Even if you and your partner are the poster people of perfect health, you may have a history of chronic illness or medical disorders further back in your lineage that could impact the health of your unborn child. Your health care provider will ask you questions about your ethnic and racial heritage and family background (and that of the baby's father) to screen for medical conditions for which your child may be at risk. Having the most complete and accurate information possible will help her determine what screening tests, if any, you ought to consider.

In addition to the medical history of your partner and you as well as that of any children you already have, you should gather all known health information going two generations back (that is, pertaining to your parents and siblings as well as to those of your partner, along with that of your second-degree relatives including grandparents and blood-related aunts and uncles). Any additional information you have about medical conditions further back in your family tree should also be brought to your provider's attention.

Don't rely too much on the health histories in family adoption records. There is no guarantee that the healthy twenty-year-old who gave birth didn't develop major medical problems later in life. In many cases the original adoption information includes no medical history beyond a brief physical indicator at the time of the adoption (for example, subject “appeared to be in good health”).

Parents-to-be who were adopted may have little to no information on their birth families. As of mid-2006, only five states (Alabama, Alaska, Kansas, New Hampshire, and Oregon) provided open and unconditional access to original birth certificates for all adopted adults; other states provide access upon consent of the birth parent or by court order only. If you'd like to pursue access to your health history, your first step is to know the law. Some states allow nonidentifying (non-ID) information to be given out. Non-ID is information about the adoption excluding any information that would enable you to identify the people involved. In many cases the non-ID information will include some medical and social history of the birth parents, although in some states this information is only voluntary and may not be available.

If you have a history of health problems or miscarriage and your doctor feels more family background would be valuable, many states provide a system by which an adoptee can petition the court to get adoption records opened or unsealed.

Keep in mind that only 3 percent of American infants are born with a birth defect, only a portion of which are thought to have a genetic component. In many cases of inherited diseases, a complex interaction of both genetic and environmental factors is required to trigger the condition. If your provider determines you are at risk for passing along a medical problem to your child, she may refer you to a genetic counselor for analysis of your risk factors and a discussion of options for additional testing or another appropriate course of action.