Why Your Doctor May Recommend Prenatal Genetic Counseling

Genetic counselors can provide answers, support and guidance for your growing family

Thinking about your baby’s health often starts long before delivery.

If you’re pregnant or planning to become pregnant, you probably have plenty of questions. While it’s exciting to welcome a new baby, it’s also natural to feel overwhelmed. You want to be sure your baby is healthy throughout your pregnancy and after birth, especially if they’re at risk for a genetic disorder or birth defect.

Genetic disorders like sickle cell disease, Tay-Sachs disease and muscular dystrophy can be passed from parents to children. But having a family history or other risk factors doesn’t necessarily mean your baby will develop these conditions.

“People with genetic disorders or who have family members with genetic disorders are often worried they will pass on the condition,” says Diane Timms, DO, a maternal-fetal medicine specialist at Geisinger. “Genetic counseling can determine if your child is at risk for a genetic disorder and, if a pregnancy is affected, provide support along the way to help you prepare for the birth of a child that may need special support.”

If your doctor refers you to genetic counseling, a counselor will help you understand inherited conditions, available screening and diagnostic testing options. They’ll also explain what results may mean for your family. With personalized guidance, genetic counseling can empower you to make informed decisions before, during and after pregnancy.

What genetic counselors do

Genetic counselors help families better understand how birth defects, genes and medical conditions run in families. You can meet with a genetic counselor before or during a pregnancy to:

Review your personal and family history
Estimate the chance of having a baby with a genetic condition, based on factors like your health history, ethnicity and previous pregnancies
Explain the benefits, limitations and risks of available screening and diagnostic tests
Help you understand your test results and what they mean
Answer questions and provide emotional support throughout the process

“Genetic counselors can help you understand the chances of your baby having a genetic condition,” says Dr. Timms. “They can answer medical questions, provide education and resources, and also provide emotional support. Genetic counselors help parents adapt and prepare for any risks or conditions.”

5 reasons you may be referred to prenatal genetic counseling

There are many reasons your OB-GYN or maternal-fetal medicine specialist may recommend genetic counseling during pregnancy. A referral doesn’t necessarily mean there’s something wrong, it just means you may benefit from more information and support.

You or a family member has an inherited disease

Some genetic diseases are more common in certain families or ethnic backgrounds. If you, your partner or a close relative has an inherited condition, genetic counseling can help you better understand whether your baby could be affected.

“Not all diseases are inherited the same way,” says Dr. Timms. “It’s possible to have a genetic disease that does not pass to your children. Likewise, it’s possible that you and your partner could be carrying genes for a genetic disorder and not even know it.”

Genetic counseling helps you understand the risks of passing on a condition and educates you about caring for a child with a genetic condition.

You’ll be 35 or older at delivery

Parents age 35 and older at the time of delivery are at a higher risk of having a baby with certain chromosome conditions.

“Studies show that people who are 35 years old or older are more likely to have a child with a genetic disorder than younger people,” says Dr. Timms. “Down syndrome and trisomy 18 and 13 are examples of conditions that appear to be linked to increased parental age.”

A genetic counselor can explain how age affects your individual risk and discuss screening tests, such as noninvasive prenatal testing, and diagnostic tests like chorionic villus sampling (CVS) or amniocentesis. They can help you understand the timing, accuracy and limitations of each testing option.

You’ve had a child with a genetic disorder

Having a child with a genetic disorder or birth defect could make you wonder if your next child will also have one.

Since genetic inheritance patterns are often complicated, genetic counselors can help parents understand the chances of another child having a similar (or different) genetic disorder.

“Depending on your situation, they may also be able to recommend screening, diagnostic testing or preventive measures like folic acid supplementation,” says Dr. Timms.

You’ve had abnormal prenatal test results

Prenatal blood tests and ultrasounds provide important information about your baby’s growth and development. Sometimes these tests show unexpected findings that require a closer look. In this case, they may recommend you see a genetic counselor.

Receiving an abnormal screening result can be stressful, but it doesn’t automatically mean your baby has a genetic condition.

A genetic counselor will explain what your results mean, discuss the likelihood of an underlying condition and review whether more testing may be helpful. If diagnostic testing confirms a genetic condition, your counselor will coordinate next steps and connect you with specialists and community resources.

You’ve had a previous miscarriage or lost a child

If you’ve had 2 or more miscarriages or had a child pass away, your doctor may recommend genetic counseling as part of your evaluation.

Using genetic testing and medical information from previous pregnancies, a genetic counselor may be able to identify inherited factors that could affect future pregnancies and help you better understand your options moving forward.

How prenatal genetic counseling can help

Every pregnancy is unique, and genetic counseling is designed to give guidance based on your individual health history, family history and personal concerns. Rather than taking a one-size-fits-all approach, genetic counselors assess your individual medical history, family history and pregnancy to make recommendations tailored to your needs.

Most importantly, genetic counselors support informed decision-making. They don’t tell you what choice to make. Instead, they provide clear, unbiased information, so you can weigh your options and make informed decisions that align with your values and preferences.

Whether you’re looking for reassurance, exploring testing options or reviewing family history, prenatal genetic counseling can help you feel informed and supported. By providing clear information and personalized guidance, genetic counselors help growing families make decisions with confidence.

“Genetic counseling and testing can provide clarity, help coordinate care during pregnancy and after birth, and support families in preparing for a range of outcomes,” says Dr. Timms. “A personalized conversation can help you make choices with confidence and focus on what matters most as you prepare to welcome your baby.”