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:
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.
On an average day, a prenatal genetic counselor might work with expectant mothers who:
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:
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.
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.
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.
The median annual earnings for genetic counselors across specialties is $80,370, according the Bureau of Labor Statistics (BLS).
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.
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.
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.
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