
Background: Uptake of postpartum family planning remains low in sub-Saharan Africa. Little is known about how postpartum women in Abakaliki arrive at their decisions to adopt postpartum family planning. Hence this study is important so as to identify gaps, and to improve engagement with reproductive health services, particularly in helping women align their contraceptive choice with their expressed need. Methods: It was a hospital based cross-sectional study which involved 55 reproductive-age women who gave birth in the last 24 months prior to the study period. The collected data was coded and entered and analyzed using Epi Info version 7.0 (CDC, USA). Results: The mean age of the respondents was 28.2±4.3 years. The prevalence of contraceptive use among postpartum women was 34 (61.8%). Forty-eight (87.3%) women received family planning counselling at antenatal and postnatal care sessions. Fear of side effects (42.9%) and spousal disapproval were the main reasons for not using contraceptive methods. Educational level, parity, antenatal care and postnatal visits, family planning counselling during ANC and PNC, knowledge of postpartum family planning and experience of side effects in previous contraceptive use showed significant and independent association with postpartum family planning use. Conclusion: This study calls attention to the importance of increased need for family planning in Abakaliki as significant number (38.2%) of respondents were not on any contraceptive method. The persistence of unmet need for family planning, particularly the high rate of unmet need amongst these women points to an important gap in service provision.