The case for premarital medical screening and nikah

The twenty-first century could be considered one of the most significant in human history. This is because it witnessed tremendous discoveries in many areas of human activity, particularly at the scientific frontier. One of the direct benefits of this new scientific period is that numerous health issues are now being treated with great skill. Such is the case with the increasingly popular pre-marital screening of prospective couples, which aims to determine the health state of spouses before marriage is contracted.

Many people believe in checking the astrological compatibility of the bride and groom to predict the success of their married life. However, why not also focus on assessing the health of the couple to ensure they live a healthy and thus happy life? By obtaining practical results through medical check-ups, we can address potential health issues that may affect their future together.

Before we dig into the details, let’s first understand what premarital medical screening is. Pre-marital medical screening basically consists of a comprehensive group of tests meant especially for those planning to get married, designed to identify potential health problems that may have an impact on one’s fertility or may be related to hereditary diseases and infections.

The first test is an infertility test, which measures the health of the ovaries and sperm count. Because there are no obvious symptoms of infertility, it is critical to conduct these tests if you intend to have a baby in the future. Knowing the results ahead allows you to seek the appropriate course of therapy, if necessary. Moreover, this saves the couple, particularly the bride, from the blame game after marriage if she is unable to conceive, which results in trauma for the entire family. Many women are also divorced after marriage if they are infertile, which destroys a woman’s life. To ensure women don’t go through this trauma after marriage, an infertility test before getting married promotes transparency between the couple and their families, resulting in an informed choice.

Then comes the Rh factor test. It may not appear to be a significant test, but if you intend to have children, you and your spouse must have the same Rh factor (Rhesus factor). If your blood types are incompatible, it may cause issues during pregnancy. Rh incompatibility is a condition in which antibodies in a pregnant woman’s blood damage her baby’s blood cells. This can be especially harmful for the second child.

Hereditary diseases, also known as inherited diseases or genetic disorders, are caused by changes in one’s genetic material (DNA) and are transmitted from generation to generation, or inherited from parents to their children. Thus, it is crucial to include a test for genetic diseases to determine if either parent has a deadly disease that could be passed on to their children. This testing also helps to diagnose any undetected genetic conditions in the couple, allowing for timely treatment. It is important to get tested for these chronic medical conditions before it is too late. Some of these diseases include breast cancer, colon cancer, kidney diseases, and diabetes. Timely diagnosis can also help in receiving proper treatment for these medical conditions before they become life-threatening.

And lastly, both the partners should get tested for sexually transmitted diseases. These diseases include HIV/AIDS, gonorrhoea, herpes, syphilis and hepatitis C. Acquiring these diseases can have a severe toll on one’s health and can even lead to death. These diseases cannot only be passed on to the partner and if they are passed to the mother, they can pass on to the children too. HIV and AIDS are common examples of such diseases. It can take 10 years or more for HIV to show any symptoms - or much, much longer than that for people who take HIV medicines. And if passed on, evidence shows that without timely treatment, one-third of children infected with HIV at birth will die by age one, and half by age two. That’s why it’s really important to get tested for HIV regularly. HIV treatment can help you stay healthy.

In case your partner’s test reports turn out to be positive, it can save you from the psychological trauma that you may face in the future and give you clarity whether you wish to go ahead with the wedding or not. It gives the widest range of informed choice to prospective couples in the event of unfavourable screening results. It’s incredibly important to be honest about medical history - even if it’s the smallest of things, like a cough. And so, the importance of pre-marital medical screening cannot be overemphasised.

Beginning in the early 20th century, several states in the United States introduced legislation requiring one or both parties to undergo medical tests prior to marriage. The most prevalent criterion was a blood test for syphilis, but other diseases such as gonorrhoea and rubella were occasionally addressed. If a spouse tested positive, they would often be compelled to seek treatment before receiving a marriage licence. Moreover, a strong example we have is Saudi Arabia. As a leading Muslim country, Saudi Arabia has implemented legislation that makes it compulsory for all couples to provide their premarital medical reports at the time of Nikah.

We, as responsible Pakistanis, also call for a similar change. Premarital medical reports from a government hospital should be made compulsory for all couples and these should be presented to the Nikah registrar at the time of solemnisation and registration of Nikah. It is time for Pakistanis to advocate for such change to ensure the health and success of not only our upcoming generations but also the women who are the change-makers and who build our society today. We need to ensure that we have healthier and happier families, as only then will our nation produce successful individuals. And so, we call for change. We call for legislation. It is late, yes, we are already late. But it is never too late.

Milhan Sarfraz is a human rights activist and social worker focusing on gender-based violence and the welfare of women in Pakistan. She is also the author of the book ‘Smart Teen: How to Live, Love, and Learn in the 21st Century,’ published on Amazon and eight other international platforms.