Background <p>Childbirth satisfaction is one of the important criteria of the quality of midwifery care. The study aimed to evaluate the effect of counseling based on Fordyce happiness approach on happiness and childbirth satisfaction among primiparous women.</p> Methods <p>This randomized controlled clinical trial was conducted on 80 pregnant women in 2022. These mothers were experiencing their first pregnancy. They were assigned to intervention and control groups by multi-stage sampling. After three weeks (6 counseling sessions) for the intervention group, the Fordyce Happiness Questionnaire and the Mackey Childbirth Satisfaction Scale were used to collect data. Data analysis was performed using SPSS-26 software and the repeated measures analysis of variance (ANOVA) test, the independent t-test, and the chi-square test at 95% confidence level.</p> Results <p>The mean happiness scores of mothers in the intervention group increased from 45.55 ± 9.76 pre-intervention to 48.2 ± 9.37 immediately post-intervention and 48.05 ± 9.06 during the follow-up period. In contrast, the control group exhibited a decrease in scores, declining from 45.6 ± 10.61 pre-intervention to 43.38 ± 9.33 post-intervention and 42.1 ± 10.43 at follow-up. Statistically significant differences in the mean scores of happiness between the two groups were observed both immediately post-intervention (<i>p</i> = 0.024) and at follow-up (<i>p</i> = 0.008). The intervention group had a mean satisfaction score of 59.58 ± 8.46, while the control group scored 48.72 ± 13.31. The total satisfaction scores differed significantly between the two groups (<i>p</i> = 0.001).</p> Conclusion <p>Conducting counseling sessions based on Fordyce’s happiness approach women was effective in improving happiness and childbirth satisfaction among primiparous women. Integrating this counseling approach into perinatal care services appears to provide mothers with emotional and psychological support.</p> Trial registration <p>Ethics Committee of Zanjan University of Medical Sciences: IR.ZUMS.REC.1401.174.</p> Registry of clinical trials <p>IRCT20201113049377N2.</p> Registration date <p>06/09/2022 (<a href="https://irct.behdasht.gov.ir">https://irct.behdasht.gov.ir</a>).</p>