Midwifery management of face presentation

The 1980 edition of Oxorn and Foote (1980) urges the midwife not to be hasty in employing cosarean (CS) for face presentation because, with patience, babies are usually born vaginally, with better outcomes. Reviewing how to manage face presentation can prepare the practitioner for this rare event, and decrease CS management. A hundred and ninety six midwives from the US, UK, Hungary and Israel were emailed, asking them to describe their experience, if any, with face presentation. Twelve midwives responded, demonstrating the rarity of the event. Face presentation was most often diagnosed at full dilation. Mode of birth was dependent on the size of the fetus, the motivation of the woman and the experience and motivation of the practitioner, not on the position of the chin. Where the posterior chin was blocking birth, CS could be avoided by rotating the head to occiput anterior (OA) or by swimming for 45 minutes in a large birthing pool.