Epilepsy is the most common neurological disorder in women of reproductive age. Phenytoin is one of the most frequently prescribed antiepileptic drugs. Although the vast majority of women with epilepsy have normal pregnancy outcomes, certain fetal anomalies and pregnancy complications are associated with epilepsy and phenytoin use. Appropriate midwifery care of women with epilepsy includes consultation and co-management with an obstetrician and a neurologist. The clinical course of a woman with epilepsy taking phenytoin is presented.