Hopelessness was a new emotion I encountered as a genetic counseling student. There were times I felt discouraged or uncertain in my clinical rotations, but never hopeless… until my prenatal rotation this past summer. Admittedly, I am ignorant about our judicial system. I thought legal decisions are not made quickly. Going into my prenatal rotation, I knew that abortion was a hot topic in the Supreme Court, but I didn’t expect a change in legislation until after my rotation.

Four weeks into my rotation, I met with my supervisor before clinic, and I became aware of the sudden change to the legal limit of termination in our state. In the few weeks prior, I had been learning how to present all the possible options and finally felt confident in facilitating decision-making for the pregnant people we were serving. Now I was being told that I could not even say the word “termination.” The effect was immediate. We had patients who were distressed by abnormal ultrasound findings or high-risk screening results, and all we could talk about was adaptation to the risk or condition.

 I felt hopeless, and it was not just because my supervisor told me to not say anything as a student. I felt hopeless because nobody knew what could and could not be said. I felt hopeless because I had four more weeks of this rotation and was unsure how I could feel I was serving these patients. I heard stories of providers continually referring patients seeking abortion to other providers. It resulted in a hot-potato style game of, “I am not going to be punished for this.” Ideally, we would live in a world where we as genetic counselors are allowed to provide comprehensive information, but we cannot expect everyone to be comfortable with the idea of losing their license or being prosecuted as a result of providing healthcare.

As my rotation progressed, we received clarification on what we could say regarding abortion access. While this provided some guidance, I still feel hopeless knowing so many patients will be facing a lack of access. When I started this rotation, I saw a future in prenatal genetics. Now it makes me question if I want to go into that clinical space. At the same time, I feel ashamed for feeling like I would abandon these patients by avoiding them.

 As I wrote this, I brainstormed ways to end this piece on a positive note. But not everything is positive. While I don’t know how this will end, what I do know now, more than ever, is that this field is about being a constant learner. Hopefully, we continue to learn how to best serve our patients, even in the most limiting of circumstances. Complacency is a luxury and one we cannot afford if we truly want to help our patients.

---