Abstract
Religious directives govern healthcare offered at Catholic hospitals, including some that outline what prenatal testing should be offered to pregnant women. These directives appear to be in conflict with prenatal testing that is typically offered during a prenatal genetic counseling session. Research has explored how physicians navigate the Catholic hospital directives, but less is understood about the experiences of prenatal genetic counselors working in Catholic hospitals. The purpose of this study was to explore the experiences of prenatal genetic counselors working in Catholic settings in order to understand how the religious directives affect their counseling. Ten genetic counselors that see prenatal patients in a Catholic setting were recruited from an online listserv to participate in a semi-structured phone interview. The major topics addressed included what prenatal testing is offered during a prenatal session, how aware genetic counselors are of the religious directives, and how they believe those directives affect their sessions. Thematic analysis of the interview transcripts was performed in ATLAS.ti (v.7.5.4) and five themes were identified: (1) the pregnancy options genetic counselors offered to patients including testing options as well as specialist referrals, (2) navigation of regulations imposed by the religious directives, (3) how genetic counselors handled any conflict that arose from their duties as a genetic counselor and their duties to uphold the religious directives, (4) patient support as a priority, and (5) job satisfaction. Genetic counselors reported that the religious directives did affect what and how various procedures were discussed, particularly termination of pregnancy. However, despite this, the findings of this study are positive indicating genetic counselors felt that they could perform their jobs and use their own jurisdiction of how to apply the religious directives appropriately. They also felt that despite the religious directives, patient care was not compromised.