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Nadia Bassuoni Elsharkawy,1,2 Sayeda Mohamed Mohamed,3 Mohamed Hammam Awad,4 Marwa Mohamed Ahmed Ouda1,5 1Nursing Department, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia; 2Maternal and Newborn Health Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt; 3Psychiatric Mental Health Nursing Department, Faculty of Nursing, Cairo University, Cairo, Egypt; 4Obstetrics and Gynecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 5Pediatric Nursing Department, Faculty of Nursing, Damanhur University, EgyptCorrespondence: Nadia Bassuoni ElsharkawyNursing Department, College of Applied Medical Sciences, Jouf University, Sakaka, Jouf, Kingdom of Saudi ArabiaTel +966-554180474Email nelsharkawy@ju.edu.saPurpose: This study investigated the effectiveness of a happiness counseling program on depression, anxiety, and stress in pregnant women with a history of recurrent miscarriage.Patients and Methods: A parallel randomized controlled trial research design was used in this study, which was conducted at the high-risk inpatient unit of the Obstetrics and Gynecology Hospital of Cairo University Hospitals in Cairo, Egypt. A total of 60 pregnant women who had previously experienced multiple miscarriages were randomly assigned to intervention and control groups (n=30 each). The tools used for data collection were demographic and obstetric data questionnaires and the 21-item Depression, Anxiety, and Stress Scale (DASS-21). Happiness counseling sessions were conducted for the intervention group. Data for qualitative variables were analyzed with the chi-squared test, and the Student’s t test for paired samples was used to compare mean DASS-21 scores of the intervention and control groups. The Pearson correlation coefficient was used to analyze the association between variables.Results: The happiness counseling sessions reduced depression, anxiety, and stress in women with recurrent miscarriage, resulting in lower