We share a practical, clinic‑tested system for hereditary cancer screening that standardizes intake and education, then confront how malpractice pressures distort obstetric decision‑making, fetal monitoring, and access to care. Former ACOG president Dr. Richard Waldman offers data, history, and solutions we can use now.

• digital workflow that screens every patient annually from age 18 
• video education improving informed consent and test completion 
• one in four patients meeting hereditary testing criteria 
• management changes after testing including MRI, meds, referrals 
• addressing cost and genetic discrimination concerns 
• OBGYNs as leaders in genetics amid counselor shortages 
• malpractice landscape, rising verdicts, and physician burnout 
• neonatal encephalopathy criteria grounding courtroom science 
• fetal monitoring limits, category II overreaction, cesarean pressure 
• VBAC safety tied to selection, readiness, and team systems 
• safety culture, simulation, and checklists reducing risk

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