THE NHS AND FIRST COUSIN MARRIAGE

Daily Mail

 

Now NHS staff are told to STOP discouraging first cousin marriages in new guidance - but are accused of 'taking the knee to damaging and oppressive cultural practices'

By NOOR QURASHI, NEWS REPORTER

Published: 05:37 EST, 11 February 2026 | Updated: 11:30 EST, 11 February 2026

 

NHS staff have been told it is 'unacceptable' to discourage cousin marriage - as new guidance insists the risk of having a genetically ill child is only 'slightly increased'.

 

The National Child Mortality Database (NCMD), based at the University of Bristol, warned employees against a 'blanket' approach to the practice.

 

Cousin marriage, fairly common in the Pakistani community, remains legal in the UK despite attempts to ban it.

 

The NCMD received more than £3.5million in taxpayer funding to record and interpret data on all children who died.

 

The organisation's report states, 'It is unacceptable to discourage close relative marriage in a blanket way,' because the risk of having a child with a genetic disorder is only 'slightly increased'.

 

It adds genetic counsellors should meet with couples and their relatives, advising them on how to 'consider arranging future marriages outside of the family'.

 

The advice follows separate NHS guidance stating the 'benefits' of cousin marriage - with critics urging health bosses to expand an ongoing investigation into the advice to include the NCMD document.

 

Babies born to cousins are up to three times more likely to have genetic disorders.

 

The NCMD document adds: 'Action at community level may help people to understand and act on [our] advice; but this is only acceptable if information is balanced, non-stigmatising and non-directive.'

 

In 2024, an attempt to outlaw the practice was proposed by Richard Holden, shadow transport secretary, when he was a backbench MP.

 

His efforts were blocked.

 

Mr Holden told The Times: 'Our NHS should stop taking the knee to damaging and oppressive cultural practices. This guidance turns basic public health into public harm.

 

'First cousin marriage carries far higher genetic risk, as well as damaging individual liberty and societal cohesion. Pretending otherwise helps no one, least of all the children born with avoidable conditions and those trapped in heavy-handed patriarchal power structures they can’t leave for fear of total ostracism.'

 

Studies suggest the risks of cousin marriage are comparable to the increased risk associated with mothers giving birth over the age of 35.

 

However, that risk is compounded if the family has a history of consanguineous marriages across generations

 

Yesterday the Daily Mail revealed a Manchester NHS Trust had advertised an 'exciting new job opportunity'  for a close-relative marriage nurse - to help cousins having children together.

 

The role - now closed for applications - was shared earlier this year in a bid to enable 'informed reproductive decision making'.

 

The ideal candidate was described as fluent in Urdu and someone who 'values diversity and difference'.

 

Last month new guidance from the health service said concerns about the risks of congenital diseases are 'exaggerated' and 'unwarranted' on the grounds that '85 to 90 per cent of cousin couples have unaffected children'.

 

The national average rate for unaffected children is 98 per cent.

 

Admitting there are some 'risks to child health associated with close relative marriage', the guidance says these should 'be balanced against the potential benefits... from this marriage practice'.

 

And marrying a relative – fairly common in the Pakistani community – can offer 'economic benefits' as well as 'emotional and social connections' and 'social capital', the document says.

 

The Manchester Foundation Trust, one of the largest NHS Trusts in England, advertised the Neonatal Nurse position as a fixed-term 12-month contract.

 

It is one of a number of similar positions being publicised across the NHS, including a Frimley Health NHS Foundation Trust role in Slough, 'close relative' midwifery and nursing posts in Bedfordshire Hospitals and at GP practices in Bradford.

 

The successful applicant will receive a salary of between £37,338 to £44,962 a year, working full-time to ensure 'support and improve engagement with genetic services for affected families' and enable parents to 'make informed choices in a culturally sensitive empowering way'.

 

An NHS source told the Daily Mail: 'The purpose of the role is to advise families of the genetic risks associated with children born from close relative marriages and promote an informed understanding.

 

'The purpose of the role is not to advise how cousins can have children, it is about working with families to assess the risks and provide access to relevant information and research on genetics so that informed choices can be made.'

 

Cousin marriage is popular among certain communities in Britain such as those of Pakistani and Bangladeshi heritage.

 

Critics have accused the NHS of turning a blind eye to an 'indefensible cultural practice'.