Fertility and sexual activity return quickly following childbirth. One in 13 women requesting an abortion have conceived within a year of a previous birth and interpregnancy intervals of less than 12 months are associated with adverse pregnancy outcomes. Childbirth is a key reproductive event and an opportunity to improve equitable access to effective contraception including long-acting reversible contraception (LARC). An antenatal discussion and plan for post-partum contraception should be recorded for all women and the chosen method provided immediately after delivery where desired by the individual and when safe to do so. All methods are safe to start immediately post-partum except combined hormonal contraception because of the risk of venous thromboembolism (VTE). All clinical staff caring for pregnant women should be able to discuss and provide immediate post-partum contraception. Primary care, secondary care and community sexual and reproductive health (SRH) services should work collaboratively to overcome the organisational and educational challenges involved.