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The Pre-Wedding Prick: Why Alabama Required a Blood Test for Marriage Until 2019
Until August 29, 2019, getting married in Alabama required a premarital blood test. This public health measure, a relic from the early 20th century, was abolished along with marriage licenses themselves in a law that modernized the state's entire approach to matrimony.
Imagine planning your wedding: you've picked the venue, tasted the cake, and sent the invitations. But for couples in Alabama, until very recently, there was one more item on the checklist that sounds like a throwback to another era: a mandatory premarital blood test. For decades, this requirement was a standard part of getting a marriage license in the state, a practice that finally ended on August 29, 2019.
A Legal Overhaul
The change came as part of a broader legislative overhaul that didn't just eliminate the blood test but did away with marriage licenses altogether. A new law replaced the traditional license application process with a simpler, more direct system. Now, couples wishing to marry in Alabama simply complete an "Alabama Marriage Certificate" form, have it notarized, and file it with their county probate court. The new process also removed the requirement for a formal wedding ceremony, streamlining the path to legal marriage.
This bill is simply to get Alabama in the 21st century.
The move was seen by lawmakers like Rep. Wes Allen as a necessary modernization. While the change was partly motivated by a desire to create an alternative for probate judges who objected to signing licenses for same-sex marriages, it also swept away a piece of medical history that had long outlived its usefulness.
A Relic of Public Health History
Why was a blood test required in the first place? These laws weren't unique to Alabama; at one point, over 40 states had similar requirements. They were a product of the early-to-mid 20th century public health movement, primarily aimed at preventing the spread of venereal diseases, most notably syphilis. Before the widespread availability of penicillin in the 1940s, syphilis was a devastating disease that could lead to severe long-term health problems and could be passed from a mother to her unborn child, causing congenital syphilis.
By testing couples before marriage, lawmakers hoped to identify infected individuals, ensure they received treatment, and prevent them from unknowingly transmitting the disease to their spouse or future children. Over time, some states also added tests for other conditions like rubella and genetic disorders such as sickle cell anemia.
Why the Requirement Faded Away
As the decades passed, the rationale for mandatory premarital testing weakened significantly. The development of effective antibiotics made syphilis easily curable. Public health screenings became more common in other medical settings, and rates of the disease fluctuated. The tests came to be seen as an expensive, inconvenient, and invasive barrier to marriage that yielded very few positive results. Most states repealed their laws in the 1980s and 90s, recognizing them as anachronistic. Alabama, however, was one of the last holdouts, continuing the practice long after its public health impact had become negligible.
Today, getting married in Alabama is a matter of paperwork, not medical procedures. The end of the pre-wedding blood test marks the closure of a fascinating chapter in public health history and a shift toward a more modern, less intrusive approach to legal marriage.