Preferring a language other than English (LOE) is associated with numerous disparities across healthcare. Despite the federally mandated requirement for use of medical interpreters, utilization is suboptimal. Families facing language barriers experience difficulties in accessing care, receive inadequate counselling, and are at high risk for preventable medical errors. Emerging evidence suggests maternal and infant health outcomes surrounding childbirth are worse for patients with a LOE preference. This review will address the impact of preferring a LOE on perinatal health outcomes from preconception care, throughout pregnancy, and into the neonatal period. We discuss quality improvement initiatives that promote language equity by sustainably increasing interpreter use. Future directions and opportunities will be explored.