Background <p>The postpartum period is linked to a high risk of unintended pregnancies, contributing to the high fertility rate in Nigeria. The study investigated the fertility preferences and spousal communication on contraceptives among postpartum mothers attending maternal and child health clinics in the Abuja district hospitals.</p> Methods <p>A descriptive cross-sectional study was conducted, and 248 postpartum mothers were purposely selected from a cluster of women attending a postnatal clinic across four district hospitals in Abuja, Nigeria. The data were summarised using mean, standard deviation, frequency, and percentages. Bivariate analysis was conducted using the Pearson χ² test at a 95% level of statistical significance.</p> Results <p>Regarding the respondents’ fertility preferences, about 80% desire to have another child; however, only a few desire to have a child soon, while over 70% want a child later. This desire to have another child increases as the parity level decreases. The study revealed a strong desire to use a contraceptive method (56.5%), however, only 15.3% of the respondents were current users. The data showed a significant association (<i>P</i> = 0.0001) between frequent spousal communication and contraceptive uptake.</p> Conclusion <p>The study revealed a high unmet need for spacing, a strong desire for contraceptives and a low uptake among postpartum mothers. Improving access to family planning (FP) methods and including spousal communication in FP interventions can help postpartum mothers fulfil fertility preferences, reducing unintended pregnancies and negative reproductive health issues.</p>