Beyond Translation: Indigenous Language, Obstetric Consent, and Patient Safety in Hispanic Health Care

Language access policies in U.S. health care are commonly operationalized as the provision of interpretation services. While necessary, this approach conflates language access with language comprehension and perpetuates inequity for vulnerable populations. Indigenous language-speaking patients within Hispanic and Latino communities are frequently rendered invisible by current frameworks, leading to communication failures in high-stakes settings such as obstetric care. Drawing on de-identified clinical experience, public health literature, and systems-level analysis of language-access practices, this commentary examines how misclassification of Indigenous patients as “Spanish-speaking” undermines informed consent and patient safety. This commentary argues that language access must be reframed as a patient-safety intervention requiring disaggregated language data, explicit assessment of comprehension, clinician training, and workflow and payment redesign. Achieving equity in Hispanic health requires moving beyond translation toward intentional, community-engaged communication systems that ensure patients understand, participate meaningfully in decisions, and consent with true understanding.