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OBJECTIVE To identify characteristics of women who have consistent plans in terms of contraceptive effectiveness from antepartum to postpartum care and whether consistency affects contraceptive outcomes. STUDY DESIGN This is a secondary analysis of a retrospective chart review of women who delivered at a single tertiary care center from 2012-2014. Preferred postpartum contraceptive plan was abstracted at three time points (prenatal care, hospital discharge, and outpatient postpartum care) and categorized into three tiers of effectiveness. We then examined consistency between the first two time points for the effectiveness in postpartum contraceptive method planned. RESULTS Of the 8,394 women in the study cohort, 2,642 (31.5%) had a consistent postpartum contraceptive tier planned at the first two time points. Women who had consistent contraceptive preferences were more likely to have higher parity (aOR 2.36, 95% CI 2.06-2.70 for parity 2+), delivered via cesarean section (aOR 1.50, 95% CI 1.34-1.68), and have received adequate prenatal care (aOR 1.93, 95% CI 1.66-2.24). Women who had a consistent choice were more likely to choose highly effective methods of contraception (p < 0.001) and more likely to achieve their contraception plan (adjusted odds ratio [aOR] 2.16, 95% confidence interval [95% CI] 1.85-2.52), but not more likely to have a subsequent pregnancy within 365 days of delivery (aOR 0.92, 95% CI 0.81-1.05). CONCLUSION The majority of women in our study had variation in effectiveness of their postpartum contraceptive method plan from prenatal to inpatient postpartum care. Better understanding contraceptive decision-making as a journey and removing external barriers during that process is a necessary component of pregnancy care. IMPLICATIONS Counseling and documentation of contraceptive preferences throughout antepartum and postpartum care can help improve contraceptive outcomes.