RESUMO
The second stage of labor has provided debates concerning when maternal pushing efforts should begin and how long they should last for, in order to safeguard maternal and neonatal wellbeing. Therefore, the aim of study was to contrast the effect of two pushing techniques [Valsalva's Maneuver and Spontaneous Pushing] during the Second Stage of Labor on maternal and neonatal conditions as well as the progress of labor in Nulliparous Women. The study was conducted at El- Shatby Maternity University Hospital throughout a period of three months, using a cross-sectional analytical design on purposeful sample of [60] women was further subdivided randomly into two groups, a study group were Valsalva's Maneuver was applied for them and a control group were Spontaneous Pushing is redemonstrated by them. Data were collected through an assessment sheet covering socio-demographic and obstetric characteristics of women enrolled in the study sample plus the examination of women during labor. An observation form for birth outcomes was also used for evaluation of the effect of the two selected pushing techniques on maternal condition such as, [degree of perineal tearing, and blood loss more than 500 mL]. neonatal condition was evaluated through items including, [Apgar scores at I and 5 mm]. As well as progress of labor based on length of the second stage of labor. The main study findings showed that, there was a statistically significant differences between the Valsalva and Spontaneous Pushing groups in relation to incidence of extended episiotomy with tears, Apgar scoring at first minute and length of second stage ad expulsions phase of labor with positive results to the spontaneous pushing group. No statistical significant difference was found regarding incidence of post-partum hemorrahg and Apgar scoring at fifth minute. Moreover, the study concluded that, Spontaneous Pushing efforts are accompanied by adequate labor progress and result in less perineal trauma. In the light of the study results, it is recommended that further examination of the common practice of encouraging women to bear down spontaneously during the second stage, responding to their involuntary urge, is recommended