Background: Alcohol is a recognized teratogen in utero because of its potential to cause damage to the brain resulting in developmental, cognitive and behavioral problems including Fetal alcohol spectrum disorders (FASDs) and mental health problems such as anxiety, depression, attention deficit hyperactivity disorders. Main objective: To explore the determinants of alcohol use among pregnant women at George Health Centre. Method: The study adopted a mixed convergent method approach. An analytical cross-sectional design recruited 255 pregnant women from which 24 participated in descriptive qualitative design collected through 4 focused group discussions from women who gave a history of drinking alcohol. Results: The study showed that 4 in every 10 pregnant women had a history of alcohol consumption prior to and during pregnancy. Significant factors associated with alcohol use included smoking which increased the odds of drinking alcohol 11.24 more times among smokers. Pregnant women’s likelihood to drink alcohol was 63% lower among those of high socioeconomic status (SES) compared to the lower classes. The results also found a behavioral gap between high levels of awareness on harmful effects of alcohol compared to the high prevalence rate recorded. Conclusion: The findings suggest a great need for assessment, identification and management of prenatal alcohol consumption among pregnant women attending antenatal care in health facilities.