Effects of Maternal Role Preparation Training and Awareness-Centered Occupational Therapy Interventions on Psychosocial Parameters and Quality of Life in Pregnant Women: A Randomized Controlled Trial With Postpartum Follow-Up

IMPORTANCE: Psychosocial well-being during pregnancy influences maternal health and adjustment to motherhood. Targeted interventions may enhance emotional resilience and occupational functioning. OBJECTIVE: To compare the effectiveness of Maternal Role Preparation Training (MRPT) and Awareness-Centered Occupational Therapy (ACOT) on anxiety, depression, coping styles, emotion regulation, and quality of life (QoL) in pregnant women. DESIGN: Three-arm randomized controlled trial. SETTING: Hospital obstetrics and gynecology clinics in Türkiye. PARTICIPANTS: Healthy pregnant women in their second trimester (N = 74) who met inclusion criteria. INTERVENTION: Participants were assigned to MRPT (n = 23), ACOT (n = 23), or the control group (n = 28). Group sessions occurred 2×/wk for 8 wk. Assessments were conducted at pretest (second trimester), posttest (third trimester), and 12-wk postpartum follow-up. Kruskal-Wallis (KW) and Friedman tests were used. MRPT targeted maternal role development, and ACOT emphasized self-awareness in daily occupations; both followed manualized protocols. OUTCOMES AND MEASURES: The Hospital Anxiety and Depression Scale, Styles of Coping With Stress Scale, Cognitive Emotion Regulation Questionnaire, and Nottingham Health Profile. RESULTS: ACOT significantly reduced anxiety (χ2 = 31.97, p < .01), improved emotion regulation, and enhanced QoL (KW = 43.55; p < .001). MRPT was more effective in reducing depression (χ2 = 17.73, p < .01) and promoting adaptive coping. Both interventions reduced maladaptive strategies. Pain and sleep gains lessened at follow-up. CONCLUSIONS AND RELEVANCE: ACOT is superior for anxiety, emotion regulation, and QoL; MRPT more effectively supports depression and coping. Occupational therapists may select approaches on the basis of individual psychosocial profiles during pregnancy. Plain-Language Summary: This study explored how two different occupational therapy programs helped pregnant women improve their emotional well-being. One program helped participants prepare for the maternal role with education and group discussions; the other program used activities that supported body awareness and emotional self-regulation. Women who took part in the awareness-based sessions had less anxiety and felt more in control of their emotions. Those in the maternal role group showed less depression and coped with stress more effectively. Both programs helped improve quality of life. These results suggest that occupational therapy can support emotional health during pregnancy.