The NHS is instructing midwives about the perceived 'benefits' of marriage between first cousins, an investigation by The Mail on Sunday has revealed. This guidance comes despite well-documented medical evidence that such unions significantly increase the risk of serious congenital birth defects in children.
Guidance Downplays Genetic Risks
The controversial new training material, part of NHS England's Maternity Transformation Programme, suggests that concerns over the health risks are frequently 'exaggerated' and 'unwarranted'. It bases this claim on the statistic that '85 to 90 per cent of cousin couples do not have affected children'. However, this figure contrasts sharply with the national average, where 98 per cent of children are unaffected by such conditions.
While the document admits there are 'risks to child health associated with close relative marriage', it argues these must 'be balanced against the potential benefits... from this marriage practice'. These purported benefits include 'economic benefits' as well as 'emotional and social connections' and the accumulation of 'social capital', particularly within communities where the practice is common, such as among those of Pakistani heritage.
Critics Condemn 'Indefensible' Stance
The guidance has provoked fierce criticism from health experts and politicians. Conservative MP Richard Holden, who campaigns to ban cousin marriage, stated unequivocally: 'There are no benefits to marriage between first cousins, only massive downsides for health, welfare, individual rights and the cohesiveness of our society.'
Professor Patrick Nash, director of the Pharos Foundation research institute in Oxford, delivered a scathing comparison. 'This is on a par with recommending alcohol and smoking during pregnancy for their calming effects, while brushing over the absolutely horrendous consequences for mother and child,' he said. He added there was 'no justification or excuse for this at all' and condemned the government for refusing to ban the practice.
Further academic criticism came from Professor Michael Muthukrishna of the London School of Economics. He warned that normalising cousin marriage and the resulting community isolation 'is what has allowed for over-representation of radicalisation and grooming gangs.'
Documented Health Impact and NHS Costs
The medical consequences are stark. The Daily Mail previously revealed that more than two child deaths a week in England are linked to parents being closely related. In cities like Birmingham and Glasgow, up to 20 per cent of children treated for congenital problems are of Pakistani descent, compared to just 4 per cent in the wider population.
Treating these complex, often lifelong conditions costs the NHS billions of pounds annually. Areas of the UK with high rates of cousin marriage also show a significantly higher likelihood of claiming benefits, linked to the increased care needs of children with disabilities.
The NHS guidance, however, maintains that 'discouraging cousin marriage is inappropriate' and would prove 'alienating and ineffective'. It stresses that staff must not 'stigmatise' patients, primarily from South Asian or Muslim backgrounds, for whom the practice is 'perfectly normal'.
In response to the controversy, an NHS spokesperson said: 'The NHS absolutely recognises the genetic risks of consanguineous relationships, and where people consider entering into them we offer referral to genetics services so individuals understand the risks and can make informed decisions.' The Maternity Transformation Programme itself aims to halve stillbirths, neonatal deaths, and maternal deaths by 2030.
