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Why medical tests are necessary before marriage

You should be thinking about life beyond the D-day-not the wedding itself, but after the wedding-specifically, your health. There’s no easy way to broach the…

You should be thinking about life beyond the D-day-not the wedding itself, but after the wedding-specifically, your health.
There’s no easy way to broach the subject, but tackling it head on could save you a lot of grief in future. Your health status during dating might not be what you need for a lifetime of marital contract.
And a pre-wedding test of health is one way to set your mind at rest. Or stay aware-be forewarned to be forearmed.
A common reality is that the cold, bare facts that health status tests present just don’t sit well with the romance of marriage. Asked whether they would do a pre-wedding test, some respondents fall off the cliff straight into romance, with answers like, “Test to prove that my hubby loves me” from one woman, and “A test for perseverance and good sex” from a man.
But the tests in question refers to health, not love and warm feelings. Carried away by love and warmth, it is easy to think a laboratory test sounds too cold to contemplate.
The consequences of not knowing your health status before tying the knot spells an oh-not-so lovely future for your kids and society.
Among Nigerian couples, the most common test is probably genotype, with particular bias for sickle cell disorder, SCD. You can be AS, a carrier of the gene, or not. But if your partner also carries the gene, then the mathematics of Mendelian inheritance suggests at each birth your kid has a 50% chance of carrying the gene, a 25% chance of not carrying the gene, and another 25% chance of carrying full-blown SCD.
It is only a game of chance, but is it one game you really want to play? Isaac Lawrence, 32, did not, he ended a two-year relationship with his girlfriend just when they would have started the family calls.
He was warned about the physical anguish that comes with SCD in children, he said, and about how having a ‘sickler’ child was ‘wicked’ to the child when it could have been prevented. It could even tear the family apart, he recalled.
Genotyping for conditions as sickle cell is one discerning couples would want to take, says Dr Esther Envuladu of Jos University Teaching Hospital.
“The fear is not about the couple, but you fear for the kids what will come up .If both are AS or one is AS, you won’t advise such couples to get married, because they are likely to give birth to an offspring that is either AS or SS, and your fear is the SS, because there is a 25% chance,” she says.
She said: “If they give birth to a child who is SS, the family itself and the child will be in problem, because they are subjecting that child to suffering, considering all the challenges that sickle cell comes with.”
Even tests for STDs sound cold. “Genotype and HIV would be an issue,” says Elias Damian, 32, and currently dating, “but I am also wondering why there should not be STD tests”. Asked what he meant, he says: “If we are both AS-AS, no way; or any of us has HIV or STD, no way. No way means no marriage.”
Along with tests for hepatitis B and C, doctors would want you to know your status-and if you have the condition, how to prevent passing it on to your partner.
“It is not to tell them not to get married, but if they choose to, they know the precautionary measures to take,” says Envuladu.
The consequences are rampant spread of sexually transmitted infections among married couples.  
Institutions of matrimony are increasingly stepping in to take the decision out of the hands of couples.
Churches these days demand pre-wedding tests for HIV-without special emphasis on any other STI-and require both individuals to be of same status. If one is positive, it isn’t that the church will stop the wedding, says Ndy Okechukwu, “but they need to be aware, so that one doesn’t feel betrayed.”
“If after knowing full well, they decide to quit or move on, the church will bless them, but they will be told the consequences,” she says.
Douglas Noel and his fiancée went through a battery of tests weeks before their wedding last year, including a pregnancy test on account that the church had to be sure it was joining two-not three-people.
The pregnancy test was taken a week before their wedding and involved just his fiancée, he said.
Medical grounds for ending unions before they even get off the ground abound but how many do fizzle out? Doctors have had few of such experiences “because most people don’t even come for tests,” says Dr Envuladu.
For every couple who quit a relationship, usually those more enlightened about possible health dangers for their children that tender loving care cannot compensate for, there have been at least couples who assigned their health status to fate or faith and went ahead.
Experts advise you are better off knowing your status even before starting the search for a Mr Right, a Prince Charming, a Better Half or a Missing Rib.
“These are investigations couples should do even before they go into a relationship,” Envuladu advises.
“So, if you know your status, by the time someone is approaching, you know, ‘this is my genotype, what’s your genotype, so we don’t even start in the first place.”
That unfortunately is rare and frequently overtaken by the rush of emotions that come with blossoming relationships.
The reality, Envuladu says, is “most people will go into relationships, and on the verge of getting married-when they have already made up their minds-you are telling them about genotype. And even when they find out, it is difficult for them to quit.”

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