Are there any benefits of using the Valsalva manoeuvre during the second stage of labour?

During the second stage of labour, many midwives working in busy maternity units arbitrarily direct women on how to push. This usually occurs with involuntary uterine contractions, but also when the woman may not feel contractions due to epidural anaesthesia. Women are often instructed by midwives to engage the Valsalva manoeuvre, which involves the woman straining abdominal muscles and controlling and holding the breath, closing the glottis, while pushing through a contraction.

The aim of this discussion paper is to explore whether there are any benefits to using the Valsalva manoeuvre during the second stage of labour.