NHS told midwives not to fear ‘exaggerated’ health risks of cousins having children together

The e-learning materials said that the health risks posed are comparable to women having children when they are older, being a smoker, obese, or living in deprivation.

The online lessons said that the practice of consanguinity had been “stigmatised” and “the level of increased risk had often been exaggerated.”

It said that the risks had been “sensationalised by politicians and media” and attempts to discourage or ban the practice were “inappropriate, alienating and ineffective".

Three of the five e-learning modules, which were published in October 2022, were retired in October 2025 after backlash regarding segments of training that said cousin marriage had “benefits".

The modules were produced for NHS England; however, they could be accessed by NHS staff across the UK.

Marrying a first cousin in the UK is legal, but scientific research shows that it increases the risk of children inheriting genetic conditions, such as sickle cell disease and cystic fibrosis.

The Telegraph accessed training modules under Freedom of Information laws, with one session being named “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".

“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.”

The training materials added that it was “useful to reflect on the risks associated with other patterns of childbearing” and “the case of older maternal age at childbirth is a useful comparator".

The materials also said that the practice was most common in, but not limited to, British Pakistani and Pakistani.

“Pakistani women in cousin marriages have been found to compare favourably to those in non-relative marriages on a range of indicators of social and financial wellbeing,” the materials said.

The training said to ask sensitive questions, such as “Is there any possibility you could be related?” and “Do you have any older relatives in common?”

“It is important to explain that being related does not only refer to first cousins, but other more distant relationships should also be mentioned,” it adds.

Richard Holden, the shadow transport secretary, who campaigned for cousin marriage to be banned, told The Telegraph: “The NHS has a duty to ensure its staff are trained in the latest medical evidence and provide clear, honest information to patients.

“It should not minimise the well-established genetic, societal and clan-focused risks associated with first-cousin marriages, which can leave families and future generations vulnerable to harm, and young people, especially women, feeling forced by family pressure into relationships they do not want.

“Suggesting all these risks and concerns are equal undermines the established evidence on the genetic risks of closely related parents and shows a deep ignorance of the real impact of first-cousin marriage in our communities.

“The NHS must focus on the facts, not justify foreign cultural practices that are anathema to British values.”

An NHS Spokesman told GB News: "“While these specific statistics reflected the academic evidence, these training materials have been removed and are no longer in use.

“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.”