What is a Face Presentation Birth?
face presentation birth occurs when the baby’s head is extended backward so that the face, rather than the top or back of the head, is the first part to enter the birth canal. In a typical delivery, the baby’s chin is tucked toward the chest, allowing the top of the head to lead during birth. However, in face presentation, the neck is hyperextended, and the baby’s face presents first. While face presentation births are relatively rare, they pose unique challenges during labor and delivery, requiring special attention and care from medical professionals.
How Does Face Presentation Occur?
Face presentation happens when the baby’s neck is overextended, causing the face to present at the cervix rather than the crown of the head. The exact cause of this positioning isn’t always clear, but several factors may increase the likelihood of a face presentation baby. These include a baby with a larger head, issues with the mother’s pelvis, or an abnormal lie of fetus. Other potential contributors include multiple pregnancies or excessive amniotic fluid, which can provide the baby with more room to move into unusual positions.
Identifying Face Presentation During Labor
In most cases, healthcare providers can identify face presentation during labor through a combination of physical examination and ultrasound. During a vaginal exam, the healthcare provider may feel the baby’s facial features—such as the nose, eyes, and mouth—instead of the rounded top of the head. An ultrasound can confirm the positioning of the baby and help determine the safest approach for delivery. Early identification of a face presentation is critical to planning the right course of action during labor.
Risks Associated with Face Presentation Birth
A face presentation birth comes with higher risks compared to a typical head-first delivery. One of the main concerns is that the baby’s face and neck are exposed to more pressure as they pass through the birth canal, which can lead to facial swelling or bruising. Additionally, labor may take longer, and there’s an increased chance that medical interventions will be necessary, such as forceps or vacuum extraction. In some cases, a cesarean section may be recommended if the baby’s position makes vaginal delivery too risky.
Can a Face Presentation Baby Be Delivered Vaginally?
While vaginal delivery is possible in some face presentation cases, it depends on several factors, such as the baby’s position and size, as well as the mother’s pelvic dimensions. If the baby’s chin is pointed downward (known as mentum anterior), vaginal delivery may be more feasible. However, if the baby’s chin is pointed upward (mentum posterior), vaginal delivery is more difficult, and the baby may not pass through the birth canal without complications. In such cases, a cesarean section may be the safest option.
Complications from Face Presentation Birth
One of the major concerns with face presentation is the potential for prolonged labor, which can increase stress on both the mother and the baby. The baby’s face may experience significant swelling or bruising due to the pressure placed on it during delivery. There’s also a risk of head entrapment breech, especially in cases where the face presentation is part of a breech birth. This can lead to serious complications for both the baby and the mother, requiring quick and decisive medical intervention.
Medical Interventions for Face Presentation
When a face presentation is identified, healthcare providers may take several steps to manage the situation and reduce risks. In some cases, the baby may turn into a more favorable position during labor. However, if the baby remains in a face presentation, medical interventions may include the use of forceps or vacuum extraction to assist with delivery. If vaginal delivery becomes too risky, especially in cases where head entrapment breech or other complications arise, a cesarean section may be necessary.
Lie of Fetus and Its Connection to Face Presentation
The lie of fetus refers to how the baby is positioned in the womb, and it plays a significant role in determining whether face presentation may occur. Normally, babies are in a longitudinal lie, with their heads or buttocks positioned toward the cervix. However, in abnormal lies, such as transverse or oblique positions, the baby’s orientation can increase the likelihood of face presentation. Understanding the baby’s lie is essential for healthcare providers to plan for a safe delivery.
Managing Labor
Labor with a face presentation baby is often more challenging and requires close monitoring by medical professionals. The healthcare team will continuously assess the baby’s position and the mother’s progress during labor. In cases where vaginal delivery is attempted, the mother may need to push for a longer period, and additional support, such as an epidural, may be recommended to manage pain. If complications arise or if the baby’s position does not change, a cesarean section may be the safest course of action to prevent injury to the baby or mother.
Long-Term Effects on the Baby
In most cases, babies born with a face presentation recover well, though they may have temporary swelling or bruising on their face. These symptoms typically resolve within a few days after birth. However, in rare cases, there can be long-term complications, such as facial nerve damage or difficulty breathing, due to the pressure exerted during delivery. Regular follow-up with a pediatrician ensures that any issues are addressed promptly.
How Face Presentation Birth Relates to Malpractice
While many face presentation births can be managed safely, there are instances where improper medical care can lead to preventable complications. If a healthcare provider fails to recognize face presentation in time or does not take appropriate action—such as recommending a cesarean section when necessary—it can result in serious injury to the baby or mother. Delayed intervention or improper use of medical tools like forceps can also lead to complications. In cases where inadequate care leads to injury, this may constitute medical malpractice.
How a Malpractice Lawyer Can Help
If you or your baby experienced complications during a face presentation birth due to medical negligence, it’s important to seek legal advice. A cerebral palsy lawyer can help determine if malpractice occurred and guide you through the legal process to seek compensation for medical expenses, pain, and suffering. Joseph M. Lichtenstein, a highly experienced malpractice attorney, specializes in birth injury cases and has over 20 years of experience helping families impacted by negligent medical care. Contact Joseph M. Lichtenstein today to discuss your case and explore your legal options.