What Is Delayed Cord Clamping?
Delayed cord clamping allows blood to continue flowing from the placenta to the baby for a short time after birth, which can provide important benefits during the baby’s transition to life outside the womb. Key Takeaways About Delayed Cord Clamping If you have been preparing for your baby’s birth, you may have heard your midwife delayed cord clamping. You may also have questions about what it actually means, how long you wait, and whether it is safe. Waiting briefly to clamp the cord is a simple practice that gives your baby additional time to receive blood from the placenta after birth. It is now recommended by several major medical organizations for most healthy newborns, although the exact timing can depend on the circumstances of the birth. What Happens During Delayed Cord Clamping? After your baby is born, blood can continue moving between the placenta and your baby through the umbilical cord. Waiting before clamping the cord allows this process, known as placental transfusion, to continue. Instead of clamping the cord immediately, the healthcare team waits for a period of time before placing the clamps and cutting the cord. During that time, your baby can often be placed directly on your chest for skin-to-skin contact while the cord remains attached. The American College of Obstetricians and Gynecologists (ACOG) recommends delayed cord clamping for at least 30 to 60 seconds after birth for most vigorous term and preterm babies. Why Is Delayed Cord Clamping Beneficial? The biggest benefit is that your baby receives additional blood from the placenta during the first moments after birth. This extra blood can increase the baby’s blood volume and hemoglobin levels. It also provides additional iron, which can help support the baby’s iron stores during the first several months of life. For premature babies, the benefits can be particularly important. Research has associated delayed cord clamping in preterm infants with better circulation after birth, a reduced need for blood transfusions, and lower rates of certain serious complications. The World Health Organization recommends delaying cord clamping for at least one minute after birth for improved maternal and newborn health outcomes. How Long Is the Cord Left Unclamped? There is not one universal amount of time that applies to every birth. ACOG recommends at least 30 to 60 seconds for most vigorous term and preterm infants. The World Health Organization recommends waiting at least one minute, and some professional organizations support waiting longer when circumstances allow. Your healthcare provider may consider factors such as your baby’s condition, your health, the condition of the placenta and umbilical cord, and whether either of you needs immediate medical attention. In other words, delaying cord clamping is not necessarily about watching a clock. The care team considers what is safest for both mother and baby. Can You Have Skin-to-Skin Contact During Delayed Cord Clamping? Often, yes. Delayed cord clamping does not necessarily mean your baby has to be taken away from you while you wait. ACOG notes that immediate skin-to-skin contact can be appropriate while the cord remains attached. For many families, this means the first moments after birth can include your baby resting on your chest while the placenta continues providing blood through the umbilical cord. Does Delayed Cord Clamping Affect the Mother? Delayed cord clamping is primarily intended to benefit the newborn, but research has also looked at whether waiting to clamp the cord affects the mother. Current evidence does not show that delayed cord clamping increases the risk of postpartum hemorrhage or significantly increases blood loss during delivery. However, there are situations in which the mother’s health takes priority and immediate cord clamping may be necessary. For example, if there is significant maternal bleeding or maternal instability, the healthcare team may need to act quickly. Does Delayed Cord Clamping Increase the Risk of Jaundice? There is a small increase in the likelihood of jaundice requiring phototherapy among term infants who have delayed cord clamping. This does not mean delayed cord clamping should be avoided. Instead, newborns should be monitored for jaundice as part of routine newborn care. Your baby’s healthcare team can check for signs of jaundice and provide treatment if necessary. Are There Situations When Delayed Cord Clamping Is Not Recommended? Delaying cord clamping is recommended for most babies, but it is not appropriate in every situation. Immediate clamping may be necessary if: The decision should be based on the health of both mother and baby rather than simply following a predetermined birth plan. The Royal College of Obstetricians and Gynaecologists’ updated 2026 guidance also emphasizes that clinical judgment is important and that immediate clamping may sometimes be necessary to protect the health of the mother or baby. What About Delayed Cord Clamping With a C-Section? Delayed cord clamping can also be performed during some cesarean births. The logistics are different because of the surgical setting, but the baby may be positioned on the mother’s abdomen or held close to the level of the placenta while the cord remains attached. Whether it is possible depends on the circumstances of the birth and the health of the mother and baby. If delayed cord clamping is important to you, talk with your provider before delivery so you understand how your hospital or birth team handles it during cesarean births. What About Premature Babies? Delayed cord clamping can be especially valuable for premature babies. Preterm infants are more vulnerable to problems with circulation, anemia, and other complications after birth. Research has found several benefits associated with delayed cord clamping in preterm infants, including improved transitional circulation and a reduced need for blood transfusions. Because premature babies may also need immediate medical support, the neonatal and obstetric teams must balance the benefits of waiting with the baby’s condition at birth. Can Delayed Cord Clamping Be Part of a Birth Plan? Absolutely. If you would like delayed cord clamping, discuss it with your midwife or OB/GYN before labor. You can include your preference in your birth plan and ask how the practice handles
Can You Have an Epidural With a Midwife?
Many women who choose midwifery care also choose epidurals, and the two are not mutually exclusive. One of the most common misconceptions about midwives is that they only support unmedicated or “natural” births. In reality, many certified nurse midwives work in hospitals and care for patients who choose a variety of pain management options, including epidurals. If you are considering midwifery care but know you may want pain relief during labor, you may be relieved to learn that choosing a midwife does not mean giving up access to medical pain management. What Is an Epidural? An epidural is a form of pain relief commonly used during labor and delivery. It involves administering medication through a small catheter placed in the lower back by an anesthesiologist or nurse anesthetist. The medication helps reduce pain while allowing many women to remain awake, alert, and actively involved in the birth of their baby. The American College of Obstetricians and Gynecologists (ACOG) answers many questions about pain relief during delivery. Epidurals are one of the most effective forms of labor pain management available. Do Midwives Support Epidurals? Yes. Midwives support informed decision-making, which means helping patients understand their options and choose what feels right for them. A midwife’s goal is not to steer someone toward or away from pain medication. Instead, midwives provide education, answer questions, and support the choices that align with a patient’s needs and birth preferences. Some women enter labor planning to use an epidural. Others hope to avoid medication but decide they would like pain relief during labor. Both experiences are common, and both are supported in many midwifery practices. How Does an Epidural Work in a Midwife-Led Birth? In hospital settings, certified nurse midwives work as part of a larger healthcare team. If a laboring patient requests an epidural, the midwife typically coordinates with: Once the epidural is placed, the midwife continues monitoring labor, supporting the patient, and managing the birth process. The American College of Nurse-Midwives explains the role of certified nurse midwives and collaborative maternity care:https://www.midwife.org Can You Change Your Mind During Labor? Absolutely. Many women create birth plans before labor begins, but labor can be unpredictable. What feels right during pregnancy may feel different in the moment. Some women who initially planned an unmedicated birth decide to request an epidural. Others who expected to use pain medication discover they are comfortable without it. One of the benefits of relationship-based midwifery care is having a provider who supports you as your needs evolve throughout labor. What Other Pain Relief Options Do Midwives Offer? Midwives are often skilled in a variety of comfort measures that can be used before or alongside an epidural. These may include: The goal is to help patients feel as comfortable and supported as possible throughout labor. Does Choosing an Epidural Change Your Birth Experience? Every labor experience is unique. For some women, an epidural allows them to rest, conserve energy, and feel more present during labor. For others, they prefer to experience labor without medication. There is no universally “right” choice. The best birth experience is often the one where a patient feels informed, respected, and supported in her decisions. Are Epidurals Safe? Epidurals have been used for decades and are generally considered safe for most laboring patients. Like any medical procedure, there are potential risks and benefits. Your healthcare provider and anesthesia team can discuss these with you and help determine whether an epidural is appropriate for your situation. Midwifery Care Is About Choice At its core, midwifery care focuses on informed consent, shared decision-making, and personalized support. Choosing a midwife does not mean committing to an unmedicated birth. It means partnering with a healthcare professional who will help you understand your options and support your choices throughout pregnancy, labor, birth, and postpartum recovery. Whether your birth plan includes an epidural, other pain relief methods, or no medication at all, many midwives are committed to helping you have a safe and positive birth experience. Trusted Resources for Expectant Parents If you would like to learn more about labor pain management and midwifery care, these resources offer evidence-based information: Key Takeaways Frequently Asked Questions Do all midwives allow epidurals? Midwives who practice in hospitals commonly care for patients who choose epidurals. Availability may vary depending on the birth setting. Can I choose a midwife if I already know I want an epidural? Yes. Many women choose midwives specifically because they appreciate the personalized care while still planning to use medical pain relief. Who administers the epidural? An epidural is typically administered by an anesthesiologist or another qualified anesthesia provider, not by the midwife. Can I request an epidural after labor starts? Yes. Many women decide whether to use an epidural during labor rather than making a final decision ahead of time. Do midwives only support natural birth? No. Modern midwifery care supports a wide range of birth preferences, including epidurals, inductions, and hospital births. Will my midwife stay involved if I get an epidural? In most hospital-based practices, yes. Your midwife continues monitoring labor, providing support, and managing your care throughout the birth process. ••• This information is not intended to serve as medical advice. For specific questions or concerns about midwifery and epidurals, we recommend you consult with one of our women’s health care specialists. We’re here to help in Tampa, Wesley Chapel and St.Petersburg! 813-258-3309
Pregnancy After 35: What to Expect
Learn what to expect during pregnancy after 35, including fertility changes, prenatal care, screening options, and tips for a healthy pregnancy. Many women are choosing to start or grow their families later in life. Whether you are expecting your first baby at 35 or preparing to welcome another child in your late 30s or early 40s, you are far from alone. While pregnancy after 35 comes with some unique considerations, it is important to remember that many women in this age group experience healthy pregnancies and deliver healthy babies. The key is understanding what to expect, staying informed, and receiving quality prenatal care throughout your pregnancy. Why Is Pregnancy After 35 Considered Different? Healthcare providers often pay closer attention to pregnancies in women who are 35 or older because certain risks become more common with age. You may hear the term “advanced maternal age,” which is the medical term traditionally used for pregnancy at age 35 and older. While the phrase can sound intimidating, it simply means your provider may recommend additional monitoring or screening during pregnancy. The American College of Obstetricians and Gynecologists (ACOG) provides guidance on pregnancy and maternal age: Being over 35 does not automatically mean you will experience complications. It simply means your healthcare team will take a proactive approach to supporting a healthy pregnancy. Fertility May Change With Age One of the biggest differences many women notice is that it may take longer to become pregnant. As women age, both the quantity and quality of eggs naturally decline. Fertility does not disappear at 35, but conception can become more challenging compared to younger years. If you have been trying to conceive for six months without success and are over age 35, it is a good idea to discuss your options with a healthcare provider. Prenatal Care Becomes Even More Important Regular prenatal visits are important during every pregnancy, but they become especially valuable as maternal age increases. Prenatal care helps monitor: Consistent prenatal care allows healthcare providers to identify concerns early and create a plan tailored to your individual needs. Additional Screening Options May Be Offered Women over 35 are often offered additional prenatal screening options because the risk of certain chromosomal conditions increases with maternal age. These may include: These screenings are optional, and your provider can help you decide which tests align with your preferences and goals. Certain Pregnancy Risks Increase With Age While many pregnancies after 35 progress without major complications, some risks become more common. These may include: Having a risk factor does not mean a complication will occur. It simply means your healthcare team may monitor certain aspects of your pregnancy more closely. Your Body May Feel Different Pregnancy can affect every woman differently, regardless of age. However, some women notice: Maintaining a healthy lifestyle, staying active as recommended by your provider, and prioritizing rest can make a meaningful difference. Emotional Considerations Matter, Too Pregnancy after 35 often comes with unique emotional experiences. Some women feel more confident and financially stable than they did in their twenties. Others may experience increased anxiety because they are aware of age-related risks. Both experiences are normal. Open communication with your healthcare provider, partner, family, or support network can help you navigate the emotional side of pregnancy. Healthy Habits Can Support a Healthy Pregnancy There is a lot you can do to support your health and your baby’s development during pregnancy. Healthy habits include: Small, consistent choices can have a positive impact throughout pregnancy. Pregnancy After 35 Can Be a Wonderful Experience Many women find that pregnancy later in life comes with advantages they did not have earlier. You may feel: Every pregnancy journey is unique. Age is only one piece of the picture. With supportive prenatal care and a trusted healthcare team, many women over 35 enjoy healthy pregnancies and positive birth experiences. Trusted Resources for Expectant Parents If you would like to learn more about pregnancy after 35, these trusted resources provide evidence-based information: Key Takeaways Frequently Asked Questions Is pregnancy after 35 considered high risk? Not necessarily. While certain risks increase with age, many women over 35 experience uncomplicated pregnancies. Your provider will evaluate your individual health and pregnancy history. Can I have a healthy baby after 35? Yes. Many women over 35 have healthy pregnancies and healthy babies with appropriate prenatal care and monitoring. Will I need extra testing if I am over 35? Your provider may offer additional screening options, but most testing decisions remain voluntary and based on your preferences. Is it harder to get pregnant after 35? Fertility generally declines with age, so some women may take longer to conceive compared to younger years. Does being over 35 mean I will need a C-section? No. While cesarean delivery rates are somewhat higher among older mothers, many women over 35 have successful vaginal births. When should I talk to a provider about fertility concerns? If you are over 35 and have been trying to conceive for six months without success, it is a good idea to schedule an evaluation with a healthcare provider. ••• This information is intended to be general guidance. If you have questions about pregnancy after age 35, our experienced midwives are here to help in Tampa, Wesley Chapel and St. Petersburg! 813-258-3309
What Causes Severe Morning Sickness?
Many women expect some nausea during pregnancy, especially during the first trimester. But for some women, morning sickness goes far beyond occasional queasiness. Severe nausea and vomiting can make it difficult to eat, drink, work, care for family, or get through daily life. If you are struggling with intense pregnancy-related nausea, you are not alone. Understanding what causes severe morning sickness and when to seek help can make a difficult situation feel a little less overwhelming. What Is Severe Morning Sickness? Morning sickness is a common pregnancy symptom that affects many women during the first trimester. Despite its name, it can happen at any time of day or night. Severe morning sickness is different. Some women experience frequent vomiting, significant weight loss, dehydration, and difficulty keeping food or fluids down. In the most severe cases, this condition is known as hyperemesis gravidarum. According to the American College of Obstetricians and Gynecologists (ACOG), hyperemesis gravidarum is more serious than typical morning sickness and may require medical treatment. What Is Hyperemesis Gravidarum? Hyperemesis gravidarum is the medical term for severe pregnancy-related nausea and vomiting. Symptoms may include: The Hyperemesis Education and Research Foundation provides valuable information and support for affected families. Unlike typical morning sickness, hyperemesis gravidarum can affect both maternal health and pregnancy well being if left untreated. What Causes Severe Morning Sickness? There is no single cause of severe morning sickness. Researchers believe several factors may contribute: Pregnancy Hormones One of the leading theories involves the rapid rise of pregnancy hormones, particularly human chorionic gonadotropin (hCG). Levels of hCG increase quickly during early pregnancy, which closely matches the time when nausea and vomiting often peak. Hormonal changes involving estrogen may also contribute to symptoms. Increased Sensitivity to Pregnancy Changes Some women appear to be more sensitive to hormonal shifts than others. This may explain why one pregnant person experiences mild nausea while another develops severe symptoms. The exact reason for this increased sensitivity is still being studied. Carrying Multiples Women pregnant with twins, triplets, or higher-order multiples often have higher hormone levels than women carrying a single baby. Because of this, severe nausea and vomiting may be more common in multiple pregnancies. A History of Severe Morning Sickness Women who experienced severe morning sickness in a previous pregnancy are more likely to experience it again. There may be genetic and biological factors that influence a person’s risk. Family History Research suggests severe morning sickness may run in families. If your mother, sister, or close relatives experienced hyperemesis gravidarum, your chances of developing it may be higher. Certain Medical Conditions In some cases, underlying health conditions may increase the likelihood of severe nausea and vomiting during pregnancy. These may include: Your healthcare provider can help determine whether additional evaluation is needed. When Does Severe Morning Sickness Start? Symptoms often begin between weeks 4 and 7 of pregnancy. For many women, symptoms peak between weeks 9 and 13 before gradually improving. However, some women experience symptoms throughout much of their pregnancy, and a smaller number continue to experience nausea until delivery. When Should You Contact Your Healthcare Provider? It is important to contact your provider if you experience: Early treatment can help prevent complications and improve quality of life. Treatment Options for Severe Morning Sickness Treatment depends on symptom severity and individual needs. Your provider may recommend: The goal is to keep both mother and baby healthy while reducing symptoms as much as possible. You Are Not Being Dramatic One of the hardest parts of severe morning sickness is that it is often misunderstood. Many women hear comments such as “everybody gets morning sickness” or “just eat crackers.” But severe pregnancy nausea is not simply a mild inconvenience. It can be physically exhausting, emotionally draining, and incredibly isolating. If you are struggling, know that your symptoms are real and deserving of medical attention and support. Key Takeaways Frequently Asked Questions Is severe morning sickness normal? While nausea is common during pregnancy, severe vomiting, dehydration, and weight loss are not considered typical and should be evaluated by a healthcare provider. What causes hyperemesis gravidarum? The exact cause is unknown, but hormones, genetics, and biological factors are believed to contribute. Does severe morning sickness mean something is wrong with the baby? Not necessarily. Many women with severe morning sickness go on to have healthy pregnancies and healthy babies. When should I go to the hospital for morning sickness? Seek medical care if you cannot keep fluids down, become dehydrated, experience significant weight loss, or feel faint or weak. Can severe morning sickness be treated? Yes. Treatment options may include hydration, dietary changes, supplements, medications, and other supportive therapies. How long does severe morning sickness last? Many women improve during the second trimester, but some continue to experience symptoms throughout pregnancy. ••• This information is intended to serve as general guidance. For specific questions or concerns about severe morning sickness, we recommend you consult with one of our women’s health care specialists. We’re here to help! 813-258-3309
Understanding Prenatal Screening and Genetic Testing
Pregnancy comes with a lot of decisions, and one topic that often raises questions is prenatal screening and genetic testing. Many parents hear these terms during early prenatal visits but are not always sure what they mean, why they are offered, or whether they are necessary. The good news is that prenatal screening and genetic testing are tools that can provide valuable information about your pregnancy. Understanding the differences between them can help you make informed choices that feel right for you and your family. What Is Prenatal Screening? Prenatal screening refers to tests that estimate the likelihood that a baby may have certain genetic conditions, chromosomal differences, or birth defects. Screening tests do not provide a diagnosis. Instead, they help identify pregnancies that may benefit from additional evaluation or testing. These tests are commonly offered during pregnancy and are typically performed through blood work, ultrasound examinations, or a combination of both. The American College of Obstetricians and Gynecologists (ACOG) recommends that all pregnant patients be offered information about available prenatal genetic screening and diagnostic testing options. Learning about these choices early can help parents feel more prepared and confident throughout pregnancy. What Is Genetic Testing? Genetic testing, sometimes called diagnostic testing, is different from screening. While screening estimates risk, diagnostic testing can determine with a much higher level of certainty whether a baby has a specific chromosomal or genetic condition. Diagnostic tests are generally offered when: Because diagnostic tests provide more definitive answers, they often involve collecting fetal cells for analysis. Common Prenatal Screening Tests Several screening options may be offered throughout pregnancy. Carrier Screening Carrier screening can be performed before or during pregnancy. It helps determine whether a parent carries a gene for certain inherited conditions. Common conditions screened for include: Being a carrier does not mean a person has the condition. It simply means they may be able to pass the gene to a child. Noninvasive Prenatal Testing (NIPT) Noninvasive prenatal testing analyzes small fragments of fetal DNA found in the mother’s bloodstream. This screening can help assess the likelihood of certain chromosomal conditions, including: Because it only requires a blood sample, NIPT poses no risk to the pregnancy. The Centers for Disease Control and Prevention (CDC) provides additional information about Down syndrome and other chromosomal conditions that may be identified through prenatal screening. First Trimester Screening This screening combines blood work with a specialized ultrasound called a nuchal translucency scan. The results help estimate the risk of certain chromosomal abnormalities and may identify some structural concerns early in pregnancy. Anatomy Ultrasound Typically performed around 18 to 22 weeks, the anatomy scan evaluates fetal growth and development. This ultrasound examines: The anatomy scan can identify many physical differences or birth defects that may require further evaluation. Common Diagnostic Tests Diagnostic testing provides more definitive information than screening tests. Chorionic Villus Sampling (CVS) CVS is usually performed between 10 and 13 weeks of pregnancy. During this procedure, a small sample of placental tissue is collected and analyzed for chromosomal or genetic conditions. Amniocentesis Amniocentesis is generally performed after 15 weeks of pregnancy. A small amount of amniotic fluid is collected and tested for chromosomal differences and certain genetic disorders. For a detailed overview of genetic testing and how results are interpreted, visit the National Library of Medicine’s MedlinePlus genetic testing resource, which explains testing methods, benefits, and limitations in patient-friendly language. Why Some Parents Choose Screening or Testing Every family approaches these decisions differently. Some parents want as much information as possible during pregnancy. Others may prefer limited testing. There is no single right answer. Prenatal screening and testing can help parents: Many families find comfort in having information, while others feel more comfortable limiting testing. Both approaches are valid. Understanding Test Results One of the most important things to remember is that screening tests are not diagnostic. A positive screening result does not mean a baby definitely has a condition. It simply means the chance is higher than average. Similarly, a negative screening result cannot guarantee that a baby has no genetic or developmental conditions. Your healthcare provider or a genetic counselor can help explain results and discuss next steps if additional testing is recommended. The Role of Genetic Counseling Genetic counselors are specially trained professionals who help patients understand: Many families find that meeting with a genetic counselor helps them feel more confident and informed about their decisions. The National Society of Genetic Counselors offers educational resources and a directory to help families find qualified genetic counseling professionals. Making the Choice That’s Right for You Prenatal screening and genetic testing are personal decisions. Some patients choose every available screening option, while others decline testing altogether. The goal is not to pressure parents into any particular choice. Instead, it is to provide information, answer questions, and support informed decision making. Your midwife or healthcare provider can help you understand your options and choose the approach that aligns with your values, goals, and comfort level. Trusted Resources for Expectant Parents If you would like to learn more about prenatal screening, genetic testing, and pregnancy health, these evidence-based resources are excellent places to start: Key Takeaways Frequently Asked Questions What is the difference between screening and diagnostic testing? Screening estimates risk, while diagnostic testing can provide a more definitive answer about whether a baby has a specific condition. Is prenatal genetic testing required? No. Prenatal screening and testing are optional. Your healthcare provider can explain available options so you can make an informed choice. Does a positive screening result mean my baby has a condition? Not necessarily. Screening tests identify increased risk but do not confirm a diagnosis. Additional testing may be recommended. Is NIPT safe during pregnancy? Yes. NIPT is a blood test and does not pose a risk to the pregnancy. Should everyone see a genetic counselor? Not everyone needs genetic counseling, but it can be especially helpful for families with a history of genetic conditions, abnormal screening results, or questions about testing options. Can prenatal
Signs That Labor Is Starting
As your due date approaches, it is natural to wonder whether every cramp, twinge, or trip to the bathroom means labor is beginning. While every pregnancy is different, there are several common signs that your body may be preparing for labor and delivery. Knowing what to watch for can help you feel more confident and prepared as you get closer to meeting your baby. Your Baby Drops Lower One of the earliest signs that labor may be approaching is when your baby moves lower into your pelvis. This is often called “lightening” because you may feel like the pressure on your lungs has eased, making it easier to breathe. At the same time, you may notice: For first-time mothers, this may happen weeks before labor begins. For women who have given birth before, it may happen much closer to labor. You Notice More Braxton Hicks Contractions Braxton Hicks contractions are often called practice contractions. As labor approaches, they may become stronger, more frequent, and more noticeable. Unlike true labor contractions, Braxton Hicks contractions typically: The American College of Obstetricians and Gynecologists (ACOG) provides helpful guidance on distinguishing false labor from true labor. Your Cervix Begins to Change Before labor begins, the cervix starts preparing for delivery through a process called effacement and dilation. Effacement means the cervix becomes thinner, while dilation refers to the opening of the cervix. These changes can happen gradually over days or even weeks before active labor begins. Your healthcare provider may check for cervical changes during late pregnancy visits, although cervical dilation alone does not always predict when labor will start. You Lose Your Mucus Plug The mucus plug helps seal and protect the cervix during pregnancy. As the cervix begins to soften and open, the mucus plug may be released. It may appear: This is sometimes called a “bloody show.” Losing the mucus plug can mean labor is approaching, but it does not necessarily mean labor will begin immediately. Some women go into labor within hours, while others may still have days or weeks remaining. Your Water Breaks One of the most well-known signs of labor is when the amniotic sac ruptures, commonly referred to as your water breaking. Despite what movies often portray, this is not always a dramatic gush of fluid. For many women, it may feel like a slow trickle or constant leaking. If you believe your water has broken, contact your healthcare provider promptly. The March of Dimes recommends notifying your provider even if contractions have not yet started. You Experience Diarrhea or Digestive Changes Hormonal changes before labor can affect the digestive system. Some women notice: While not everyone experiences these symptoms, they can be part of the body’s natural preparation for labor. Nesting Energy Kicks In Many expectant mothers report a sudden burst of energy shortly before labor begins. This phenomenon is often called nesting. You may find yourself wanting to: While nesting can occur at any point in pregnancy, some women notice a stronger urge in the days leading up to labor. True Labor Contractions Begin The clearest sign that labor is starting is the onset of regular contractions that continue to intensify. True labor contractions: Many providers recommend following the 5-1-1 rule: Ask your healthcare provider whether they recommend a different guideline based on your individual pregnancy. When Should You Call Your Provider? Contact your healthcare provider if: The CDC’s Hear Her campaign also encourages pregnant and postpartum women to seek medical attention if something feels unusual or concerning. Every Labor Story Is Different One of the most important things to remember is that labor does not look exactly the same for everyone. Some women experience every classic sign, while others move into labor with very little warning. Trust your instincts, stay in communication with your healthcare provider, and remember that no question is too small when it comes to the health and safety of you and your baby. Key Takeaways Frequently Asked Questions How do I know if labor is really starting? True labor contractions become stronger, longer, and closer together over time. They typically continue regardless of movement, hydration, or rest. Can you be in labor without your water breaking? Yes. Many women begin labor with contractions before their water breaks. How long after losing the mucus plug does labor start? There is no set timeline. Labor may begin within hours, days, or even weeks after losing the mucus plug. Is diarrhea a sign that labor is near? It can be. Some women experience digestive changes due to hormonal shifts before labor begins. When should I go to the hospital? Follow your provider’s instructions. Many recommend coming in when contractions follow the 5-1-1 rule, but individual recommendations may vary. What if I am unsure whether I am in labor? Call your healthcare provider. They can help you determine whether your symptoms suggest labor and advise you on the next steps. ••• This is intended to be general guidance. If you are concerned that you may be starting labor, please call your provider or your Women’s Health Care midwife. 813-258-3309
Are Midwives Only for Natural Birth?
One of the biggest misconceptions about midwives is that they only support unmedicated or “natural” birth. While many midwives are experienced in helping women through labor without medication, that is only part of what they do. Modern midwifery care is about supporting women through pregnancy, birth, postpartum recovery, and gynecologic care while respecting each patient’s individual preferences and medical needs. For some women, that means an unmedicated birth. For others, it means an epidural, induction, or even a cesarean delivery. Midwives are there to provide guidance, education, and safe care regardless of the type of birth a patient chooses. Midwives Support Many Types of Birth Experiences Midwives care for women with a wide range of birth plans and comfort levels. Some patients want minimal intervention, while others know from the beginning that they want pain medication during labor. A midwife’s role is not to judge those choices. Instead, midwives help patients understand their options and make informed decisions. Many certified nurse midwives practice in hospitals where patients have access to: The American College of Nurse-Midwives explains that certified nurse midwives are trained healthcare professionals who provide comprehensive maternity and gynecologic care. Can You Get an Epidural With a Midwife? Yes. Many women who choose midwives also choose epidurals. In hospital settings, certified nurse midwives work alongside anesthesiologists, nurses, and obstetricians. If a patient decides she wants pain relief during labor, the midwife can help coordinate that care. Some women begin labor hoping to avoid medication and later decide they want an epidural. Others plan for one from the start. Both choices are valid. Midwifery care is meant to support the patient, not pressure her into a specific birth experience. Midwives Work in Hospitals Too Another common myth is that midwives only attend home births or birth center deliveries. In reality, many midwives practice in hospitals and deliver babies in traditional labor and delivery units. Hospital-based midwives can provide a blend of personalized support and access to medical resources if complications arise. According to the American College of Obstetricians and Gynecologists, collaborative care between midwives and physicians can help provide safe and effective maternity care for many patients. What Happens If Complications Arise? Midwives are trained to recognize when additional medical support is needed. If labor becomes complicated or a cesarean delivery becomes necessary, midwives work closely with obstetricians and hospital teams. Patient safety is always the priority. Depending on the practice and hospital, the midwife may remain involved throughout labor, surgery preparation, and postpartum care even if another physician performs the cesarean delivery. Midwifery Care Is About Personalized Care The heart of midwifery care is not “natural birth.” It is relationship-based care and patient-centered decision making. Midwives often spend more time with patients during appointments discussing: Many women appreciate having a provider who listens carefully and treats them like an active participant in their healthcare. Midwives Provide More Than Pregnancy Care Certified nurse midwives do much more than deliver babies. Many provide full women’s healthcare services, including: The World Health Organization has recognized the important role midwives play in improving maternal and newborn health worldwide. Why Some Women Prefer Midwives Women choose midwives for many different reasons, including: For some patients, the experience feels less rushed and more relationship-driven. Choosing the Right Provider for You Every pregnancy and every patient is different. Some women feel most comfortable with an obstetrician, while others prefer midwifery care. Some practices even combine both approaches. The most important thing is finding a provider who makes you feel informed, respected, and supported. Key Takeaways Frequently Asked Questions Do midwives only deliver babies without pain medication? No. Many patients under midwife care choose epidurals or other forms of pain relief during labor. Can midwives work in hospitals? Yes. Many certified nurse midwives practice in hospitals and deliver babies in labor and delivery units. What happens if I need a C-section? If a cesarean delivery becomes necessary, midwives work with obstetricians and hospital staff to ensure safe care. Can midwives induce labor? Depending on the practice setting and hospital privileges, many midwives can manage or participate in labor inductions. Are midwives qualified medical professionals? Yes. Certified nurse midwives are licensed healthcare providers with advanced medical training in pregnancy, birth, postpartum, and gynecologic care. Can I switch from an OB/GYN to a midwife during pregnancy? In many cases, yes. Patients often transfer care during pregnancy if they decide a midwifery approach better fits their goals and needs. ••• This information is not intended to serve as medical advice. For specific questions or concerns about midwifery or natural births, we recommend you consult with one of our women’s health care specialists. We’re here to help in Tampa, Wesley Chapel and St.Petersburg! 813-258-3309
Signs of Postpartum Depression and Anxiety
Having a baby can bring a mix of emotions that no one fully prepares you for. Joy, exhaustion, overwhelm, love, and worry can all show up at the same time. But when sadness, fear, or anxiety start to feel constant or heavy, it may be more than just “new mom stress.” Postpartum depression and postpartum anxiety are real medical conditions. They are common, treatable, and nothing to feel ashamed about. Knowing the signs early can make a big difference in getting support. What Is Postpartum Depression? Postpartum depression is a mood disorder that can happen after childbirth. It is more intense and longer lasting than the “baby blues,” which usually pass within two weeks. According to the Postpartum Depression, symptoms can start within days after birth or develop gradually in the first year. Common Signs of Postpartum Depression Postpartum depression can look different for everyone, but some common signs include: Some mothers describe it as feeling like they are going through the motions but not really present in their own lives. What Is Postpartum Anxiety? Postpartum anxiety is less talked about, but just as real and just as common. It often involves constant worry, racing thoughts, and physical tension. The Postpartum Anxiety can occur on its own or alongside postpartum depression. Common Signs of Postpartum Anxiety Signs may include: Many mothers say it feels like their brain “won’t shut off.” When Baby Blues Turn Into Something More The “baby blues” are common in the first couple of weeks after delivery. They can include mood swings, crying spells, and irritability. But if symptoms: …then it may be time to talk to a healthcare provider. Risk Factors That May Increase the Chance Postpartum depression and anxiety can happen to anyone, but certain factors may increase risk: None of these mean someone will develop postpartum mood disorders, but they can make symptoms more likely. Why It Happens There is no single cause. Postpartum depression and anxiety are usually the result of a combination of factors: It’s important to remember that is NOT caused by something a mother did or did not do. When to Seek Help It is important to reach out if symptoms feel overwhelming or persistent. Early support can make recovery much easier. You can start with: You can also learn more through trusted resources like the Postpartum Support International, which offers support groups, education, and helplines. If you are ever having thoughts of harming yourself or your baby, seek immediate help by calling emergency services or going to the nearest emergency room. Treatment Options Postpartum depression and anxiety are very treatable. Options may include: Many women improve significantly with the right combination of support. How Partners and Family Can Help Support makes a big difference. Loved ones can help by: Sometimes the most helpful thing is simply saying, “You are not alone in this.” Key Takeaways Frequently Asked Questions How long after birth can postpartum depression start? It can begin within days after delivery or develop gradually in the first year postpartum. Can postpartum anxiety happen without depression? Yes. Some mothers experience anxiety without depression, though they can also occur together. Is postpartum depression my fault? No. It is a medical condition influenced by hormonal, emotional, and physical changes after birth. How do I know if I need help? If symptoms last more than two weeks, feel overwhelming, or interfere with daily life, it is important to talk to a provider. Can postpartum depression go away on its own? Some mild cases improve with time, but many require treatment and support for full recovery. If something about your mood or anxiety after birth does not feel right, it is worth speaking up. You do not have to push through it alone, and help is available. ••• This is intended to be general guidance. If you have any questions or concerns about postpartum depression and anxiety or your gynecological health, please consult with one of our highly qualified nurse midwives or nurse practitioners at Women’s Health Care of Tampa. Make your appointment today at our Tampa, St. Petersburg or Wesley Chapel locations. 813-258-3309
Why Many Women Choose Midwives for Their Second Baby
For many mothers, the first birth experience teaches them a lot about what matters most during pregnancy and labor. By the time a second baby comes along, many women have a clearer picture of the kind of care they want. That is one reason why more mothers are choosing midwives for their second pregnancy. Midwives provide comprehensive prenatal, birth, and postpartum care, often with a strong focus on education, shared decision making, and personal support. For women who want a different experience the second time around, midwifery care can feel like a better fit. Here are some of the most common reasons mothers choose a midwife for their second baby. A Desire for More Personalized Care Many women say their first pregnancy felt rushed. Short appointments and limited time to ask questions can leave patients feeling like just another chart on the schedule. Midwives are known for spending more time with their patients. Prenatal visits are often longer, allowing time to talk about nutrition, emotional well-being, birth preferences, and concerns. This approach can help women feel heard and supported. For mothers who already understand the basics of pregnancy, these conversations often focus on what matters most to them personally. Research from the American College of Nurse-Midwives highlights that midwifery care often emphasizes relationship-based care and shared decision making. A Different Birth Experience Some women turn to midwives after a first birth that involved more interventions than expected. Others simply want a more hands-on support system during labor. Midwives are trained to manage normal pregnancies and births while closely monitoring mother and baby. Their approach often prioritizes patience, movement during labor, and non-medication comfort techniques. That does not mean medical options are off the table. Many midwives practice in hospitals and work alongside physicians if complications arise. According to research summarized by the World Health Organization, midwife-led care has been associated with lower rates of certain interventions while maintaining strong safety outcomes for healthy pregnancies. More Confidence the Second Time Around First-time mothers often enter pregnancy with a lot of unknowns. By the time a second baby is on the way, many women feel more confident in their bodies and their instincts. This confidence can make the midwifery model of care especially appealing. Midwives often encourage mothers to trust their bodies and participate actively in decisions about their care. For women who want a collaborative approach rather than a highly structured medical experience, midwifery care can feel empowering. Support for Vaginal Birth After Cesarean (VBAC) Another common reason women choose midwives for a second pregnancy is interest in vaginal birth after a previous cesarean. Many midwives are experienced in supporting women who hope for a vaginal birth after cesarean when it is medically appropriate. They often spend time discussing risks, benefits, and individual circumstances so patients can make informed decisions. Guidelines from the American College of Obstetricians and Gynecologists support offering VBAC as a safe option for many women with a prior cesarean delivery. A Focus on the Whole Person Midwives often take a holistic view of health. That means looking beyond physical symptoms and considering emotional well-being, family support, stress levels, and lifestyle. For mothers balancing work, parenting, and pregnancy, this approach can feel especially valuable. Instead of focusing only on medical checklists, appointments often include conversations about sleep, nutrition, mental health, and preparation for life with two children. Continuity of Care Many women appreciate seeing the same provider throughout pregnancy and birth. Continuity of care can help build trust and make the experience feel more personal. Knowing the provider who will be present during labor can ease anxiety and help mothers feel more comfortable when the big day arrives. A Balanced Approach to Birth Choosing a midwife does not mean rejecting medical care. Many midwives practice in hospitals and work closely with obstetricians when needed. The goal is to support normal pregnancy and birth while ensuring quick access to medical care if complications arise. For many families, this balance of personal attention and medical collaboration offers the best of both worlds. Key Takeaways Frequently Asked Questions Are midwives only for natural births? No. While many midwives support natural birth techniques, patients can still choose pain relief options such as epidurals in hospital settings. Is midwife care safe for second pregnancies? For healthy pregnancies, research shows midwife-led care has strong safety outcomes. Midwives are trained to monitor for complications and refer to physicians when necessary. Can midwives provide regular gynecologic care too? Yes. Certified nurse midwives provide a wide range of women’s healthcare services including annual exams, Pap smears, contraception counseling, and menopause care. Can you switch to a midwife for your second pregnancy? In many cases, yes. Women often switch providers between pregnancies if they want a different approach to prenatal care or labor support. Do midwives work in hospitals? Many do. Certified nurse midwives frequently practice in hospitals, birth centers, and medical clinics, depending on the practice setting. If you are considering your options for a second pregnancy, talking with a midwife can help you learn whether their approach aligns with your goals for birth and women’s healthcare. ••• This information is not intended to serve as medical advice. For specific questions or concerns about midwifery, we recommend you consult with one of our women’s health care specialists. 813-258-3309
Non-Hormonal Birth Control Options
Not everyone wants to use hormonal birth control. Some people prefer to avoid synthetic hormones because of side effects, medical history, breastfeeding, personal values, or simply wanting a more natural approach. The good news is that there are several effective non-hormonal birth control options available. If you are looking for reliable pregnancy prevention without hormones, understanding how each method works can help you choose the right fit for your body and lifestyle. Why Choose Non-Hormonal Birth Control? Hormonal birth control methods such as pills, patches, injections, and hormonal IUDs work by altering your body’s natural hormone levels. While they are safe and effective for many, some people experience side effects like mood changes, headaches, breast tenderness, or changes in libido. Others may have medical conditions that make estrogen-containing contraception less appropriate. The Centers for Disease Control and Prevention outlines medical eligibility guidelines for contraception. For those seeking alternatives, non-hormonal options provide pregnancy prevention without altering natural hormone cycles. Copper IUD The copper intrauterine device, often known by the brand name Paragard, is one of the most effective non-hormonal birth control methods available. It is a small T-shaped device placed inside the uterus by a healthcare provider. The copper creates an environment that is toxic to sperm, preventing fertilization. According to the American College of Obstetricians and Gynecologists, copper IUDs are more than 99 percent effective and can last up to 10 years. Because it does not contain hormones, your natural cycle continues. Some women may experience heavier periods or stronger cramps, especially in the first few months. Condoms Male and female condoms are widely available and protect against both pregnancy and sexually transmitted infections. When used correctly every time, condoms are highly effective. The CDC provides detailed guidance on correct condom use here. Condoms are a good choice for those who want flexibility, STI protection, or a non-prescription option. Diaphragm and Cervical Cap A diaphragm or cervical cap is a reusable barrier device placed inside the vagina to cover the cervix before intercourse. These methods are typically used with spermicide to increase effectiveness. They require fitting by a healthcare provider and must be inserted before sex and left in place for several hours afterward. Fertility Awareness Methods Fertility awareness involves tracking your menstrual cycle to identify fertile days and avoiding intercourse or using barrier protection during that time. This method requires consistent cycle tracking and a good understanding of ovulation patterns. The Office on Women’s Health explains fertility awareness methods. When practiced correctly, fertility awareness can be effective, but it requires commitment and regular monitoring. Withdrawal Method The withdrawal method involves removing the penis before ejaculation. While it is widely used, it is less effective than other methods because pre-ejaculate fluid may contain sperm and timing must be precise. It is often used in combination with other methods for additional protection. Permanent Non-Hormonal Options For individuals who are certain they do not want future pregnancies, permanent contraception is an option. Tubal ligation blocks or seals the fallopian tubes. Vasectomy, performed on a male partner, blocks sperm from being released. Both procedures are highly effective. The Mayo Clinic offers an overview of tubal ligation here. Choosing the Right Option for You If you live in Florida, OB GYNs and midwives across the state offer counseling on non-hormonal birth control. Choosing the best method depends on your health history, lifestyle, comfort level, and long-term family planning goals. Shared decision-making with a provider helps ensure you feel confident in your choice. Key Takeaways Frequently Asked Questions Is non-hormonal birth control effective?Yes. Copper IUDs are among the most effective birth control methods available. Barrier and fertility awareness methods vary in effectiveness depending on consistent and correct use. Does the copper IUD affect your hormones?No. The copper IUD does not release hormones and does not alter your natural cycle. Can I use non-hormonal birth control while breastfeeding?Yes. Many non-hormonal methods, including copper IUDs and condoms, are safe during breastfeeding. Do non-hormonal methods protect against STIs?Only condoms provide protection against sexually transmitted infections. How do I know which method is right for me?A consultation with a healthcare provider can help you compare effectiveness, convenience, side effects, and long-term goals. If you would like, I can also create a comparison chart article or a Florida-specific version optimized for a particular city or practice. ••• This is intended to be general guidance. If you have any questions or concerns about non-hormonal birth control or your gynecological health, please consult with one of our highly qualified nurse midwives or nurse practitioners at Women’s Health Care of Tampa. Make your appointment today at our Tampa, St. Petersburg or Wesley Chapel locations. 813-258-3309