Variation in content in prenatal genetic counseling interviews

Thirty non-MD genetic counselors from five cities described their pre-test interview for a client of advanced maternal age, indicating the frequency they addressed each of 16 topics. Near-universal were family history taking, procedural descriptions and complication rates, and the client's fetal risk level for certain disorders. Less frequently included were description of sex chromosome abnormalities with variable expression, choices if an abnormality is found, and description of actual abortion procedures (fewer than one-third always included this). Counselors cited client discomfort in minimizing abortion-related discussions. Both training programs and genetic services might stress conveying the differences in maternal risk associated with trimester of abortion, a factor arguably relevant to a client's informed decision making. Also, given U.S. demographic changes, they should consider increased staff training in cross-cultural counseling techniques.