What Does ‘In Sickness and in Health’ Mean in Marriage?

Love is an action, but it is also a choice. Loving another sometimes means laying down the self and choosing to serve the needs of another. When the rubber hits the road so to speak, it is then that these vows matter most.

Updated Oct 03, 2023
What Does ‘In Sickness and in Health’ Mean in Marriage?

I am sure everyone, in one place, or another has heard these words “in sickness and in health.” I am confident that we all know that they are a selection of words taken from the well-known wedding vows.

Even if you are unmarried, you will likely have heard them referenced. The full set of vows are as follows:

“I take you to be my husband/wife, to have and to hold from this day forward, for better, for worse, for richer, for poorer, in sickness and in health, to love and to cherish, till death do us part, according to God’s holy law. In the presence of God, I make this vow.”

But what do these words mean after the day of the wedding? What is it that we are promising to each other from now until death do us part? Is there a greater meaning hidden in the simplistic phrasing of these vows?

What Is the Significance of ‘In Sickness and in Health’?

Firstly, I would like to address that nowhere in the Bible are these words found. They are not a biblical vow, but rather a pledge to one another on the day of marriage. A vow or promise to love, to give, to be sacrificial, to choose love and they are to be kept and upheld.

The oldest traditional wedding vows go as far back as the 16th century and are based on the Sarum Manual. They were originally written down by the Medieval church.

No matter which type of church we attend or marry in, these same words are repeated in some form, in the Catholic, Lutheran, Anglican, Quaker, and protestant churches.

However, if we zoom in on these five little words, “in sickness and in health”, we recognize instantly that they are just words, if we are honest, we say, but never actually see ourselves living out.

We may stand in our gorgeous white dresses, and black suits and imagine that they may mean in colds and hay fever, or in tummy bugs and broken arms.

But I doubt many of us declared these words and in the back of our minds considered cancer, terminal illness, physical disability, or mental disability. We never envision our lives taking these routes.

But the vow has already been declared before God, and now they must be lived out. But how? Interestingly we could ask when they are not scriptural promises, are we still bound to them? Can we not run when the rubber hits the road as it were?

The answer is yes, of course, we could run away, but I believe we are still bound to fulfill these promises morally. In the same way that pinkie promises matter to my children, these promises matter to your spouse, probably more so.

I have had the privilege of being married for 11 years. My husband is a wonderful man, I don’t say that because I know he will read this. To be fair, he is a pain in the neck on occasion.

He is a typical man, he forgets things easily, works too much, and stresses out over the small things until his stomach is physically sore.

But he is wonderful in so many other more important ways. When we married, I was deep in post-natal depression — a story for another time. Yet on the day of our marriage, he promised to love me in sickness and in health.

For the past 11 years, he has lived up to that promise, every, single, day!

I have health issues, both physically and mentally, nothing in comparison to some, but enough that it affects our lives at times. Yet, he is the first to help me put my socks on when I need it and help me into bed when I have pushed myself too far.

He combs my hair when my hand is sore, and he never draws attention to the fact that I need him. He is never judgmental and surprisingly never claims it’s my fault when I do something I know I shouldn’t.

He lets me try. He picks up the ball when I drop it. Even when I refuse his help and push him away, I see him wait patiently for me to fall into the realization that I need him.

But let’s be honest friend, not all of us are made this way. So, what do we do when we have made the promise and then our spouse gets sick?

We have a disability as the third wheel in our marriage, depression haunts our spouses, or they are too frail to uphold their half of the vows. Well, friend, we respond how Jesus would.

Husband and Wives

The Bible describes to us different types of women and men. The most popular being the Proverbs 31 woman who takes care of all things and is of course portrayed as the ideal, or as Genesis 2 tells us, the man who goes out to work, in this case, Adam into the Garden of Eden.

But what if your marriage doesn’t look like that? What if your roles are different due to illness, be it temporary or permanent?

To answer this, we must read into the fifth chapter of Ephesians a little deeper. It reads in verse 21: “Submit to one another out of reverence for Christ.”

But then we see a breakdown of how each spouse is supposed to love the other, as verse 22 of Ephesians 5 reads:

Wives, submit yourselves to your own husbands as you do to the Lord…… as the church submits to Christ, so also wives should submit to their husbands in everything.

Here we see a specific outline: women are to submit to their husband who is submitted to God. This word here submit basically means to be selfless, to serve him, and respect him.

Nowhere here is there a specific time frame on submission but it is required in all marriages as though onto God, whether you feel like it today or not. (However, I will say if you are in an abusive relationship, get help immediately whether you are a man or woman — biblical submission is not included in abusive relationships).

We see here that there is an expectancy that the wife will serve the husband whatever the need. If he is unable to help in his roles, she can come alongside and serve him as Christ would have served the church. Then we read:

Husbands, love your wives, just as Christ loved the church and gave himself up for her …... In this same way, husband’s ought to love their wives as their own bodies. He who loves his wife loves himself. After all, no one ever hated their own body, but they feed and care for their body, just as Christ does the church — for we are members of his body (Ephesians 5:25, 28-30).

So already here we see the proper order: men are to love their wives sacrificially also. This is a two-way street. Both parties’ roles may differ, but the main aim is the same; to love, to sacrifice for the other, and most importantly to submit to God and live a life together in happy unison.

Ecclesiastes 4:9-12 reminds us that two are better than one, for if one falls, the other will pick up his fellow, also stated is if two lie together one can keep the other warm. From this, we see relationships are vital as we can help each other in the areas we need help in.

Then again in Ephesians 4:32, we read: Be kind to one another, tender-hearted, forgiving one another, as God in Christ forgave you. And so not only do we see a relationship of sacrifice but one that is forged from tenderness and love. These are important godly attributes to have.

More Than a Vow

When the rubber hits the road so to speak, it is then that these vows matter most. The best piece of advice I could give a woman or man getting married now is simple, if you both enter marriage with an attitude that chooses to give 100% of yourself to the other, you both choose to submit to God and respect each other, you both choose to serve as the Church serves Christ, then when these things come up you will both be able to have your needs met.

Love is an action, but it is also a choice. Loving another sometimes means laying down self and choosing to serve the needs of another. Psalm 55:22 tells us that we need to “Cast our burdens on the Lord, and he will sustain you."

Friend if you are in the depths of trials, frustrations, and uncertainties right now, go to God with it, He will make a way to sustain you during trials, he will meet you in your uncertainty, and He will clear the path for you and make the uncertain things clearer.

May you know the blessing of God as you serve your spouse, and may God grant you the patience to continue.

For further reading:

What Is the Origin of Traditional Marriage Vows?

What Is God’s Created Design for Marriage?

What Is the Biblical View of Submission?

Photo credit: ©GettyImages/gorodenkoff

SWN authorMichelle Treacy is a Christian writer, a wife to Gerald, and a busy mother of three, Emily, Ava Rose, and Matthew. Finding time to write is not always easy. However, Michelle’s desire to write about Jesus, and passion to teach is what motivates her. Michelle writes on Instagram, Michelle_Treacy_, and WordPress at Thoughts From My Bible. If you meet her in person, you will likely find her with two things in hand, a good Christian book and a cup of tea!


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