Risk factors in pregnancy are prominent all over the world and these claim the lives of many pregnant women. Such factors include number of antenatal visits made by the pregnant women, age of the pregnant woman, duration of the current pregnancy at the time of registration, the number of previous pregnancies with delivery outcomes and haemoglobin level in the blood less than 11 .0g/dl which indicate Anaemia, as defined by WHO. In developing countries, the prevalence of anaemia in pregnancy is 56% and Ghana has a much higher prevalence rate of 65% (GDHS, 2003). The Ministry of Health and the Ghana Health Service have instituted Safe Motherhood Programmes to reduce this high prevalence rate. Since 2003 Bosomtwe Atwima Kwanwoma (BAK) district in Ashanti Region of Ghana has recorded at least one maternal death due to anaemia in pregnancy. This study assessed anaemia as a risk factor in pregnancy and its management at St Michael’s Hospital in BAK district It was a descriptive cross sectional study involving 135 interviewees made up of 100 pregnant women aged 15-49 years, 30 health care providers and five key informants. In addition, eighty maternal health record books were reviewed The major findings in the study indicated that health personnel did not take pregnancy histories for 58.8% of the pregnant women, and health education messages delivered were not recorded in the maternal health record books of 61.2% of the women and as high as 46.0% of the pregnant women reported at the hospital during the second and third trimesters of their pregnancies. Health care providers did not check the haemoglobin level of the pregnant women at 36 weeks of the gestation period. Even though the hospital has adequate facilities, equipment and medicines, there was inadequate health staff and therefore focused antenatal cafe could not be practiced. The blood bank at the hospital was not functioning due to power fluctuation and lack of blood from donors. However 93.0% of the pregnant received iron and folic acid supplementation. The study also found out that over 80.0% of the health care providers at the hospital were not trained in the Ghana Health Service anaemia in pregnancy control protocol. This reflected in the educational messages given to the pregnant women. It is recommended that pregnant women have to be educated on the link between malaria infection and anaemia in pregnancy since only 53.3% of them slept under ITN and 50.0% received IPT against malaria. Again musing awareness of anaemia prevention and control, promoting behaviour change in the communities (and among pregnant women) and training to build capacity among health workers are activities that could be implemented by all sections. This should be adopted by the Management of St. Michael’s hospital and the District Health Directorate to address the problem of the potential of anaemia as a high risk factor among pregnant women in BAK district.