Thinking about prenatal testing

You now know that both Genevieve and Sam are carriers for CF

This means their baby has a 1 in 4 or 25% chance of being affected by CF. You can offer them the option of prenatal testing (i.e. testing in pregnancy of the baby’s genes).

As a genetic counsellor your role would be, in part, to ensure that Genevieve and Sam have accurate information. This would include an explanation as to why their current baby and all future children would have an increased risk of having CF. It would also include an explanation of how we could test the baby’s genes and the risks associated with this. You would also encourage the couple to do their own research about CF and what living with the condition is like for people currently affected. You would also explain the options available to the couple in terms of choosing to continue or end the pregnancy. It is also crucial for you to support Genevieve and Sam as they think through what they would like to do next. This means there is an important psychosocial aspect to your role.

Genetic counselling is about empowering patients to make decisions that are right for them. This is especially true in prenatal settings. As such, as a genetic counsellor you would need to listen to Genevieve and Sam, to understand their beliefs and values, helping them to navigate the options available to them.

To support patients further, genetic counsellors also use a range of counselling skills. As we learned in week 1, Carl Rogers’ core conditions for therapy are empathy, congruence (being genuine) and unconditional positive regard. These conditions are important, in Rogers’ view, for maintaining a non-judgmental and supportive attitude. Your role as a genetic counsellor is to understand your patients’ position, to provide accessible information and to support them as they choose what to do.

• What kind of psychological issues do you think would arise in prenatal genetic counselling and how might genetic counsellors be able to support patients?
• It might help to think about the role of a genetic counsellor and how you might feel providing genetic counselling to Genevieve and Sam.
• It might also be helpful to imagine you were in the position of Genevieve or Sam – what might they be feeling?

Share your thinking on this question in the comments area.