Date of Award

5-2022

Document Type

Thesis - Closed Access

Degree Name

MS in Human Genetics

First Advisor

Laura Hercher

Abstract

Genetic counselors (GCs) play an important role in providing and coordinating care for patients considering abortion care secondary to fetal anomaly and/or genetic diagnosis. Restrictive legislation affecting abortion access in the United States has increased in recent years. Only a few studies have analyzed the effects of restrictive legislation on GCs. This study aimed to understand how prenatal GCs’ practice is impacted by restrictive legislation and how GCs are preparing for more restrictive legislation. Thirty-four qualitative interviews were conducted with GCs practicing in Texas, as well as states categorized as “leans hostile,” “hostile,” and “very hostile” by the Guttmacher Institute. Our findings revealed that prenatal GCs adapted patient discussions, witnessed timing affect access to abortion, and noted excess stress related to legislation and patient coaching. Many participants shared that their institutions were more of a barrier than a resource regarding abortion care. Collectively, the traditional role of the prenatal GC has been altered in response to restrictive legislation. GCs are conflicted on how prenatal testing will be utilized if abortion legislation becomes more restrictive. In Texas, the uncertainty of the “aiding and abetting” language of Senate Bill Eight has impacted the way GCs are able to counsel their patients. Overwhelmingly, participants shared that resources providing updated information on legislation would be helpful to GCs, and resources funding abortion care would be helpful for patients. Further restrictive legislation may irreversibly change how reproductive medicine and prenatal genetic counseling are practiced, resulting in further reproductive inequities across the US.

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