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
Debunking Common Myths About VBAC
Vaginal birth after cesarean (VBAC) has become a safe and empowering option for many families. Yet, misinformation often prevents people from considering it. Understanding the facts can help you make an informed decision about your birth experience. Whether you’re in Tampa Bay or elsewhere, knowing what’s true—and what’s not—about VBAC can help you plan with confidence. Myth 1: “VBAC is too risky.” One of the biggest myths about VBAC is that it’s inherently dangerous. The truth is that for most people, VBAC is a safe and reasonable option. According to the American College of Obstetricians and Gynecologists (ACOG), VBAC success rates are between 60% and 80% for individuals who meet certain criteria. While there is a small risk of uterine rupture, it occurs in less than 1% of cases. Choosing a facility equipped for emergency care and working with experienced providers further reduces this risk. Myth 2: “Once a C-section, always a C-section.” This outdated saying has been proven false. Most people with one prior cesarean and a low transverse incision are good candidates for VBAC. Even those with two prior cesareans may still qualify under specific conditions. Your provider can review your surgical records and overall health to determine your individual eligibility. The National Institutes of Health (NIH) supports offering VBAC as a safe and appropriate choice for most people with previous cesareans. Myth 3: “VBAC isn’t available at most hospitals.” While some hospitals have restrictions, many Tampa Bay hospitals and birth centers now support VBACs. Florida’s growing midwifery community and supportive providers have expanded access to VBAC-friendly facilities across the state. If your current provider or hospital doesn’t offer VBAC, you can seek care at a VBAC-supportive practice or birth center. The International Cesarean Awareness Network (ICAN) offers resources and local chapter listings that can help you find supportive providers in your area. Myth 4: “VBAC recovery is harder than a repeat C-section.” Recovery after a VBAC is often faster and less painful than recovery from a surgical birth. Vaginal birth generally results in shorter hospital stays, lower infection risk, and faster return to normal activities. However, every person’s recovery is unique, and your provider can help you prepare for either outcome. Myth 5: “I can’t plan a VBAC—it’s too unpredictable.” VBACs can be carefully planned with your healthcare team. You’ll discuss your birth preferences, safety measures, and what to expect if a cesarean becomes necessary. Working with a midwife or doula who has VBAC experience can also provide emotional support and advocacy during labor. The Florida Perspective In Florida, where maternity care options vary by county, patients have increasing access to VBAC-supportive facilities and providers. Many hospitals in cities like Tampa and Wesley Chapel now welcome VBAC births, and community birth centers continue to expand access to safe, personalized care. Choosing a provider who believes in shared decision-making and informed consent is key to having a positive VBAC experience. Key Takeaways Frequently Asked Questions Is VBAC safer than a repeat C-section?For most people, yes. VBAC avoids surgical risks such as infection, bleeding, and longer recovery time, while maintaining a very low risk of complications like uterine rupture. Can I have a VBAC after two C-sections?Possibly. Many providers in Florida consider VBAC after two cesareans if both used low transverse incisions and there are no other risk factors. How can I find a VBAC-supportive provider in Florida?You can check the ICAN Provider Directory or ask local midwifery practices about their VBAC experience. What if my hospital doesn’t allow VBAC?You can request a referral to another facility or discuss your options for out-of-hospital birth with a licensed midwife, as allowed by Florida law. ••• This information is not intended to serve as medical advice. For questions or concerns about pursuing a VBAC, we recommend you speak with one of our women’s health care specialists. 813-258-3309