In 2005, I observed 20 prenatal genetic counseling sessions at Vanderbilt University Medical Center. With each patient’s permission, I sat as a student observer in a small patient education room listening and watching the conversations that unfolded between the genetic counselors, patients, and family members. The sessions usually involved a pregnant woman who had been referred for amniocentesis either because she was of advanced maternal age (AMA) or because a screening test indicated she was in a high-risk group for having a child with a chromosomal abnormality. Initially, what attracted me to this area of research was the ethical complexity of decision making in pregnancies diagnosed with genetic abnormalities, but my observations confronted me with the equally complex phenomena of communicating about genetics. The interest in comparing and contrasting the styles of four different genetic counselors prompted the research question that guides this project: What are and what should be the dominant model(s) of communication between genetic counselors and patients?