Objectives: We aimed to determine if an innovative system-level intervention offering postpartum women contraceptive counseling and provision in conjunction with their infant’s well-baby visit (WBV) increases utilization rates of long-acting reversible contraception, and describe facilitators and barriers to implementation. Methods: We conducted a randomized controlled trial among women bringing their infants (4.5 months of age or younger) for routine pediatric care. Intervention participants were offered contraception care co-located with their infant’s care. Control participants received usual postpartum care. Using intention to treat analysis, participants were assessed for LARC use by five months postpartum. Women’s perceptions of, and satisfaction with, the intervention was assessed using a quantitative survey. Results: In total, 446 women were enrolled and randomized. No significant difference in LARC use between groups (19.1% intervention, 20.9% control) was found at five months postpartum. Of the 231 women offered the intervention, 28% accepted the co-located services. The intervention was highly favorable; 89% of all women liked the intervention “a lot” and 62% “definitely would” choose to receive the intervention if offered again in the future. The most common reasons for not accepting the intervention included: no time to stay after the pediatric visit (21%), not wanting birth control (17%), had birth control (25%), or had a postpartum visit scheduled (26%). Among those who accepted the intervention, 70% “definitely would” recommend the intervention to a friend. Conclusion: Postpartum contraception provision co-located with infant care is a novel approach to meet women’s contraceptive needs, is a feasible approach, and accepted by women.