This analysis is part of ‘E Hine’, a longitudinal qualitative Kaupapa Māori (by Māori for Māori) study involving Māori women aged 14–19 years, following them through pregnancy (n=44) and the birth of their babies until their babies’ first birthdays (n=41). This analysis focused on contraception before and after pregnancy and aimed to identify any barriers and facilitators to contraception amongst Māori teenage mothers. Pre-pregnancy, most participants accessed contraception or advice, but contraception use was compromised by a lack of information, negative side effects, and limited follow-up. All reported their subsequent pregnancies as unplanned. Participants gave considerable thought to post-pregnancy contraception. However, many experienced clinical and service delays, financial barriers and negative contraceptive side effects. There was little focus on contraception initiation and a lack of integrated care between midwives and other primary care services, leaving many participants without timely effective contraception. The system worked well when there was a contraception plan that included navigation, free access, and providing contraception.