Research report submitted to the Faculty of Health Sciences, University of the Witswatersrand, in partial fulfilment of the requirements for the degree of Master of Public Health in the field of Hospital Management / Background: Use of drugs in maternity unit plays a major role in maternal health service delivery. Therefore, drug use during pregnancy requires close monitoring which includes prescription of appropriate medication to their diagnosis, correct doses, and adequate period of time. Drugs are also one of the major cost drivers in health facilities. Although maternal health services are receiving increasing attention in South Africa, very few systematic studies have been done to analyze this important component (prescribing patterns and costs of drugs) of maternal health care services in a district hospital setting. Aims: The overall aim of the study is to assess the drugs utilized in a maternity ward at Pretoria West District Hospital (A district hospital in the Tshwane District in the Gauteng Province) and the factors that might influence its use and their cost over a period of one year. Methodology: Cross-section study design was used. Retrospective review of hospital records was undertaken for 2087 maternal patient deliveries during one year study period (01 January to December 2009) and no primary data was collected. Data was extracted for variables used in the study (quantity and cost of drug used, profile of patients). The study commenced after obtaining necessary approval from the Gauteng Department of Health and Social Development and University of the 2 Witwatersrand “Human Research Ethics Committee (Medical)’. Results: The study found that all the patients were prescribed iron supplements. The second most commonly prescribed drugs are uterotonics. Besides these two items other prescription drugs were prescribed to 7% of patients. Postnatal contraceptives were seldom used. The most commonly used antibiotic was Ceftriaxone. Bezylpenicillin was prescribed only for one RPR positive patient during one month. Only 13% HIV positive received antiretrovirals which is too low as compared to number of mothers delivered. The study found underprescription of anti-hypertensive drugs. Low use of parenteral analgesics signifies that probably patients were not given adequate pain relief during labour and this policy should be reviewed. The quantity of biological vaccines (BCG and oral polio) was prescribed routinely for all the newborn babies. However, the antiretrovirals (Zidovudine and Nevirapine syrups) were prescribed for fewer newborn babies (n= 51), in comparison to total number of babies born to a HIV positive mothers (n=266) and of concern. Total cost for the drugs used during one year study period was R 113,664.56. The average costs per mother and newborn babies were R 39.40 and R 15.08 respectively. Routine availability of affordable and effective drugs is one of the key indicators of quality health. The study showed that affordable and effective drugs were readily available in the Unit. Conclusion: This is probably the first study that documented the use of drugs in the maternity unit in a district hospital. Further prospective study would be able to provide more information in this important subject.