into your bottom… Count to ten… quick
breathe in and push again…’
As Perez-Botella and Downe (2006) highlight,
it is unclear how the Valsalva technique became
associated with women in childbirth. It has been
suggested that a possible reason for its use was the
perception that directed pushing led to a shorter
second stage of labour (Bosomworth and BettanySaltikov, 2006). A prolonged second stage (longer
than 2–3 hours) was considered particularly
hazardous for the fetus, leading to increased
perinatal mortality and morbidity (Rossi and
Lindell, 1986). Early studies on the use of Valsalva
pushing did appear to indicate that it led to a
shorter second stage (e.g. Barnett and Humenick,
1982) and so it was considered the safest way to
manage the second stage of labour.