Inclusion of Adoption as a Pregnancy Management Option in Prenatal Genetic Counseling Practice
Bibliographic record
Abstract
Prenatal genetic counselors are essential to providing education, psychosocial support, and guidance on pregnancy options to patients who receive a fetal diagnosis of an anomaly or genetic condition. Therefore, genetic counselors should be well-educated on comprehensive pregnancy management options consisting of parenting, abortion, and adoption. The landscape of adoption education in genetic counseling practice was last characterized in 2010 by Perry and Henry, revealing substantial variability in both the inclusion of adoption-specific education in genetic counseling program (GCP) curricula and the discussion of pregnancy options with patients in prenatal practice. As a result, the authors published a call to action promoting the expansion of adoption-specific education in GCP curriculum and CEU opportunities. With over a decade having passed since this call to action, the current study sought to provide an update on adoption education content in GCP curricula, assess the current state of prenatal genetic counselors’ comfort levels and perceived preparedness counseling on the option of adoption, and identify factors influencing discussion of adoption as a pregnancy management option in the case of a non-life-limiting prenatal anomaly or genetic diagnosis. This study surveyed a representative sample of genetic counselors with prenatal genetic counseling experience in the US and Canada, where data from 148 participants was analyzed using descriptive statistics and statistical tests including Mann-Whitney U tests, Kruskal-Wallis tests with post-hoc Dunn’s tests, Fisher’s exact tests, and multivariable ordinal logistic models as appropriate in Stata (17.0, StataCorp LLC, College Station, TX) to determine statistical significance (p<0.05). One third of participants reported inclusion of adoption-specific education in their GCP curriculum as either mandatory or optional. Genetic counselors reported both lower comfort levels and lower frequencies counseling on adoption as a pregnancy management option compared to the options of parenting and abortion. Higher comfort levels counseling on adoption were significantly associated with certain curricular components, identification of certain adoption resources, post-grad CEU completion, more time spent in a prenatal role, and higher frequency counseling on adoption. The current study highlights a continued lack of adoption-specific educational opportunities and persistent discomfort with counseling on adoption as a pregnancy management option. Therefore, we provide updated guidance on adoption education and identification of resources for genetic counselors, genetic counseling programs, and national organizations to promote comprehensive, unbiased options counseling for pregnant individuals following prenatal detection of a non-life-limiting anomaly or genetic diagnosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".