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Introduction Contraceptive provision at the time of abortion lowers rates of subsequent unplanned pregnancy but cost, method availability and other considerations impact decision-making. We examined factors associated with contraceptive preferences at the time of abortion in a US safety net hospital.Methods This is a retrospective cohort study. We abstracted medical records for patients seen in the gynaecology clinic between April 2019 and June 2021 who received a medication or procedural abortion for an undesired pregnancy. We collected demographic and clinical data from the electronic medical record. We generated descriptive statistics using Stata V.18 and used R to perform a latent class analysis to identify patterns of association with selected demographic variables and chosen contraceptive methods.Results 638 met inclusion criteria. Latent group 1, which was largely Hispanic, on Medicaid, and/or undergoing medication abortion, most often chose the subdermal implant or pills. Latent group 2, which was largely non-Hispanic and undergoing procedural abortion, most often chose a levonorgestrel intrauterine device (LNG IUD) or declined birth control. Nearly 80% initiated any contraceptive method, with over 20% choosing an LNG-IUD and over 40% choosing any IUD or the subdermal implant. Contraceptive uptake was highest among Spanish-speaking individuals (115/131, 87.8%). Non-initiation occurred most frequently among individuals who did not have insurance/self-paid (24/72, 33.3%), spoke a language other than English or Spanish (8/27, 29.6%), or had a procedural abortion <14 weeks (38/171, 22.2%).Conclusions Contraceptive uptake was high among abortion-seeking individuals. Further research can clarify how other factors impact decision-making and uptake among vulnerable populations.