Self-medication in pregnancy is a concern in Ghana. We assessed the practice among 136 pregnant women in Effutu and Agona West Municipalities using facility-based, cross-sectional design and mixed method approach of data collection. Our findings show that pregnant women of varying backgrounds self-medicate for sociocultural and economic reasons, with 69% prevalence, motivated by cheaper treatment cost (17%), minor ailments (29%) and positive outcomes (33%). Commonly used medications include antibiotics (23%), pain killers (20%) and herbal preparations (19%). We recommend further studies on pharmacological compositions of the medications used and effects on pregnancy outcomes to inform policy and programs decisions.