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Is it safe for pregnant women to do the Valsalva Maneuver?




I am Julia Rosenthal. I am the owner and founder of Empower Physical Therapy and I am so excited to welcome you to the first ever Empower Physical Therapy vlog. We're going to be creating short episodes that are answering questions that we get from our clients.


Our hope is that you can use this information yourself if you're having any of these symptoms.


If you watch one of these and there's a question you really want us to answer, please send it. We would love to get feedback from all of you about what you would want us to be talking about so that we can answer your questions directly.


Our first episode and question is, “Is it safe for pregnant women to do the Valsalva Maneuver”? If you don't know what the Valsalva Maneuver is, it is a strategy of breathing where you fill up with air really big and then you hold your breath. It helps to create tension and stiffness in your trunk.  


For example, if you're going to do a heavy squat you will need to create a lot of stiffness in the trunk. The Valsalva maneuver can help you create that stiffness with your core musculature so that your spine and other parts of your body that are going through the movements have good stability.


One of the reasons women are told not to practice the Valsalva Maneuver is that some people have had concerns about a decrease in oxygenation of the placental blood flow. There have been a couple of studies that have tried to refute that, but it's a difficult thing to refute. The reality is, that the amount of time that people spend straining when they feel constipated or holding their breath for different reasons that come up in regular day-to-day life is usually longer than the couple of seconds that it takes to perform a heavy lift. 


So there's no evidence that there is a risk in terms of oxygenation of the placental blood flow. And not only that, there is actually not a specific recommendation from ACOG, which is the governing body of gynecologists, that specifically recommends against the Valsalva maneuver during pregnancy. 


This recommendation is actually coming out of a place of caution rather than any actual evidence that it would be harmful to the fetus. The other reason that people counsel against a Valsalva maneuver during pregnancy is that they're worried that it might have negative impacts on the pelvic floors of the people doing the Valsalva Maneuver or lifting the heavy weights. 


People also counsel against lifting heavy weights during pregnancy. (Spoiler alert, I'm pro heavy weights during pregnancy as long as it's feeling good.) There is some concern among some providers that that amount of pressure is unhealthy for the pelvic floor. There is research that is not true. There was a survey study that followed up with women who had continued to lift heavy throughout their pregnancies (using the Valsalva Maneuver). Those people had better pregnancies, they felt better in the postpartum period, and they didn't have any increase of negative outcomes relative to other populations.


In fact, in some ways they had less concerns going on both during their pregnancies and postpartum. Typically, the short answer is, there is no indication that it's unsafe, but as a pelvic floor physical therapist, we at Empower Physical Therapy can make sure that people know how to do it effectively and safely throughout pregnancy.


We hope this answers your question. If you have any follow-up questions, please feel free to comment or message us. I would love to hear from you and to hear more about what you wanna learn about.




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