Using the Valsalva technique during the second stage of labour

Abstract

The Valsalva technique for directed pushing during the second stage of labour is an intervention still used by some health care practitioners in the UK, despite evidence suggesting that this is not the best approach to intrapartum care. Current research in this area is limited, with ambiguous findings. The latest National Institute for Health and Care Excellence ( NICE, 2014 ) guidelines recommend that until further research is forthcoming, women should be guided by their own instinctive urge to push during the second stage and directed pushing should not be used as part of routine intrapartum care. Midwives are encouraged to ensure that women are fully informed of the latest evidence, and use their professional judgement in conjunction with the woman's individual needs and preferences while undertaking care during the second stage of labour.