Pregnant women continue to drink despite evidence that prenatal alcohol consumption can negatively affect fetal growth and development. Because no universally safe level of prenatal alcohol use has been established, it is beneficial to identify and modify a woman's prenatal alcohol use early in her pregnancy, particularly as her past drinking habits can predict her drinking levels during pregnancy. Some women may voluntarily disclose the extent of their prenatal alcohol consumption. If not, the T-ACE, a four-item screening questionnaire based on the CAGE assessment tool, has been demonstrated to be a valuable and efficient method for identifying a range of alcohol use. Studies have shown that combined with brief interventions, early identification of a woman's prenatal alcohol use could avert its more severe adverse consequences and may be the logical first-line approach.