الفهرس 
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Abstract
The aim of the current study was to evaluate the effect of spontaneous versus valsalva pushing technique on maternal and neonatal outcomes during second stage of labor (comparative study). The setting: This study was conducted at the labor room of the University hospital and Shebin Elkom teaching hospital. The sample size of this study was Ninety primiparous and multiparous women and their babies were selected randomly after fulfilling the including criteria of the sample. They were divided into two equal groups, first group (Case group) was delivered with spontaneous pushing technique, and second group (control group) was delivered with valsalva pushing technique. Tools of this study included a structured interviewing questionnaire, partogram, and Apgar score. The findings revealed that there was a statistically significant difference between the two groups (case & control) regarding the satisfaction to pushing techniques, duration of the second stage of labor, perineal condition and fetal outcomes. It is concluded that the spontaneous pushing technique during the second stage of labor has more positive impact on maternal and fetal outcomes than valsalva pushing technique. Recommendation of the study includes: Teaching pregnant women about the spontaneous pushing technique and giving them enough time for training on this technique during pregnancy to help them apply this technique effectively during labor
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