The National Health Service has launched an urgent investigation after official midwifery training materials suggested there could be 'potential benefits' to marriage between first cousins, while claiming the associated genetic risks to children have been 'exaggerated'.
Controversial Guidance Sparks Alarm
The guidance document, made public following a Freedom of Information request, has caused significant concern among medical professionals and politicians. It directly contradicts established medical evidence on the elevated risks for children born to related parents.
The NHS training material stated that '85 to 90 per cent of cousin couples do not have affected children' and argued that 'close relative marriage is often stigmatised in England'. It further suggested that discussions about health risks 'must also be balanced against the potential benefits' arising from the 'collective social capital' of such unions.
These purported benefits included 'financial and social security at the individual, family and wider kinship levels'. The document criticised what it called an 'unwarranted, narrow focus on close relative marriage'.
Clear Genetic Risks and Political Backlash
Medical science presents a starkly different picture. In the UK, a child of two first cousins carries a 6 per cent chance of inheriting a recessive genetic disorder, double the 3 per cent risk for the general population. Recent research also indicates these children more frequently experience developmental issues and other health concerns beyond diagnosable disorders.
The revelation prompted immediate condemnation. Conservative MP Richard Holden, who campaigns to ban consanguineous marriage, told The Times: "I just find this unbelievable. It is really concerning to me. There are no benefits to marriage between first cousins, only massive downsides for health, welfare, individual rights and the cohesiveness of our society."
Marriage between first cousins is legal in the UK and is relatively common in some communities. A 2024 Oxford journal paper estimated cousins account for 40-60% of all marriages in British Pakistani and Bangladeshi communities, and 20-40% in the Irish Traveller community, compared to under 1% in the rest of the population.
NHS Retraction and Government Response
This is not the first such incident. In September last year, Health Secretary Wes Streeting demanded an apology after an NHS Genomics Education Programme article linked cousin marriage to 'stronger extended family support systems and economic advantages'.
The latest guidance was reportedly part of NHS England's Maternity Transformation Programme, which aims to halve stillbirths, neonatal and maternal deaths by 2030. The NHS has now swiftly distanced itself from the document.
An NHS spokesperson stated: "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." They confirmed an investigation is underway to identify and remove the 'inappropriate wording' from any guidance or training.
The government has also intervened. A Department of Health and Social Care spokesperson said: "The medical science and evidence is clear. First cousin marriages are high risk and unsafe, and we know the genetic defects and harm they can cause. We are working with the NHS to look into how this guidance was developed, and to make sure it doesn't happen again." The investigation will focus on how the guidance was produced to prevent a recurrence.
