In this paper, we explore the incidence of unplanned pregnancies; contraceptive usage; and contributing factors associated with unplanned pregnancies in the Ahafo Ano South District, Ghana. Using a well-structured questionnaire, random sample of 472 expectant mothers who accessed maternity service at healthcare points in the district were interviewed. The data obtained was analyzed using descriptive statistics and multinomial regression. Results indicate that, every 28 out of 59 pregnancies in the district were somehow unplanned; 71.2% of expectant mothers were not using contraceptives, whereas 21.4% and 7.4% uses modern and traditional contraceptives respectively. Age, marital status, abode, educational status, profession, gravity and parity were significant predictive factors of unplanned pregnancy in the district. Again, the study recorded high incidence of teenage pregnancies. In pursuance to these, we recommend the Reproductive and Child Health Unit to intensify education on effective use of modern contraceptives in preventing unplanned pregnancies and its associated risks.