Why Genetic Counseling Can Be a Powerful Part of Preconception Care
When we think about preparing for pregnancy, prenatal vitamins, nutrition, fertility, and healthy lifestyle changes often come to mind first. But there’s another part of preconception care that may be worth considering: genetics.
Genetic counseling can be a helpful resource long before pregnancy—not only when there is a known genetic condition in the family. It can also help you better understand your health, reproductive options, and the information available to you as you prepare to grow your family.
To learn more, we spoke with Natalie Hart Samson, founder of Golden Genetics, about what genetic counseling can tell us, when it may be worth considering, and how understanding our genetics can sometimes create clarity rather than fear.
What Does a Genetic Counselor Do?
Natalie was drawn to genetic counseling because of its unique intersection of science and human connection.
“I’ve always been fascinated by how the human body works on a micro level and how we can use that information to optimize our health,” she explains.
After studying biology and discovering genetics, she found a field that brought together her interests in science, psychology, and working directly with people.
As her education continued, Natalie became increasingly interested in looking at the whole person—not genetics in isolation. That perspective serves as the foundation of Golden Genetics, where genetics is considered alongside nutrition, lifestyle, medical history, and other aspects of health.
One of the most important things to understand is that genetic counseling isn’t only for situations in which something has already gone wrong. You don't necessarily need a previous diagnosis or known genetic condition to speak with a genetic counselor.
Natalie describes genetics as a tool for supporting four P's: personalized, precise, proactive, and preventative care.
“When it comes to preconception specifically, having information beforehand can help couples make informed decisions about family planning and understand whether there is genetic information they may want to consider before pregnancy,” she says.
What Is Carrier Screening Before Pregnancy?
You may have heard the term carrier screening during a preconception appointment or while researching pregnancy. It can sound complicated, but the basic concept is relatively straightforward.
Carrier screening looks at whether someone carries certain genetic variants that typically do not affect their own health but could have implications for a future child.
For some recessive genetic conditions, a child would need to inherit a relevant genetic variant from both parents to be affected. If both biological parents are carriers of variants associated with the same condition, a genetic counselor can help them understand what those results may mean.
“Most people who are planning a pregnancy can consider carrier screening,” Natalie says.
At Golden Genetics, patients speak with a genetic counselor before testing so they can understand what a particular test can—and cannot—tell them.
Knowing this information before pregnancy can provide something particularly valuable: time to understand your options.
Genetic Counseling Is About More Than Test Results
Receiving genetic information can bring up a range of emotions. That is one reason working with a genetic counselor can be different from simply receiving a laboratory report or ordering an at-home DNA test.
Natalie emphasizes that helping patients understand and process information is central to the work.
“Our job isn’t just to give someone genetic information, it’s also to help them process that information, however that looks emotionally for them,” she says.
Natalie often reminds patients that genetics is information. The value comes from understanding what that information means, what its limitations are, and what—if anything—you may want to do with it.
Some forms of genetic testing, for example, may explore pathways related to inflammation, nutrient metabolism, or histamine processing. These findings aren't necessarily diagnostic on their own. Instead, they may provide information to consider alongside symptoms, medical history, laboratory results, lifestyle, and guidance from appropriate healthcare professionals.
In other words, genetics can be one piece of the picture rather than the entire picture.
Genetics: Nature or Nurture?
When we asked Natalie whether she views genetics as nature or nurture, her answer was simple: both.
How much genetics and environment matter varies depending on the specific gene, trait, or condition.
This whole-person perspective can be particularly helpful when approaching preconception care. Genetic information does not necessarily determine what will happen. Instead, it may provide another source of information that you and your healthcare providers can put into context.
Are At-Home DNA Tests the Same as Genetic Counseling?
With the growing popularity of at-home DNA kits and simplified genetic testing, it can be difficult to determine which tests are meaningful for your particular circumstances.
“There are SO many tests and they are definitely not all created equal!” Natalie says.
A genetic counselor can help determine whether genetic testing is appropriate in the first place and, if it is, which type of testing may be useful for the questions you're trying to answer.
With thousands of genes in the human genome, simply ordering a “genetic test” does not guarantee that you're getting information that is relevant or useful for your individual situation.
Genetic counseling adds an important layer: helping you understand what question you're trying to answer before deciding which test, if any, may help answer it.
What Family History Should You Share With a Genetic Counselor?
Before a genetic counseling appointment, it can be easy to worry: I barely know my family's medical history.
That's okay. You don't need a perfectly documented family medical history before making an appointment.
Family history can nevertheless provide useful information, particularly during preconception genetic counseling. If you know of them, some things that may be helpful to mention include a family history of:
Birth defects
Developmental or intellectual disabilities
Known genetic conditions
Infant or childhood deaths
Multiple miscarriages
Cancer occurring at younger-than-expected ages
Heart disease occurring unusually early
Dementia at younger-than-expected ages
Multiple relatives with the same or related conditions
Several diagnoses occurring on one side of the family
But don't let gaps in your family history keep you from seeking information.
“You don’t have to know everything about your family’s health history before seeing us!” Natalie says.
At Golden Genetics, patients complete a family-history questionnaire before their appointment, and the counselor works through the information with them. You can start with what you know.
Genetic Counseling Can Help You Understand Your Options
Perhaps one of the most important things to understand about genetic counseling is that its purpose isn't to tell you what you should do.
It's about giving you information, helping put that information into context, and supporting you as you understand the options available to you.
As Natalie puts it:
“Genetics is information.”
For people preparing to become parents, having that information before pregnancy may provide more time to ask questions, talk with healthcare professionals, consider different options, and make decisions that feel informed and aligned with their circumstances.
Supporting Your Emotional Health While Preparing for Pregnancy
Preparing for pregnancy can involve much more than physical health. Fertility decisions, genetic testing, uncertainty, previous pregnancy experiences, and the many “what ifs” of trying to conceive can bring up anxiety, fear, grief, or overwhelm.
If the emotional side of preparing for pregnancy is becoming difficult to carry, you don't have to navigate it by yourself.
Life After Birth offers pregnancy and postpartum therapy in Los Angeles, including support for people trying to conceive, expecting a baby, and adjusting to early parenthood.
Learn more about Pregnancy & Postpartum Therapy in Los Angeles →
You can also submit a confidential inquiry → to connect with the Life After Birth team.
This article is for educational purposes only and is not a substitute for individualized medical or genetic advice. Questions about genetic testing, carrier screening, or reproductive risks should be discussed with an appropriately qualified healthcare professional or genetic counselor.
