How to Become a Prenatal Genetic Counselor

How to Become a Prenatal Genetic Counselor
Sometimes, the most important thing you’ll give families when you become a prenatal genetic counselor is empathy. Image from Unsplash
Christa Terry profile
Christa Terry August 14, 2019

Do you love science... and helping people in crisis? Prenatal genetic counseling is a rewarding career that combines these passions.

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Most pregnancies are relatively uneventful, but sometimes an unborn baby is at risk of a birth defect or genetic condition. That’s when families are referred to a prenatal genetic counselor. These specialists play an important role in an expectant mother’s care team because they make complex medical information easier to understand and offer strategies for coping with a difficult diagnosis.

Becoming a prenatal genetic counselor is a great option for anyone looking for a career that’s both scientific and people-focused. On one hand, you’ll be an educator, helping parents understand genetic abnormalities, the tests available, risk factors, and what to expect. On the other hand, you’ll be a support resource. Prenatal genetic counselors share all available options, from amniocentesis to abortion to assisted reproduction techniques, without pushing a family to make one choice over another or judging the family’s final decision.

Sometimes, the most important thing you’ll give families when you become a prenatal genetic counselor is empathy. Whether the people who come to you have an increased risk of having a child with a genetic condition or birth defect, or they’ve received a prenatal test that has come back positive for a disorder like cystic fibrosis, a large part of your job will be delivering tough news in a way that helps families cope with their situation.

In this article we’ll cover:

  • Where can a prenatal genetic counselor work?
  • What does a prenatal genetic counselor do?
  • Educational commitment for becoming a prenatal genetic counselor
  • Licensure and accreditation for becoming a prenatal genetic counselor
  • Pros and cons of becoming a prenatal genetic counselor

Where can a prenatal genetic counselor work?

Prenatal genetic counselors work with OB/GYN care providers and with doctors in maternal fetal medicine departments in hospitals. Prenatal counseling as a specialty also includes preconception genetic counseling for people with known genetic abnormalities or a family history of heritable conditions. If you become a prenatal genetic counselor, you could work in the reproductive genetics department or maternal fetal medicine department at a hospital, in a standalone genetics lab, in a private prenatal care practice, or in a medical center.

You should be aware that some people who choose prenatal genetic counseling as a specialty will likely also work with patients who themselves have conditions like hereditary cancer or Huntington’s disease. That’s because many medical practices seeking to fill genetic counselor positions look for generalists with a specialization in prenatal genetic counseling.


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What does a prenatal genetic counselor do?

On an average day, a prenatal genetic counselor might work with expectant mothers who:

  • Are 35 or older
  • Have a family history of genetic disorders, birth defects, or developmental issues
  • Have had a stillbirth or multiple miscarriages
  • Screened positive on a nuchal translucency screening, first trimester combined screening tests, or multiple marker screening
  • Have had an abnormal ultrasound reading
  • Used drugs or alcohol during pregnancy
  • Have had certain infections, like chicken pox or rubella, during pregnancy
  • Underwent chemotherapy prior to becoming pregnant
  • Are carrying babies that have been diagnosed with a genetic disorder
  • Need specialized prenatal testing like amniocentesis or chorionic villus sampling
  • Are worried about having a baby with a birth defect or genetic disorder

They’ll also work with couples who want to become pregnant but have screened positive for the genes associated with inherited disorders like sickle cell disease or thalassemia, or come from populations in which conditions like Tay-Sachs disease are more common.

When you become a prenatal genetic counselor, you’ll:

  • Take thorough health histories that go back as far as possible
  • Talk to patients about heritable diseases (e.g., how they’re passed on and how they’re treated)
  • Discuss the risks, benefits, and limitations of genetic tests
  • Order those diagnostic and screening tests
  • Explain the results of tests that expectant mothers have already taken
  • Help people understand what their options are, now and in the future, when it comes to a current pregnancy and future pregnancies.

In general, you’ll spend 20 to 60 minutes in each counseling session. You’ll also refer people to community resources for families with disabled children, spend time conferring with doctors and nurses… and do plenty of paperwork.

Educational commitment to become a prenatal genetic counselor

Before you can become a prenatal genetic counselor, you’ll need to earn a bachelor’s degree in a subject like biology, chemistry, social work, or another healthcare-related discipline. As you work toward your undergraduate degree, it’s a good idea to think ahead. Taking elective courses in genetics, biochemistry, and statistics, and pursuing internships in a clinical healthcare setting will make you a more attractive candidate when you’re applying to master’s programs in genetic counseling.

There are only about 40 such master’s degree programs in the US that are accredited by the American Board of Genetic Counselors (ABGC).

Some of the oldest and most established programs include:

Most master’s of science in genetic counseling programs accept only six to eight students per year. They study genetics, medicine, risk assessment, and lab work, as well as counseling, communication, psychology, and patient education. While there are no specialized prenatal counseling master’s degree programs, all students who follow this degree path are prepared to become well-rounded genetic counselors.

Some schools—like Stanford University—offer the opportunity to choose elective courses specific to your future area of professional focus. If your goal is to become a prenatal genetic counselor, look for programs that include a reproductive health component.

Licensure and accreditation for becoming a prenatal genetic counselor

After you earn your master’s degree and complete the national board examination, you’ll be qualified to work as a generalist or as a prenatal genetic counselor. Some genetic counselors choose to pursue further accreditation or education, either because they feel driven to or because they work in a state that requires genetic counselors to have earned an ABGC certification. The National Society of Genetic Counselors (NSGC) also offers continuing education resources, including clinical skills courses related to specific specialties and courses in existing and emerging genomics technologies.

Pros and cons of becoming a prenatal genetic counselor

Pro: the pay is good

The median annual earnings for genetic counselors across specialties is $80,370, according the Bureau of Labor Statistics (BLS).

Pro: job prospects are good

Thanks to both improvements in existing diagnostic and screening tests and the development of new prenatal tests based on cutting edge genomics research, opportunities for genetic counselors are expanding. The BLS predicts that the job market for genetic counselors will grow much faster than in other professions.

Con: the work is intense

There’s no denying that this is a tough role to step into. You will work closely with families dealing with uncertainty or the realities of a grim diagnosis. Many of your counseling sessions will be sad or emotionally draining. And you will have to treat all of your patients with the same level of respect and compassion—even when their religious, cultural, or personal beliefs lead them to make a decision you would not choose for yourself.

Is prenatal genetic counseling the career for you?

If you love the idea of helping families feel empowered and confident during uncertain times, this may be the right career for you. As Meg Menzel, a genetic counselor in the Fetal Medicine Institute, put it in the Children’s National Health System blog, “Learning that your unborn child may have a serious health issue is stressful, confusing, and scary. Our role is to help our pregnant patients make sense of all aspects of the complex information they receive.”

It’s an important job. At the end of the day, you—a dedicated prenatal genetic counselor—may provide the most important medical support those patients receive.

(Last Updated on February 26, 2024)

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Tom Meltzer spent over 20 years writing and teaching for The Princeton Review, where he was lead author of the company's popular guide to colleges, before joining Noodle.

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