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Planning for the future

Last Modified: May 17, 2022

Family Medicine, Women & Children

family history when pregnant

Knowing your family health history is a critical component of your well-being, but it also plays a considerable role in preconception appointments and initial prenatal visits. Understanding this vital information could help reduce your child’s risk of developing health problems in the future. Olivia McMillan, genetic counselor, Advanced Perinatal Care Center, Parkview Health, discusses the importance of knowing your family history when pregnant and how it can help identify possible genetic disorders.

What is a family health history?

Family health history is a record of a person’s health history and the health history of their blood-related relatives. Typically, when speaking with a genetic counselor, you will discuss the health history of at least three generations of relatives. This includes children, siblings, parents, aunts, uncles, nieces, nephews, grandparents and cousins.  

Why is your family health history so important?

Knowing your family health history can help identify multifactorial disorders and genetic diseases caused by specific mutations or variants within a person’s DNA. Multifactorial disorders (like heart disease, high blood pressure or type 2 diabetes) are conditions in which the risk of developing symptoms occurs due to genetic and environmental factors and lifestyle choices. Family history can also provide information about the risk of genetic conditions such as alpha thalassemia or factor V Leiden caused by specific mutations. When a provider is aware of your family health history, they can help educate and inform you of the possible risk to yourself or other relatives, including your children.

How can you begin gathering your family health history?

As a patient, you can begin discussing your family health history with a provider and talking with family members about their health. You will want to ask questions like, “Have you had any past or recent health concerns that you are willing to discuss?” If your family members feel uncomfortable sharing this information, it may help to explain that knowing their health history could impact other family members.

How can your provider use this information?

A provider can use information from the family health history to inform your care plan. Knowing that you have a family history of a specific condition may allow a physician or other healthcare workers to devise proactive strategies. For example, if many individuals within your family have high cholesterol, your doctor may start checking your cholesterol levels earlier. If your levels begin to rise, this provider may recommend an exercise and diet plan to manage cholesterol levels without medication. This is just one example of how a provider can use a family health history to personalize your medical care.

What role does your family health history play when pregnant?

During pregnancy, your family health history is critical because it can directly influence the care and management of both mother and unborn child. For example, if there is a significant family history of a blood clotting disorder, the expectant mother may be at an increased risk of clotting during pregnancy. Knowing this vital information allows the physician to be prepared for the possibility while watching for specific signs of blood clots. Some inherited genetic conditions can also impact a baby during pregnancy. For instance, a fetus with cystic fibrosis has a higher risk of developing a bowel obstruction in utero. If both parents are carriers of cystic fibrosis, your provider can monitor the fetus during the pregnancy to see if a bowel obstruction develops. This information can influence the delivery plans and post-natal care of the baby.

What can someone expect when meeting with a genetic counselor?

When taking a family health history during an appointment, a genetic counselor (or health care provider) will want to know about current and past illnesses of blood-related relatives. Depending on the provider you are seeing, you may need to provide different kinds of family health history information. For example, a cardiologist may want to know if any family members have had a history of heart disease, heart attack, high blood pressure, or stroke. In contrast, an oncologist would want to know more about your family’s history of cancer. As a prenatal genetic counselor, I typically ask about the health history of the pregnant person, their partner, any children they may have, and their extended family. This can include questions about miscarriages and stillbirths, birth defects, intellectual disability, genetic conditions and geographic ancestry.

Where else can someone turn for help?

If you feel that you may need the services of a prenatal genetic counselor, please speak with your primary care provider or obstetrician about a possible referral to the Parkview Advanced Perinatal Care Center, or visit the National Society of Genetic Counselors to find a genetic counselor near you.

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