INTRODUCTION: An estimated 1.5 million experience physical or sexual violence from an intimate partner each year in the United States, however little data exists on how obstetric providers assess intimate partner violence (IPV), or on how IPV-affected women experience the discussions. METHODS: Patients who disclosed IPV on a computerized pre-visit survey or during an audio-recorded first obstetric visit were asked to return for qualitative semi-structured interviews during which they reviewed their recorded visit and provided their reflections regarding the IPV screening and counseling. Transcripts from these interviews were qualitatively coded for common themes. RESULTS: Of the 250 participants, 91 disclosed IPV either by computer survey or in-person during the recorded visit. Thirty-two women returned for semi-structured interviews. Interviews revealed women’s reasons not to disclose, positive and negative aspects about current approaches, and recommendations for providers. Reasons not to disclose included fears regarding confidentiality, stigma, and concern for involvement of child protective services. Positive attributes of current interviewing included expressions of care, direct questioning, telling patients they are not alone, and open body language. Negative attributes included asking about IPV in an insensitive manner. Recommendations for addressing IPV included being direct, nonjudgmental, and caring, and providing follow-up counseling after IPV disclosure. Women advised that post-disclosure discussions should include emotional support, strategies for emergency situations, housing resources, and self-defense resources. CONCLUSION: Understanding the experiences of pregnant IPV-affected women provides insight into specific approaches to use or avoid when addressing IPV. IPV training for obstetric care providers should include these strategies to improve IPV screening and counseling.