Effect of Spontaneous Open-glottis versus Valsalva Closed-glottis Pushing during Second Stage of Labour on Pelvic Floor Morbidity and Fatigue

Document Type : Original Article


1 Assist. Professor of Obstetrics & Gynecological Nursing, Faculty of nursing, Benha University, Egypt

2 Lecturer of Maternity and newborn health nursing, Faculty of nursing, Helwan University, Egypt


Background: Maternal pushing techniques during the second stage of labor may affect women's pelvic floor function. The aim of this research was to evaluate the effect of spontaneous open-glottis versus Valsalva closed-glottis pushing during second stage of labour on pelvic floor morbidity and fatigue. Design: A quasi-experimental design (Comparative study) (two groups "control/study" Post-test only). Setting: The research was conducted in obstetrics and gynecological emergency department (labour unit) at Benha University hospitals in Qaliubya governorate, Egypt. Sample: A purposive sample of 180 primipara women who admitted to the previous setting for a period of six months, Valsalva pushing technique group (n=90) and Spontaneous pushing technique group (n=90). Data collection tools: Four tools were used to collect data: A structured interviewing questionnaire (Personal characteristics of studied women and Current labor and delivery outcomes sheet), Pelvic Floor Morbidity Questionnaires (Fecal Incontinence Severity Index, Pelvic Floor Distress Inventory Questionnaire- Short Form 20 (PFDI-20) and Pelvic Floor Impact Questionnaire-short form 7 (PFIQ-7)), Modified Fatigue Impact Scale (MFIS) and Women's Satisfaction Questionnaire. Results: There was a statistically significant difference between both spontaneous open-glottis pushing and Valsalva closed-glottis pushing groups regarding the current labor and delivery outcomes. Moreover, there was a highly statistically significant differences between spontaneous open-glottis pushing and Valsalva closed-glottis pushing groups in relation to duration of second stage of labor, the total mean scores of pelvic floor morbidity questionnaires, postpartum fatigue impact and women's satisfaction; in favor of spontaneous pushing group. Conclusion: Spontaneous open-glottis pushing during the second stage of labor had positive desirable effect on current labor and delivery outcomes, pelvic floor morbidity, postpartum fatigue impact and women's satisfaction. Recommendation: Researchers recommended that until further research is forthcoming, women should be encouraged to follow their own instinctive urge to push (spontaneous pushing).