Objective <p>Describe health-harming legal needs of families supported by a perinatal medical-legal partnership (MLP).</p> Study design <p>Retrospective descriptive study of a fetal care program (FCP) and neonatal intensive care unit (NICU) MLP at an academic medical center in the Pacific Northwest from 2020 to 2024. Sociodemographic, clinical, and legal data were collected for newborns and their families.</p> Results <p>110 families, including 123 newborns, received MLP services. A total of 183 legal needs were addressed. Of those referred during NICU admission (<i>n</i> = 83 families), legal issues were identified over the course of hospitalization (hospital day 3–250). Nearly half of families (44%) identified more than one legal issue. The most frequent legal needs centered around family stability (e.g., custody, establishing parentage, divorce, and personal safety), followed by needs related to housing stability.</p> Conclusion <p>Perinatal MLPs offer a unique, upstream opportunity to mitigate social determinants of health at the earliest moments of a child’s life.</p>