BACKGROUND: The most important reasons for choosing cesarean include negative attitude of pregnant women toward natural childbirth, and it is not easy for many women to make a decision about the choice of delivery, Midwives as responsible individuals, play an important role in providing maternal counseling and care during pregnancy and childbirth and the postpartum period. This study was carried out to determine the effect of individual counseling on attitudes and decisional conflict in the choice of delivery among nulliparous women. MATERIALS AND METHODS: This clinical trial was performed on 90 nulliparous women with 28–30 weeks of gestational age, who were referred to health-care centers in Mashhad. They were divided randomly into intervention and control groups. The intervention group received the counseling program individually during three sessions, while the control group received routine care, childbirth attitudes, and decisional conflict on choice of delivery were compared on women of 34–36 weeks of pregnancy. Data collection tools included demographic details form, Childbirth Attitudes Scale and Decisional Conflict Scale; data were analyzed using Chi-square tests, Fisher\\\\\\\\\\\\\\\'s exact test, Mann–Whitney test, t-test, parried t-test, and ANCOVA in SPSS v. 16, and P < 0.05 was considered statistically significant. RESULTS: After consultation, there was a significant difference in attitude score between the intervention group (86.577 ± 13.531) and the control group (69.955 ± 19.858) (P < 0.001), And there was a significant difference in decisional conflict score between the intervention group (0.614 ± 0.626) and the control group (1.216 ± 0.949) (P < 0.001), and there were significant differences between the two groups in terms of preferred delivery (P < 0.001). CONCLUSION: According to the results of this randomized control trial, individual counseling in nulliparous women during pregnancy leads to a positive attitude toward natural childbirth, informed decision-making, and increase in the selection of natural childbirth.

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