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Antenatal care (ANC) has been a routine practice throughout the world since early 20th Century.1 Quality of ANC is an important determinant of pregnancy outcome2 and has been designated one of the four pillars of safe motherhood along with clean and safe delivery, essential obstetric care, and family planning which could contribute to the reduction of maternal mortality.3 Client satisfaction with the quality of care which reflects goals or preferences are met by the health care provider and or service,4 is an integral part of the quality assurance process of health delivery.5 The traditional risk approach to ANC, which is based on European models assumes that better care is achieved by frequent routine visits. However, evidence-based research has found the practice of the traditional approach to ANC based on the European models to be wasteful and misleading.6 Women are classified by risk status to determine their chances of complications and the levels of care needed.7 Focused ANC recognizes that every pregnant woman is at risk for complications and should receive the same basic care and monitoring for complications.8,9 Evaluating to what extent patients are satisfied with health services is clinically relevant, as satisfied patients are more likely to comply with treatment, take an active role in their own care, to continue using medical care services, and recommend center’s services to others.10 Despite the fact that client satisfaction is essential for further improvement of the quality of care, little is known about the quality and associated factors of satisfaction in Erbil city and Kurdistan region of Iraq. This study, therefore, would have a certain contribution in closing this gap. Methods

Satisfaction with focused and risk approach antenatal care services among pregnant women attending primary health care centers in Erbil city