Objective: To investigate postnatal contraception use amongst physician women, who would be expected to be health-literate and therefore a possible “best case” scenario of postnatal contraception behaviours. Design: Secondary analysis of cross-sectional survey data Setting: United Kingdom Population or Sample: Registered physicians in the United Kingdom less than two years postpartum, aged 30-55 years old, who reported spontaneous conception. Methods: Secondary analysis of online, anonymous, survey data collected April - June 2021. Chi-squared or Fisher’s exact tests were used to compare efficacy of postnatal contraception by socio-demographics and experience of contraception counselling. A Sankey plot presents timing of initiation and type of postnatal contraception used. Main Outcome Measures: Postnatal contraception use; time postpartum at which contraception initiated; contraception efficacy. Results: Among the 146 women who had had sex postpartum, only 11.6% used a very effective method (LARC/ sterilisation) as first contraception, and 16.4% had had sex without appropriate postnatal contraception. Postnatal contraception-efficacy was associated with timing of initiation (p<0.001); 92.3% of women initiating contraception up to 3 weeks postpartum used effective or very effective methods. Contraception counselling at the place of birth was associated with initiation of effective or very effective postnatal contraception (p=0.041). Conclusions: Uptake of effective or very effective postnatal contraception in the first 6 months postpartum was low, despite a highly health-literate population. However, the significantly high proportion of women choosing these options less than 3 weeks postpartum indicates their acceptability where services are available.