A Marriage License & Blood Tests

By Beverly Bird

Updated November 28, 2018

Blood Sample

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In the first half of the 1900s, many people who wanted a marriage license had to take a blood test first, depending on which state they lived in. In part, this was an attempt by the government to identify those with venereal and other diseases, so as to protect would-be spouses from contracting the diseases and infecting their unborn babies. However, strides in medical care and a convincing body of evidence against the blood test requirement have now eliminated this marriage license requirement in all but a handful of states.


As of 2010, according to the Find Law website, only the District of Columbia and three states require blood tests: Mississippi, Montana and New York. The Massachusetts legislature repealed their marriage law that mandated blood tests for a marriage license in 2005, calling the practice outdated.


Premarital blood testing was intended to detect sickle cell anemia, Tay-Sachs disease, syphilis and rubella, diseases that could sicken adults and affect or impair partners or babies born to the marriage. During one period, Illinois tested for AIDS but the law requiring this was repealed in 1989. Generally, both partners are tested in states that still have this requirement in their laws. However, vaccines are now available against rubella and syphilis can be cured by penicillin, and this has largely negated the purpose of the test.


Laws in the states that still require blood tests may vary regarding what happens if either partner tests positive for a disease that is being screened for. Nolo, a website offering free legal information, says that some states may refuse you a marriage license while others may permit it with disclosure of the disease to the other spouse.


Like most states, Massachusetts first began requiring blood tests for marriage during World War II. Men all over America were enlisting in the armed forces and being deployed quickly, many marrying before they went off to fight. Dr. Alfred DeMaria, a director with Massachusetts’ Department of Public Health in 2005, said that health officials wanted to prevent men who were infected from joining the war effort. There was no reliable treatment for syphilis in the 1940s. After the war, states began abandoning the practice of premarital blood testing and by 2002, only 11 states still required the tests for a marriage license, according to the National Conference of State Legislatures.


Mississippi not only still requires blood tests before marriage, but it places an expiration date on them. You must apply for your marriage license within 30 days or you’ll have to have your blood tested all over again.


New York does not require anyone other than African American and Hispanic individuals to take blood tests because the state tests only for sickle cell anemia. These ethnic groups are considered most likely to carry the sickle cell trait, according to the Find Law website and the National Heart, Lung, and Blood Institute. Mississippi currently tests only for syphilis. It has stopped testing for rubella. According to Nolo, the remaining states that require blood tests will waive them if both prospective spouses are older than 50 or if one of them is sterile, presumably because passing on an infectious disease to progeny is not an issue in these marriages.