What would you do differently? Part 1: It’s not all about abortion.

For many people deciding about prenatal testing, their decision comes down to the answer of one questions, “Would I do anything differently if I knew the baby had ____?” As a genetic counselor, it’s my job to help people answer that question.

When I tell people I am a prenatal genetic counselor, I get a very wide range of responses. For some, they find it fascinating and we spend the next hour discussing how to correctly use the term “first cousin once removed” and their family member with an interesting medical history. But for others, just the mention of my career can turn a pleasant introduction into an awkward encounter.

For those currently expanding their families, the fact the my job exists is a reminder that things won’t always go according to plan. I try my best to be optimistic and reassuring to couples, but, in the end, we’re there to have real conversations about real possibilities. I force people to imagine a life that they don’t want, to think critically about what that would look like and feel like, and consider if that life would be better or worse with a heads up about what’s to come. Then we talk about the tests themselves, risks for false results, and, of course, cost. It’s an important conversation, but sometimes not a popular one.

More often than I expected, when I tell people I am a prenatal genetic counselor they immediately bring up abortion. (Talk about diving into a very personal, very political conversation with your boyfriend’s coworker’s wife who you just met at a holiday party.) My attitude and energy level at that moment determine how deeply I choose to go into dive into that conversation, knowing it will likely get much more awkward very quickly. But the fact that this is brought up to me so quickly and so often, shows how many people believe that abortion is why prenatal genetic testing exists.

When I ask couples, “Would you do anything differently if you knew the baby had ____?” many couples quickly reply no. And in that moment, what they are trying to communicate is that they would not have an abortion. But when someone answers so quickly to such a complex question, I worry that they did not considered all of the things that could potentially be done differently. And, as someone who thinks about this topic constantly, I feel it’s my responsibility to help them explore that.

In this series, I am going to explore the many things I help people consider when they are answering that question that have nothing to do with ending a pregnancy.

So to kick this off, I invite you to tell me what are things you have or would consider? What are reasons you decided to do prenatal testing? What are reasons you decided not to?

-Erin

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