Nonintervention in normal processes and promoting self-determination are both important aspects of midwifery philosophy and care; midwives are sometimes faced with situations in which these actually or potentially conflict. An example of this is epidural anesthesia, when the normal process of labor and birth may be affected by the woman's choices. This article focuses on an approach to this conflict that is essential to midwifery but often overlooked: the importance of trusting women to know what is best for themselves. The concept of trust in midwifery care is explored in depth, as a context from which to provide care, promote normal processes, ensure informed decision-making, empower women no matter what choices they make, and, when the woman's choice and midwife's philosophy differ, as a bridge from which to provide effective midwifery care.