The primary reason for state health departments to test people applying for marriage licenses for syphilis was (still is, in some states) to prevent the devastating effects of congenital syphilis in babies born to infected women. As Cecil said, this is not really a cost effective public health strategy. There has been re-emergence of syphilis in some areas of the country, but the yield would probably still be small in those applying for marriage licenses. I used to do this test on people in my state and the only positives we found were those who had the disease long ago and were already treated (the blood often still shows antibodies to syphilis after it’s gone).
Colorado apparently tests blood for Rh factor in couples about to be married, also for the purpose of preventing birth defects in those babies born to Rh negative mothers and Rh positive fathers. Cecil says:
“Rh testing is not the reason most states require premarital blood tests. According to the most recent list I have, Rh testing is required only in Colorado. No question it’s a good idea though.”
Would Rh testing be any more cost effective or prevent any more problems than premarital STD testing would?
Considering that:
many babies are born out of wedlock
some percentage of people getting married don’t intend to (or are too old to) have children
all mothers receiving prenatal care are tested for Rh incompatability
it’s usually only a health issue with the second birth (at which time the mother should know about the Rh issue because they would have tested her with the first delivery even if she didn’t get early prenatal care)
only an issue if the parents have incompatable Rh factor blood
I don’t know that it makes any more sense to test couples for Rh type than it does to test them for STDs.
Were marriage licenses actually denied to couples when one of them tested positive for syphilis (or anything else)? Or was it just informational, so the infected one could get treatment?
[[Were marriage licenses actually denied to couples when one of them tested positive for syphilis (or anything else)? Or was it just informational, so the infected one could get treatment?]]
Marriage licenses were issued when the person showed proof of treatment for syphilis.
My Pre-IB Biology teacher told our class that premarital blood testing was, and may still be, used mainly to test for the possibility of a genetic defect. The main example she used was Tay-Sachs. She noted that following WWII, the large influx of European Jews caused a huge increase in the number of Tay-Sachs cases in the United States. We were told that testing enabled the parents to know if they were at a high risk and allowed them to assess the situation before deciding whether or not they would have a child. The same thing applies to minorities such as African-Americans who stand at a higher risk of being born with Sick-Cell Anemia. I am not sure if this is the sole, or even the main reason for premarital blood testing, it’s simply the thoughts of an educated pre-Soph.
You think they actually test for sick-as-hell anemia? I don’t think so. Genetic screening would require much more money than the state budgets for this job.
I got married in Texas in 1983, among the last batch to be tested for syphilis. Soon after, Texas discontinued the practice because of the few that it found who didn’t already know. They might have since started it back up, after HIV came along.
OK, when JillGat questions Cecil’s answer on a public health issue, who’s a guy to believe? On the one hand, Jill knows just about everthing concerning public health, but on the other, Cecil knows just about everything concerning everything.
Not to disagree with either, but on the question of cost-effectiveness of Rh testing: It seems to me that Rh testing would be cheaper than syphilis, and that there’s a lot more couples with different Rh types than there are with syphilis. Comments, Jill? (or, dare we hope, Cecil?)
Well, unfortunately for Cecil’s most recent posting, Colorado doesn’t require blood testing anymore. I got married last October, and no one said a word about blood testing.
Perhaps there is a slight misunderstanding by what Cecil meant by Rh testing being a good idea? Maybe he meant it would be a good idea for prospective parents to test, but not that it would be a good idea as a state mandated test?
I got married in Illinois in the early 80’s. A blood test was required. When my wife asked about why the test was required, I said something about VD. The lady we were talking to quickly jumped in, “Oh, we don’t screen for that anymore. It’s just an Rh test.”
In case anyone’s interested, Indiana requires a blood test to check for vaccination against rubella in the wife. I’ve always wondered why only the wife was required, since that didn’t really fit VD screening, Rh factor, genetic screening, etc. This column repost prodded me to get off my butt and find out. Details are here:
I thought it was quite obvious that Cecil was merely stating that Rh type testing was a good idea for couples with the intent to reproduce, not for the State to mandate.
I can see how Jill would take it the other way, though.
I didn’t mean to actually disagree with Cecil… yes, it is a good idea for couples intending to have children to be tested for Rh factor, and that may have been his point. It’s a routine part of prenatal care, when all kinds of tests are done. I just wanted to add some stuff.
[[In case anyone’s interested, Indiana requires a blood test to check for vaccination against rubella in the wife. I’ve always wondered why only the wife was required, since that didn’t really fit VD screening, Rh factor, genetic screening, etc.]]
If a woman contracts rubella during pregnancy, it can cause serious problems for the fetus.