The NHS has been teaching midwives that health risks associated with cousins having children are "exaggerated". Wes Streeting, the former health secretary, said the "advice should never have been published" and the NHS should have apologised.
Official teaching modules under fire
Official teaching modules for staff said the health risks of consanguinity, relatives having a child together, are similar to those where the mother is older, a smoker, obese, or living in poverty. Online teaching given to midwives, nurses, GPs, and genetic counsellors also said that consanguinity has been "stigmatised" and that "the level of increased risk had often been exaggerated".
It added that risks have been "sensationalised by politicians and media" and attempts by NHS staff to discourage consanguinity among patients were "inappropriate, alienating and ineffective".
Legal but with genetic risks
In the UK, it is legal to marry a first cousin (the child of a person's biological aunt or uncle). But, it has been found that the children of these partnerships can inherit genetic conditions like sickle cell disease and cystic fibrosis.
Training modules axed
Three of the five training modules used by staff were axed in 2025 after NHS documents emerged that claimed marriage between cousins had "benefits", with one session titled "benefits of marrying within the family". Staff were also taught that it is "important to put the increased risk associated with close relative marriage in perspective".
The document said: "There are many factors that increase the risk of a child being born with a congenital anomaly, and of a neonatal death, such as: social deprivation, maternal smoking, maternal obesity, maternal age." They added it was "useful to reflect on the risks associated with other patterns of childbearing" and that "the case of older maternal age at childbirth is a useful comparator".
Current NHS stance
While teaching materials that say there are "benefits" to consanguinity have been removed, midwives are still taught how to broach the topic with patients and assess whether people need to be referred to genomic services. An NHS spokesman said that while the comparison between consanguinity and other maternal factors "reflected the academic evidence", these training materials had been removed and were no longer in use.
He added: "The evidence is clear that having closely related parents can increase the risk of inheriting certain genetic conditions, and the NHS is fully committed to ensuring that more families can access the information and support they need."
