Chapter 5 - Addressing diversity in prenatal genetic counseling

This chapter aims to inform how to address cultural, religious, and ethnic diversity in prenatal genetic counseling. For prenatal genetic counselors, it is needed to understand the sociocultural and religious underpinnings of immigrant pregnant women regarding prenatal diagnostics as a first step to engage these women in shared and informed decision-making. In comparison with native pregnant women, women with an immigrant background are at a higher risk of adverse pregnancy outcomes and insufficient prenatal health-care utilization. Also consanguinity is more often seen within migrant couples, which makes genetic counseling more needed. Especially for immigrant pregnant women, a prenatal diagnosis of a fetal anomaly leads to an unexpected personal tragedy due to more compelling religious and cultural beliefs and convictions. This chapter provides an exploration of the concepts of cultural, religious, and ethnic differences and elaborates existing inequalities in prenatal healthcare and experiences with provided prenatal care within a multiethnic women’s population. Also best practices and practical examples for tailored prenatal genetic counseling addressing diversity are offered in this chapter.