Introduction. The Russian Federation provides assistance to the socio-economic development of the Republic of South Ossetia (RSO) in the framework of investment programs. Rational planning and distribution of financial resources allocated to the healthcare industry is impossible without possession of relevant data on demographics and morbidity. The purpose of the study: updating the data on the work of pregnancy and birth services of RSO in the context of socio-demographic changes that have occurred in the region over the past 35 years. Materials and methods: primary data from birth registers of the Tskhinval Maternity Hospital, data from the statistical department and data from the chief specialists of the Ministry of Health and Social Development of RSO. Were used data from the State Committee for Statistics of the USSR (Central Statistical Department of the USSR), Russian Federal State Statistics Service, and the Ministry of Health of Russia for a comparative analysis. Descriptive statistics are presented as mean and standard deviation (M ± σ), fractional expression (%). Research result. The authors analyzed and evaluated the work results of pregnancy and birth services of South Ossetia at the turn of the 20th and 21st centuries. The results obtained are considered in different years, in the medical, social and demographic aspects: 1984, the time of stable birth rate growth in the USSR, the presence of South Ossetia in the Georgian SSR; 1990 - 2008, the period of independence of South Ossetia, high military, socio-economic and political instability in the South Caucasus; 2008 - 2018, recognition by the Russian Federation of the independence of RSO, implementation of investment programs in Russia in RSO, peace period. Summary. The results of pregnancy and birth services is highly dependent on the level of social well-being. We should talk about the end of the period of social upheaval in RSO, however, indicators of the effectiveness of pregnancy and birth services in the RSO are still unstable. It is necessary to take a number of practical steps aimed at developing of pregnancy and birth services in the Republic: providing the RSO health care system with medical personnel, developing a system of women's consultations and family planning services.