The first class of genetic counselors graduated with an M.A. from the Sarah Lawrence College in 1971; less than two years later, the Supreme Court decision in Roe v. Wade legalized abortion in all fifty states. In the U.S., the field of reproductive genetic counseling came of age against a backdrop of legal abortion, and the option of terminating a pregnancy after a prenatal diagnosis has always been an integral part of the standard of care. In 1992, the Supreme Court decision in Casey v.

The ability to examine the health of the fetus has expanded dramatically in the last half century. Most of the time, the news is reassuring. However, prenatal screening and diagnosis detect genetic conditions in a small percentage of cases. Effective prenatal intervention for these conditions is still uncommon—few are treatable prenatally. Therefore, when their physician detects a congenital fetal condition, some people choose to terminate their pregnancies.