Random allocation and intervention
Participants were randomly assigned to one of the two intervention and control groups (35 people in each group) using a stratified blocked randomization method (stratified by first or second pregnancy), with a block sizes of 4 and 6 and allocation ratio of 1:1. The allocation sequence was determined by a person not involved in the sampling and data collection. For allocation concealment, the type of intervention was written on paper and placed in opaque envelops numbered sequentially. The envelopes were opened in the order of the participants entering the study and the type of intervention received by each participant was determined.Counseling based on a cognitive-behavioral approach was provided to the intervention group in 8 sessions of 60 to 90 min once a week by a master’s student of counseling in midwifery who had been trained for CBT by a professional psychologist. In addition, we have a psychologist on our team who supervised the intervention. The sessions were held in a calm environment in health centers considered for counseling. Body image counseling was based on Cash and Strachan’s body image workbook [
Contents of cognitive-behavior counseling sessionsBecause of the COVID-19 pandemic and the need to maintain social distancing, the number of participants in each session was limited to at least three and no more than five people (depending on the available space in the health centers).