Our understanding of birth physiology is based on the simple fact that adrenaline (the emergency hormone mammals release when they are scared, when they are cold or when they feel observed) and oxytocin are antagonistic. In other words, when human beings release adrenaline, they cannot release oxytocin.

This indicates the main role of the midwife: to protect the laboring woman against any situation associated with a rising level of adrenaline. This is an art because it involves the personality, the way of being, the background, the experience and the intuition of the birth attendant. Since adrenaline release is highly contagious, one of the main preoccupations of the birth attendant is maintaining her own level of adrenaline as low as possible. Midwives often use tricks to keep their stress levels low. One of these is to engage in a repetitive task, such as knitting.

Avoiding useless stimulation of the maternal neocortex, which is the source of powerful inhibitions, is a real art. Remaining silent when verbal language is not absolutely necessary is an art. Escaping notice while, at the same time, being able to detect whether something is wrong is an art. Adapting to every particular case and to every particular situation is also an art.

— Michel Odent, excerpted from "Can the Art of Midwifery Survive Protocols?" Midwifery Today Issue 73