Background <p>The World Health Organization recognizes that approximately half of all maternal deaths occur in the immediate postnatal period or 24&#xa0;h after birth. Forty-seven percent of Lao women aged 15–49 who delivered a baby in the last two years received a postnatal health check in the first two days after delivery. After leaving the presence of a provider, 98.5% of these women never received another postnatal check. The maternal mortality ratio (MMR) in Lao PDR was 126 deaths per 100,000 live births in 2020. Immediate postnatal care (PNC) is a crucial step to improving maternal mortality. The aim of this study was to identify factors associated with the lack of PNC, which is necessary for developing targeted interventions.</p> Methods <p>A secondary data analysis of the Lao PDR MICS 2017 women and household data sets was completed to identify factors associated with immediate PNC. The selection of variables draws from The Behavioral Model of Health Services Use for the predisposing, enabling, and need factors. Participants included women between the ages of 15–49 who had a live birth two years before the study.</p> Results <p>The weighted sample included 4,231 participants; 2,234 (52.8%) did not receive immediate PNC, while 1,996 (47.2%) did receive immediate postnatal care. The Rao–Scott likelihood ratio chi-square identified differences in factors associated with women receiving immediate PNC. Univariate and multivariate analyses identified factors associated with immediate PNC utilization. Among the predisposing, enabling, and need factors, ethnicity, religion, literacy, region, media exposure, wealth, parity, delivery location, delivery assistant, and maternal-infant skin-to-skin were associated with PNC utilization.</p> Conclusions <p>This study suggests that selective interventions need to be developed to improve immediate postnatal care and reduce maternal mortality and morbidity in Lao PDR, providing a foundation for targeted intervention.</p>