Background: Postpartum period is one of the critical periods for initiating contraception to reduce the unmet need for contraception. The study was aimed at reviewing records of postpartum contraception (PPC) users at the Rivers State University Teaching Hospital (RSUTH) to determine the prevalence, pattern of use, and the indications for postpartum contraception. Methods: A cross-sectional study of all cases of postpartum contraception at the RSUTH from 1st January 2018 to 31st December 2022. Descriptive and inferential statistics were derived using IBM, Statistical Product and Service Solutions (SPSS), version 25.0 (Armonk, NY). Results: The prevalence of postpartum contraception at the RSUTH was 18.5% of all contraceptive users or 63.4/1000 deliveries. Overall, a decreasing pattern of postpartum contraception was observed over the period under review. The commonest method of postpartum contraceptives used by participants was Implanon, accounting for 26.6% of total acceptors of postpartum contraception. This was followed by bilateral tubal ligation (25.1%), Jadelle (22.0%), and copper IUD (21.2%). The most common indication for the uptake of PPC was for spacing of childbirth (71.9%) respectively. Conclusion: The prevalence of postpartum contraception in RSUTH is low and demonstrates a decreasing trend. Women used postpartum contraception mainly for spacing and limiting of childbirth.