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Your doctor or midwife may recommend a variety of different screenings, tests, and imaging techniques throughout your pregnancy. Certain routine procedures (especially those that are noninvasive and low-risk) are offered to most pregnant people but others are generally only recommended if you have certain risk factors that may affect your health or your baby’s health. Ask your doctor to explain the tests in detail to make sure you have as much information as possible to help guide your decision.  For example, ask your doctor why he or she is recommending this specific test and what it will tell you. Make sure to ask which tests will give definitive answers and which are simply indicators. You may also want to ask about the accuracy of the test. Prenatal screening, like most medical testing, is not perfect. The rate of inaccurate results, known as false-negatives or false-positives, varies from test to test. Increasingly, all pregnant people, regardless of age or risk factors, are offered prenatal genetic testing. A genetic counselor is trained to help you understand how genes can affect your baby’s health, including the risks of certain birth defects, chromosomal conditions, and other medical conditions that may run in your family. Certain prenatal tests, such as an ultrasound (which uses high-frequency sound waves to create an image of your baby), have no known risks. Other tests, such as amniocentesis, carry a slight risk of miscarriage. Make sure to speak to your doctor about the potential risks of any prenatal test to help you decide. Even for low- to no-risk procedures, it is important to visit a well-trained medical professional who can correctly interpret the results of the test. For example, while ultrasounds are considered quite safe, an untrained interpreter may misread the results, miss an abnormality, or create unnecessary concern about the baby’s well-being. Not all prenatal screenings and tests are covered by all insurance plans. If you have health insurance, you may want to call your health insurance provider before deciding to undergo an expensive procedure. While this may or may not change your mind about the test, it can help you make a more responsible plan. While 96-97% of babies are born healthy, it’s important to understand that prenatal testing can reveal some undesired complications, such as birth defects, medical conditions, and genetic abnormalities. Some of these results may leave you with the difficult decision of whether or not to continue the pregnancy. This might be scary or overwhelming, but it can be helpful to take the time to think about what you will do with the test results, no matter how they turn out. Some prenatal tests detect problems that can be treated during pregnancy. In this case, prenatal testing can help you improve your prenatal care with increased office visits, dietary changes, additional medications, or other doctor recommendations. Speak to your health care professional about whether the test results could help guide prenatal care decisions.   Some conditions cannot be treated through prenatal care. However, testing results may still help you plan for your baby’s care in advance. They can also alert your health care provider to conditions that will require immediate treatment after birth, ensuring faster care.  Knowing that your child has a certain condition may also help you prepare to raise them successfully. For example, if you learn that your unborn child has Down syndrome, you can prepare for their birth by learning more about the condition, networking with other Down syndrome families, and preparing medical and educational resources. Whether they are routine tests or not, know that you have the right as the parent of the unborn child to refuse any test that you are uncomfortable with. If you decide that the risks of the test—including anxiety, pain, or possible miscarriage—are not worth the value of knowing the results, speak to your health care professional about your decision to refuse the test. While your doctor may provide additional information and advice, you should never feel forced to undergo a test you do not want.

Summary:
Speak with your health care professional about their recommendations. Inquire about genetic testing. Ask about the risks of the test. Talk to your health insurance provider to determine what they will cover. Consider how the results might affect your decision to continue the pregnancy. Determine how the information might shape your prenatal care. Understand that you have the right to refuse a test.