Ushta Canteenwalla | What Your Genes Are Trying to Tell You: A Genetic Counselor's Guide to Pregnancy, IVF, and Reproductive Health

What Your Genes Are Trying to Tell You

Most of us walk into our first OB appointment with our arm out, ready for blood work, and no real idea what we're being tested for.

We assume our doctor is covering everything. We assume that if something was important, someone would have told us. And we move through pregnancy trusting that the system is designed to catch what it needs to catch.

But Ushta Canteenwalla has spent 20 years watching what falls through the cracks. And she built an entire practice to close the gap.

Who Is Ushta?

Ushta is a board-certified licensed genetic counselor with two decades of experience — including managing a high-risk fetal center at a major NYC university medical center and leading a large team of genetic counselors at one of the top reproductive genetic testing labs in the country. She is also a mom of three boys, ranging from 8 to almost 16.

A few years ago, she made the deliberate choice to step away from institutional clinical work and build something different: Find Genetics, a telemedicine genetic counseling practice built around the idea that access to this kind of support should not depend on where you live, who your OB is, or whether you happen to fall into a neat clinical category.

Her reason was both professional and personal. She had seen, too many times, what happens when people don't get the information they need early enough. And she knew that the traditional system — where an OB covers genetics in a 10-minute appointment alongside everything else on their list — was not set up to serve people the way this work deserved.

The Gap Nobody Talks About

Here's what Ushta encounters regularly: people who are well into their fertility or pregnancy journey and have never been offered testing they could have had. People who have had two miscarriages and nobody thought to order carrier screening. People who got NIPT results and were told everything was fine — without anyone explaining what that test actually does and doesn't look at.

Most OBs, she's clear to say, are doing incredible work. They are not the problem. But a doctor who had one genetics class in their entire training, covering a hundred things in a first prenatal visit, cannot give genetics the depth it deserves. And the nuance of what's available — what you can know, what it means, what you'd do with it — is enormous.

The result is two women in the same situation, same age, same history, being offered completely different things depending on which office they walked into. That inequity, Ushta says, is what drives her.

What Can Be Done Before You're Pregnant

There is testing you can do before you ever conceive — and Ushta is a strong advocate for doing it then, not after.

Carrier screening is blood work that looks at whether you carry a gene variant for certain conditions — things like cystic fibrosis, spinal muscular atrophy, fragile X, and hundreds of others. Being a carrier yourself typically means no health impact to you. But if both you and your reproductive partner are carriers for the same condition, there's a 25% chance a pregnancy could be affected.

The reason timing matters: if you find out you're a carrier before pregnancy, you have options. You can test your partner. You can decide whether IVF with embryo testing makes sense for you. You can research the condition, find specialists, plan. If you find out at 15 weeks, the options narrow and the timeline compresses — and the emotional weight of all of it lands at once.

Ushta frames this not as a reason to create anxiety, but as a reason to have the conversation early, when there's space and time to think clearly.

What Happens Once You're Pregnant

Once you're pregnant, there are two main checkpoints from a genetics standpoint.

The first is NIPT — noninvasive prenatal testing — which can be done after 10 weeks of gestation. This is a blood test that looks at fetal DNA circulating in your bloodstream and can screen for certain chromosome conditions, including Down syndrome and a handful of others. It is the best non-invasive blood test available for this purpose, with strong detection rates and a relatively low false positive rate.

But here's what Ushta wants every pregnant person to understand: NIPT does not look at all chromosomes. It does not give a definitive yes or no. It screens for a specific set of conditions — and a reassuring result does not mean everything is fine across the board. The way the test is sometimes marketed creates a false sense of completeness that Ushta finds deeply concerning.

If an NIPT comes back with a concerning result, the next step is typically a diagnostic test — an amniocentesis or CVS procedure — which does look at all chromosomes and provides a definitive answer. Both are invasive and carry a small risk of complications, around one in 700. Both require their own counseling and decision-making process.

The second major checkpoint is the 20-week anatomy scan, where baby is developed enough for a detailed look at all the major organs and structures. If something appears concerning on ultrasound, genetic testing can help determine whether there is an underlying chromosomal or genetic cause — and whether it's isolated or part of a broader condition.

The Designer Baby Misconception

IVF with preimplantation genetic testing — selecting which embryos to transfer based on genetic results — is, in Ushta's experience, frequently misunderstood.

The public perception is that people are selecting for traits: hair color, athletic ability, intelligence. The reality is that the vast majority of people using this technology are selecting against devastating health conditions — conditions where children die in early childhood, conditions where multiple family members have suffered, conditions where a parent has watched too much loss and is doing everything in their power to protect the next generation.

Ushta shared the example of someone choosing IVF to avoid passing on an adult-onset cancer gene — perhaps someone who watched their mother, sister, and aunt all die from the same condition. Is it wrong to want to spare your child that? Is it wrong for someone else to decide that's a choice their child should make for themselves? Neither answer is right. Both are valid. And a genetic counselor's role is not to decide — it is to make sure you understand the options and can trust the decision you make.

What Ushta Is Building

Beyond one-on-one telemedicine sessions, Ushta is developing more accessible ways to get this information to people who need it. She hosts periodic live webinars on testing options — what's available, what questions to ask your OB — and is building a program that includes ongoing live Q&A access for people who want support throughout their journey, not just at one appointment.

Her vision is something she describes simply as: what if everyone had a friend who was a genetic counselor? Someone you could text when the results came back and you weren't sure what they meant. Someone who remembered your history and could put the pieces together across different appointments. That ongoing, connected, personalized support is what the medical system is not designed to provide — and what she is trying to build.

The Takeaway

You cannot advocate for yourself if you don't know what you can ask for.

The testing is out there. The options exist. And in many cases, doing this work before or early in a pregnancy — rather than after something concerning is found — changes everything about how you experience the journey.

You deserve a genetic counselor in your corner. And Ushta is building a world where that's actually accessible.

How to Connect with Ushta Canteenwalla

• Website: findgenetics.com

• Instagram: @findgenetics

• LinkedIn: Find Genetics or Ushta Canteenwalla