The Valsalva maneuver duration during labor expulsive stage: repercussions on the maternal and neonatal birth condition

Do maternal pushing techniques during labour affect obstetric or neonatal outcomes?

“…Questions have been raised about Valsalva-type pushing for many years. The exertion of pushing may increase intrathoracic and intra-abdominal pressure and thus lead to maternal haemodynamic modifications, including a drop in venous return followed by reduced oxygenation of the maternal blood and therefore also of the uterus, placenta, and fetus [19,20]. Fetal cerebral oxygenation then drops, while cerebral blood volume increases [21].…”

“…It is important to bear in mind that epidural analgesia may attenuate the physiological augmentation of oxytocin that takes place during the second stage of labour and therefore the reflex of spontaneous pushing [31]. Moreover, an older study reported that women who push spontaneously do not start until intrauterine pressure reaches at least 30 mm Hg [19]. Pushing therefore does not occur simultaneously with the beginning of a contraction.…”

Birthing outcomes from an Australian HypnoBirthing programme

“…This creates a disruption of the blood flow to the uterus-and ultimately to the baby-resulting in fetal distress. This technique also results in altered body fluid pH which contributes to inefficient uterine contractions (Lemos et al, 2011;Brown, 1999). Bloom et al (2006) found that the Valsalva method was of little use to women in labour.…”

Traditionally vs sonographically coached pushing in second stage of labor: a pilot randomized controlled trial

“…The effect of different pushing techniques in the active second stage of labor and the role of coached maternal pushing have been the subject of many studies in recent years [1][2][3][4][5][6][7][8][9] . At present, there is no evidence to support one specific method over others, and the decision as to which method to adopt depends on the preferences of the caregiver and patient 5 .…”