Anecdotally, use of the Valsalva technique
appears to have become widespread in modern
midwifery and obstetric practice (Royal College
of Midwives (RCM), 2007; Hanson, 2009; Cooke,
2010) despite a lack of evidence to support its
routine use. There is, however, very little published
research into the practices undertaken by midwives
during the second stage of labour, so evidence
around how often Valsalva is recommended in
modern midwifery care is lacking.