The practice of medicine has, at least on the surface, changed from a paternalistic “doctor knows best” approach to one that focuses on patient autonomy. However, when it comes to pregnancy and antenatal testing, paternalism seems to sneak back in, at least in the approach to informed consent obtained from pregnant women in regard to what testing they desire to receive and how they wish to respond to the results of these tests. Some studies have assessed the effectiveness of prenatal screening, but fewer studies have examined women’s understanding of these ‘routine’ tests, or the efficacy of the counseling they received prior to testing. The studies that exist show that women are not adequately counseled by obstetric clinicians, and as such are not giving a truly informed consent before proceeding with antenatal testing for conditions such as Down syndrome (trisomy 21), trisomy 13 and 18, and other possible genetic defects. Studies also show that most clinicians are not adequately prepared to share abnormal screening results with patients in a compassionate and supportive manner. A review of the literature also reveals that women do feel pressure to respond to a result which suggests or confirms a genetic abnormality by terminating the pregnancy, which theoretically should not be occurring due to the claim that all genetic counseling is nondirective. In a time when patient autonomy guides most medical decision making, we see clinician paternalism and societal pressure dominating in the field of prenatal testing.