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