Clients with Language Barriers

When midwives and their clients do not share a mutual language, care involves challenges to ensure that clients and midwives fully understand information and decisions. There are clear advantages to using professional spoken and sign language interpreter services rather than clients’ family members, friends, or non-professional volunteers. Complications may result from using non-professional interpreters, including:

  • errors related to incompetent interpretation leading to medical errors;
  • conflicts of interest, such as in situations of suspected domestic abuse;
  • difficulty determining if it is the client or the family member who is actually making the decision;
  • clients may be embarrassed to discuss intimate health issues in front of family members or non-professional strangers;
  • minors may lack understanding of the issues, be embarrassed about intimate topics and may inhibit the client from fully sharing information with the midwife.

Some of the advantages of professional interpretation services include:

  • protects client confidentiality by providing privacy (from family) for clients to freely discuss care choices;
  • avoids family members from withholding information that may be upsetting or to ensure compliance;
  • mitigate risk of liability or complaints.

As a result, practices should consider developing a protocol on using interpreters; practices may review a sample protocol here (listed under Client Relations).

NB: There is currently no dedicated source of funding specifically for purchasing interpretation services.

Other Resources

  • Free American Sign Language or langue des signes québécoise interpretation services for private health care offices, provided by Ontario Interpreting Services. Practice groups can book an interpreter for scheduled appointments or emergencies during after hours or weekends by calling 1-855-656-3748 or email
  • In-person and telephone interpreter services available 24 hours a day, 7 days a week at a cost (extra costs may apply for services outside the GTA). Contact Access Alliance Language Services at 416-324-2731 or email