It is estimated that 324,000 pregnant women are abused by their partners in the United States each year. The purpose of this qualitative study was to explore the intimate partner violence-screening practices of certified nurse-midwives (CNMs). In-depth interviews were conducted with a sample (n = 8) of CNMs, and the data were analyzed by using with-case and across-case methods. The findings demonstrate that the midwives were inconsistent in their intimate partner violence-screening practice during pregnancy and increase or decrease screening in response to a woman's cultural background. Screening in a culturally competent manner is expected of all clinicians, but the demands of an increasingly complex, culturally diverse practice environment make it difficult. Consistent intimate partner abuse screening in a culturally competent manner is a challenge for all primary care providers.