Alcohol use during pregnancy is associated with a wide range of adverse health effects for both the mother and developing fetus. It is the leading preventable cause of mental retardation in the United States and is also associated with many other physical, cognitive, and behavioral disabilities known collectively as fetal alcohol spectrum disorder. Although the risk of fetal alcohol spectrum disorder increases as the quantity of alcohol consumed during pregnancy increases, no known level of alcohol consumption at any time during pregnancy is considered safe. For this reason, the Surgeon General Advisory on Alcohol Use in Pregnancy “urges women who are pregnant or who may become pregnant to abstain from alcohol.”1A 2000 report of a survey of active members of the American College of Obstetricians and Gynecologists revealed that 97% of physicians who responded (n=604) asked their patients at least once during prenatal care about alcohol use.2 However, only 23% of respondents reported using a standard screening questionnaire, and the most common screen used had not been validated for pregnancy. The majority of physicians reported the existence of barriers to effective alcohol use assessment such as time limitations, patient sensitivity, and the need for additional clinician training to enhance ascertainment skills. Prenatal alcohol screening and counseling from the patient's perspective are largely unknown. A survey of women about their prenatal care may provide different results about the prevalence and content of screening for alcohol use. Our objective was to estimate the prevalence of prenatal alcohol consumption and the extent of provider screening and discussion about alcohol use during pregnancy.