Abstract: Background: Post-placental intrauterine device is a family planning method which is highly effective, reliable, inexpensive, immediately reversible, and long-acting contraceptive that can be initiated during the immediate postpartum period. Purpose: To evaluate the effect of motivational intervention on acceptance, health literacy, and decisional conflict regarding post-placental IUD among pregnant women. Methods: A Quasi-experimental design (study and control group) pre and posttest was used. Subjects: A purposive sample of 300 pregnant women was chosen. Setting: This study was conducted at Maternal and Child Health Centers at Shebin El-Kom, Menoufia Governorate. Instruments: Data was collected using five instruments (Structured interviewing questionnaire, Post-placental intrauterine contraceptive device knowledge questionnaire, Post-placental intrauterine contraceptive device attitude scale, post-placental intrauterine contraceptive device acceptance questionnaire and Decisional conflict scale). Results: Pregnant women in the study group had higher level of knowledge than pregnant women in the control group at post-intervention (P<0.001). Post-intervention, 88.7% of the study group exhibited a positive attitude as compared to 47.3% of the control group (P<0.001). Regarding decisional conflict, after the intervention, the study group had a lower mean total score of decisional conflict than the control group (14.5±2.6 vs. 51.23±32.5, respectively; P <0.001). The study findings revealed that post-intervention, acceptance of PPIUCD was higher in the study group (84.0%) than in the control group (48.0%) (P<0.001). Conclusion: Women who participated in the motivational intervention experience an improvement in knowledge and attitude and exhibit lower decisional conflict than controls. Recommendations:  Pregnant women should be empowered with adequate knowledge to enhance their decision-making abilities regarding PPIUCD.