The National Child Mortality Database (NCMD), a government-funded entity, has recently advised NHS medical professionals to refrain from universally advising against marriages between first cousins. This guidance challenges previous practices where healthcare workers routinely discouraged such unions.

According to the NCMD, parents who are first cousins face only a “slightly increased” risk of having children with genetic disorders. The new directive emphasizes that healthcare providers, particularly genetic counselors, should engage with couples and their families to explore the option of arranging marriages outside family lines, without imposing this as a blanket recommendation.

The guidance document stresses the importance of community-level action to help individuals understand and act on the advice provided. However, it strictly stipulates that this information must remain balanced, non-stigmatizing, and non-directive to ensure it is both respectful and informative.

Community-level approach recommended

In light of this development, health authorities are under pressure to broaden an ongoing investigation into various NHS guidelines, some of which suggest there may be benefits to cousin marriages. Critics are calling for the NCMD document to be included in this scrutiny to ensure comprehensive evaluation and clarity.

While marriages between first cousins are legally permitted in Britain, concerns linger due to repeated warnings about the potential for increased birth defects. This practice is notably more prevalent within the British-Pakistani community compared to white British parents, highlighting cultural differences and the need for sensitive handling by healthcare professionals.

First cousin unions stay legal in Britain even though warnings have been issued repeatedly about higher chances of birth defects, with the practice being practiced more frequently in the British-Pakistani community compared to white British parents.

Based at the University of Bristol, the NCMD has received more than £3.5m from taxpayers to record and interpret data on child deaths. It issued the document in 2023.

Political pressure mounts for ban

Ministers have faced mounting calls in recent years to outlaw cousin marriages because of potential health problems for children of blood relatives.

Shadow transport secretary Richard Holden introduced proposals to ban the practice in 2024 when he was a backbench MP.

He said children of first cousins were at greater risk of birth defects and the practice should be outlawed on public health grounds. Downing Street said at the time it had no plans to prohibit it.

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.”

Specialist nursing role created

Last week it emerged that an NHS hospital trust had recruited a nurse to support families where parents are close relatives.

Bradford Teaching Hospitals NHS Foundation Trust advertised the position for a “close relative marriage neonatal nurse/midwife.”

The job description said the successful candidate would “provide comprehensive care and support to families who have recently had a baby and are close relatives, cousins, uncles, aunts, or other closely related family members.”

The NCMD told The Times: “The purpose of the National Child Mortality Database is to collect data on deaths and share our findings to improve and save children’s lives.

“We do not instruct the NHS or its staff on practice, except where we either a) make recommendations for professionals to help reduce mortality in children; or b) inform those professionals who have a statutory responsibility to review child deaths of how best to submit information to our database.”