Afghanistan has one of the highest maternal mortality ratios and lowest contraceptive prevalence rates globally. Limited information is known regarding Afghan men and women's attitudes toward childbearing, child spacing, and contraceptive use, which is essential for delivery of appropriate services. We conducted a qualitative study among postpartum couples enrolled at maternity hospitals in Kabul, Afghanistan. We identified important themes that highlight the complex inter-relationship between acknowledged risks of childbearing, desire for family planning, rationales for limited contraceptive use, and sociocultural barriers to contraceptive use. We offer practical recommendations for application of findings toward family planning and maternal mortality reduction programs.