NHS Midwives Urged to Embrace Cousin Marriage Amid Controversy

The National Health Service (NHS) in the United Kingdom has prompted significant backlash after issuing new guidance encouraging midwives to support cousin marriage. This controversial directive suggests that concerns regarding birth defects in children of cousin couples are overstated, claiming that “85 to 90 percent” of these couples do not have affected children. This assertion stands in stark contrast to the national average of 98 percent for unaffected children in the general population.

The guidance acknowledges that while there are some risks associated with marriages between close relatives, these should be weighed against the purported benefits. The NHS document states that cousin marriages can provide economic advantages, emotional connections, and social capital, particularly within communities where this practice is culturally accepted, such as among some South Asian groups.

Critics argue that the NHS is downplaying serious health risks. Richard Holden, a Conservative MP advocating for a ban on cousin marriages, expressed his concern: “There are no benefits to marriage between first cousins, only massive downsides for health, welfare, individual rights, and the cohesiveness of our society.”

The guidance was created as part of NHS England’s Maternity Transformation Programme, which aims to reduce stillbirths, neonatal and maternal deaths, and brain injuries by 2030. The document, intended for midwife training, discourages the stigmatization of those who choose cousin marriage, describing the practice as “perfectly normal” in specific cultural contexts.

Critics of the NHS guidance include Patrick Nash, a professor and director at the Pharos Foundation, who criticized the recommendations as reckless. He equated the encouragement of cousin marriage to endorsing harmful behaviors such as alcohol and smoking during pregnancy. Nash stated, “There is no justification or excuse for this at all.”

The document also highlights that children born to cousin couples have been found to have comparable health outcomes to those born to non-relative couples. It argues that such marriages can enhance financial and social security within families, a viewpoint supported by some cultural perspectives.

Yet, research points to concerning statistics regarding the health of children from cousin marriages. Areas in the UK where cousin marriage is prevalent tend to show higher rates of congenital issues. Data indicates that up to 20 percent of children treated for congenital problems in cities like Glasgow and Birmingham are of Pakistani descent, in contrast to just 4 percent in the broader population. The financial burden of addressing these health issues has been substantial, costing the NHS billions annually.

Michael Muthukrishna, a professor at the London School of Economics, highlighted the broader social implications of cousin marriages, noting that they can lead to community isolation and increased risks of radicalization. He stated that “when marriage is restricted to family members, communities become more isolated, limiting social integration.”

An NHS spokesperson acknowledged the genetic risks associated with consanguineous relationships, stating that they offer referrals to genetic services for those considering such marriages, ensuring individuals can make informed choices.

The debate surrounding cousin marriage, especially in the context of public health, continues as the NHS navigates the cultural sensitivities and health implications associated with this practice. As discussions evolve, the focus on balancing cultural considerations with health risks remains critical.