The purpose of this study is to determine if spontaneous pushing during the second stage of labor produces better maternal outcomes than the more commonly used directed Valsalva pushing. A literature review of the recent studies has been performed to determine if Valsalva pushing is simply archaic or absolutely necessary for healthier mother/baby outcomes. To recommend that women go against their primal urges to push in the manner that their own bodies are directing them, indicates that there must be research-based evidence to intervene in the natural order of things and use Valsalva pushing instead. When in fact, there are several study results proving that women using spontaneous pushing experienced less pain, fatigue, and appreciated an overall more positive experience over directed Valsalva pushing. Another study revealed decreased bladder capacity and problems with the first urge to void three months postpartum after use of the Valsalva pushing technique. The only current evidence to support directed Valsalva pushing is due to a shorter second stage of labor, although, despite the shorter duration, the maternal and fetal outcomes were the same using both techniques. At this point in time there does not seem to be enough research-based evidence to recommend one pushing technique over the other, therefore the only recommendation should be to allow birthing mothers to push naturally and spontaneously, when their bodies instinctively tell them it is time to push
