention groups (multiparous and nulliparous) were significantly higher immediately after the intervention (p=0.001) and four weeks later (p=0.001) compared to baseline.<br> <b>Conclusion</b>: The results indicated the effectiveness of mindfulness-based art therapy in enhancing self-efficacy and mindfulness among pregnant women. Thus, it is recommended that this therapeutic method be utilized to manage and reduce the fear of childbirth in pregnant women.</span></span><br> &nbsp;</div> Mindfulness-based stress reduction, Art therapy, Self-efficacy, Multiparous, Nulliparous 41 46 http://nmj.goums.ac.ir/browse.php?a_code=A-10-1968-1&slc_lang=en&sid=1 Ashraf Beirami zeynabhiseinnezhad@gmai.com 100319475328460014786 100319475328460014786 No Department of Nursing, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran Zahra Rahemi zrahemi@clemson.edu 100319475328460014787 100319475328460014787 Yes School of Nursing, Clemson University, Carolina, United States