The National Health Service (NHS) in England has ignited controversy by encouraging midwives to support cousin marriage, despite evidence suggesting increased risks of congenital disabilities in offspring. New guidance issued by the NHS states that concerns surrounding this practice are “exaggerated,” asserting that “85 to 90 per cent of cousin couples do not have affected children.” This contrasts sharply with the national average, where approximately 98 per cent of children are born without congenital issues.
While acknowledging that there are health risks associated with marriages between close relatives, the NHS guidance argues that these should be weighed against potential benefits, such as economic stability and emotional connections. The document emphasizes that staff should not stigmatize patients from predominantly South Asian or Muslim backgrounds who marry cousins, framing the practice as “perfectly normal” within certain cultures.
Critics have voiced strong objections, arguing that the NHS is neglecting serious health implications. Conservative MP Richard Holden, who is advocating for a ban on cousin marriage, remarked, “There are no benefits to marriage between first cousins, only massive downsides for health, welfare, individual rights, and the cohesiveness of our society.”
Concerns about the guidance have been echoed by experts in the field. Patrick Nash, a professor and director at the Pharos Foundation, likened the recommendations to endorsing unhealthy behaviours during pregnancy, saying, “There is no justification or excuse for this at all. Shame on the authors and shame on the Government for refusing to ban this indefensible cultural practice.”
The guidance forms part of the NHS England’s Maternity Transformation Programme, which aims to reduce stillbirths, neonatal and maternal deaths, and brain injuries by 2030. The document suggests that discouraging cousin marriage is inappropriate and could alienate individuals seeking care, arguing that the risks of genetic conditions have often been overstated.
Despite these claims, many healthcare professionals remain concerned about the implications of cousin marriages. Michael Muthukrishna, a professor of economic psychology at the London School of Economics, stated, “When marriage is restricted to family members, communities become more isolated, limiting social integration.” He added that such isolation can lead to social issues, including radicalization.
Evidence has shown a concerning relationship between cousin marriages and health complications in children. A report indicated that over two children a week in England die as a result of health issues linked to closely related parents. In certain areas, such as Glasgow and Birmingham, up to 20 per cent of children treated for congenital problems are of Pakistani descent, compared to just 4 per cent in the broader population. This disparity has significant financial implications for the NHS, which spends billions on treating these conditions.
An NHS spokesperson confirmed the organization’s awareness of the genetic risks associated with consanguineous relationships, stating that they provide referrals to genetics services to help individuals understand the risks involved.
As discussions continue, the NHS faces pressure from multiple fronts regarding its guidance on cousin marriage and the broader implications for public health. The controversy raises critical questions about cultural practices, health risks, and the responsibilities of healthcare providers in addressing these issues.
