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Language access in the neonatal intensive care unit: inequities, legality, practice, and call to action

J Perinatol. 2026 May 26. doi: 10.1038/s41372-026-02731-9. Online ahead of print.

ABSTRACT

OBJECTIVE: Evaluate Neonatal Intensive Care Unit (NICU) interpreter access and utilization, unit-based interpreter policies and initiatives, staff awareness and confidence in understanding language-access laws, and perceptions of language-based inequities.

STUDY DESIGN: An exploratory national survey of NICU staff was distributed via the National Association of Neonatal Nurses and the American Academy of Pediatrics (AAP) (10/2024-4/2025). Descriptive statistics and qualitative analysis were used for survey results.

RESULT: The 189 respondents represented all ten AAP districts. Most were aware of NICU-based interpreter policies (76%). 81% were not aware of additional state laws/provisions and many lacked confidence understanding federal (43%) or state (63%) language-access laws. Many respondents disagreed that language-discordance resulted in worse quality of care (40%) and outcomes (59%) in their NICU.

CONCLUSION: Results highlight the need for additional education on federal and state laws and provisions as well as the broad and systemic nature of language-based healthcare inequities across institutions.

PMID:42192163 | DOI:10.1038/s41372-026-02731-9

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