define presentation position

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Breech, posterior, transverse lie: What position is my baby in?

Fetal presentation, or how your baby is situated in your womb at birth, is determined by the body part that's positioned to come out first, and it can affect the way you deliver. At the time of delivery, 97 percent of babies are head-down (cephalic presentation). But there are several other possibilities, including feet or bottom first (breech) as well as sideways (transverse lie) and diagonal (oblique lie).

Fetal presentation and position

During the last trimester of your pregnancy, your provider will check your baby's presentation by feeling your belly to locate the head, bottom, and back. If it's unclear, your provider may do an ultrasound or an internal exam to feel what part of the baby is in your pelvis.

Fetal position refers to whether the baby is facing your spine (anterior position) or facing your belly (posterior position). Fetal position can change often: Your baby may be face up at the beginning of labor and face down at delivery.

Here are the many possibilities for fetal presentation and position in the womb.

Medical illustrations by Jonathan Dimes

Head down, facing down (anterior position)

A baby who is head down and facing your spine is in the anterior position. This is the most common fetal presentation and the easiest position for a vaginal delivery.

This position is also known as "occiput anterior" because the back of your baby's skull (occipital bone) is in the front (anterior) of your pelvis.

Head down, facing up (posterior position)

In the posterior position , your baby is head down and facing your belly. You may also hear it called "sunny-side up" because babies who stay in this position are born facing up. But many babies who are facing up during labor rotate to the easier face down (anterior) position before birth.

Posterior position is formally known as "occiput posterior" because the back of your baby's skull (occipital bone) is in the back (posterior) of your pelvis.

Frank breech

In the frank breech presentation, both the baby's legs are extended so that the feet are up near the face. This is the most common type of breech presentation. Breech babies are difficult to deliver vaginally, so most arrive by c-section .

Some providers will attempt to turn your baby manually to the head down position by applying pressure to your belly. This is called an external cephalic version , and it has a 58 percent success rate for turning breech babies. For more information, see our article on breech birth .

Complete breech

A complete breech is when your baby is bottom down with hips and knees bent in a tuck or cross-legged position. If your baby is in a complete breech, you may feel kicking in your lower abdomen.

Incomplete breech

In an incomplete breech, one of the baby's knees is bent so that the foot is tucked next to the bottom with the other leg extended, positioning that foot closer to the face.

Single footling breech

In the single footling breech presentation, one of the baby's feet is pointed toward your cervix.

Double footling breech

In the double footling breech presentation, both of the baby's feet are pointed toward your cervix.

Transverse lie

In a transverse lie, the baby is lying horizontally in your uterus and may be facing up toward your head or down toward your feet. Babies settle this way less than 1 percent of the time, but it happens more commonly if you're carrying multiples or deliver before your due date.

If your baby stays in a transverse lie until the end of your pregnancy, it can be dangerous for delivery. Your provider will likely schedule a c-section or attempt an external cephalic version , which is highly successful for turning babies in this position.

Oblique lie

In rare cases, your baby may lie diagonally in your uterus, with his rump facing the side of your body at an angle.

Like the transverse lie, this position is more common earlier in pregnancy, and it's likely your provider will intervene if your baby is still in the oblique lie at the end of your third trimester.

Was this article helpful?

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BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

Ahmad A et al. 2014. Association of fetal position at onset of labor and mode of delivery: A prospective cohort study. Ultrasound in obstetrics & gynecology 43(2):176-182. https://www.ncbi.nlm.nih.gov/pubmed/23929533 Opens a new window [Accessed September 2021]

Gray CJ and Shanahan MM. 2019. Breech presentation. StatPearls.  https://www.ncbi.nlm.nih.gov/books/NBK448063/ Opens a new window [Accessed September 2021]

Hankins GD. 1990. Transverse lie. American Journal of Perinatology 7(1):66-70.  https://www.ncbi.nlm.nih.gov/pubmed/2131781 Opens a new window [Accessed September 2021]

Medline Plus. 2020. Your baby in the birth canal. U.S. National Library of Medicine. https://medlineplus.gov/ency/article/002060.htm Opens a new window [Accessed September 2021]

Where to go next

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• Pregnancy week by week
• Fetal presentation before birth

The way a baby is positioned in the uterus just before birth can have a big effect on labor and delivery. This positioning is called fetal presentation.

Babies twist, stretch and tumble quite a bit during pregnancy. Before labor starts, however, they usually come to rest in a way that allows them to be delivered through the birth canal headfirst. This position is called cephalic presentation. But there are other ways a baby may settle just before labor begins.

Following are some of the possible ways a baby may be positioned at the end of pregnancy.

Head down, face down

When a baby is head down, face down, the medical term for it is the cephalic occiput anterior position. This the most common position for a baby to be born in. With the face down and turned slightly to the side, the smallest part of the baby's head leads the way through the birth canal. It is the easiest way for a baby to be born.

Head down, face up

When a baby is head down, face up, the medical term for it is the cephalic occiput posterior position. In this position, it might be harder for a baby's head to go under the pubic bone during delivery. That can make labor take longer.

Most babies who begin labor in this position eventually turn to be face down. If that doesn't happen, and the second stage of labor is taking a long time, a member of the health care team may reach through the vagina to help the baby turn. This is called manual rotation.

In some cases, a baby can be born in the head-down, face-up position. Use of forceps or a vacuum device to help with delivery is more common when a baby is in this position than in the head-down, face-down position. In some cases, a C-section delivery may be needed.

Frank breech

When a baby's feet or buttocks are in place to come out first during birth, it's called a breech presentation. This happens in about 3% to 4% of babies close to the time of birth. The baby shown below is in a frank breech presentation. That's when the knees aren't bent, and the feet are close to the baby's head. This is the most common type of breech presentation.

If you are more than 36 weeks into your pregnancy and your baby is in a frank breech presentation, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. It involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a breech position, talk with a member of your health care team about the choices you have for delivery. Most babies in a frank breech position are born by planned C-section.

Complete and incomplete breech

A complete breech presentation, as shown below, is when the baby has both knees bent and both legs pulled close to the body. In an incomplete breech, one or both of the legs are not pulled close to the body, and one or both of the feet or knees are below the baby's buttocks. If a baby is in either of these positions, you might feel kicking in the lower part of your belly.

If you are more than 36 weeks into your pregnancy and your baby is in a complete or incomplete breech presentation, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. It involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a breech position, talk with a member of your health care team about the choices you have for delivery. Many babies in a complete or incomplete breech position are born by planned C-section.

When a baby is sideways — lying horizontal across the uterus, rather than vertical — it's called a transverse lie. In this position, the baby's back might be:

• Down, with the back facing the birth canal.
• Sideways, with one shoulder pointing toward the birth canal.
• Up, with the hands and feet facing the birth canal.

Although many babies are sideways early in pregnancy, few stay this way when labor begins.

If your baby is in a transverse lie during week 37 of your pregnancy, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. External cephalic version involves one or two members of your health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a transverse lie, talk with a member of your health care team about the choices you have for delivery. Many babies who are in a transverse lie are born by C-section.

If you're pregnant with twins and only the twin that's lower in the uterus is head down, as shown below, your health care provider may first deliver that baby vaginally.

Then, in some cases, your health care team may suggest delivering the second twin in the breech position. Or they may try to move the second twin into a head-down position. This is done using a procedure called external cephalic version. External cephalic version involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

Your health care team may suggest delivery by C-section for the second twin if:

• An attempt to deliver the baby in the breech position is not successful.
• You do not want to try to have the baby delivered vaginally in the breech position.
• An attempt to move the baby into a head-down position is not successful.
• You do not want to try to move the baby to a head-down position.

In some cases, your health care team may advise that you have both twins delivered by C-section. That might happen if the lower twin is not head down, the second twin has low or high birth weight as compared to the first twin, or if preterm labor starts.

• Landon MB, et al., eds. Normal labor and delivery. In: Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 19, 2023.
• Holcroft Argani C, et al. Occiput posterior position. https://www.updtodate.com/contents/search. Accessed May 19, 2023.
• Frequently asked questions: If your baby is breech. American College of Obstetricians and Gynecologists https://www.acog.org/womens-health/faqs/if-your-baby-is-breech. Accessed May 22, 2023.
• Hofmeyr GJ. Overview of breech presentation. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
• Strauss RA, et al. Transverse fetal lie. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
• Chasen ST, et al. Twin pregnancy: Labor and delivery. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
• Cohen R, et al. Is vaginal delivery of a breech second twin safe? A comparison between delivery of vertex and non-vertex second twins. The Journal of Maternal-Fetal & Neonatal Medicine. 2021; doi:10.1080/14767058.2021.2005569.
• Marnach ML (expert opinion). Mayo Clinic. May 31, 2023.

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Delivery, face and brow presentation.

Julija Makajeva ; Mohsina Ashraf .

Affiliations

Last Update: January 9, 2023 .

• Continuing Education Activity

Face and brow presentation is a malpresentation during labor when the presenting part is either the face or, in the case of brow presentation, it is the area between the orbital ridge and the anterior fontanelle. This activity reviews the evaluation and management of these two presentations and explains the role of the interprofessional team in managing delivery safely for both the mother and the baby.

• Describe the mechanism of labor in the face and brow presentation.
• Summarize potential maternal and fetal complications during the face and brow presentations.
• Review different management approaches for the face and brow presentation.
• Outline some interprofessional strategies that will improve patient outcomes in delivery cases with face and brow presentation issues.
• Introduction

The term presentation describes the leading part of the fetus or the anatomical structure closest to the maternal pelvic inlet during labor. The presentation can roughly be divided into the following classifications: cephalic, breech, shoulder, and compound. Cephalic presentation is the most common and can be further subclassified as vertex, sinciput, brow, face, and chin. The most common presentation in term labor is the vertex, where the fetal neck is flexed to the chin, minimizing the head circumference.

Face presentation – an abnormal form of cephalic presentation where the presenting part is mentum. This typically occurs because of hyperextension of the neck and the occiput touching the fetal back. Incidence of face presentation is rare, accounting for approximately 1 in 600 of all presentations. [1] [2] [3]

In brow presentation, the neck is not extended as much as in face presentation, and the leading part is the area between the anterior fontanelle and the orbital ridges. Brow presentation is considered the rarest of all malpresentation with a prevalence of 1 in 500 to 1 in 4000 deliveries. [3]

Both face and brow presentations occur due to extension of the fetal neck instead of flexion; therefore, conditions that would lead to hyperextension or prevent flexion of the fetal neck can all contribute to face or brow presentation. These risk factors may be related to either the mother or the fetus. Maternal risk factors are preterm delivery, contracted maternal pelvis, platypelloid pelvis, multiparity, previous cesarean section, black race. Fetal risk factors include anencephaly, multiple loops of cord around the neck, masses of the neck, macrosomia, polyhydramnios. [2] [4] [5]

These malpresentations are usually diagnosed during the second stage of labor when performing a digital examination. It is possible to palpate orbital ridges, nose, malar eminences, mentum, mouth, gums, and chin in face presentation. Based on the position of the chin, face presentation can be further divided into mentum anterior, posterior, or transverse. In brow presentation, anterior fontanelle and face can be palpated except for the mouth and the chin. Brow presentation can then be further described based on the position of the anterior fontanelle as frontal anterior, posterior, or transverse.

Diagnosing the exact presentation can be challenging, and face presentation may be misdiagnosed as frank breech. To avoid any confusion, a bedside ultrasound scan can be performed. [6]  The ultrasound imaging can show a reduced angle between the occiput and the spine or, the chin is separated from the chest. However, ultrasound does not provide much predicting value in the outcome of the labor. [7]

• Anatomy and Physiology

Before discussing the mechanism of labor in the face or brow presentation, it is crucial to highlight some anatomical landmarks and their measurements. 

Planes and Diameters of the Pelvis

The three most important planes in the female pelvis are the pelvic inlet, mid pelvis, and pelvic outlet. 

Four diameters can describe the pelvic inlet: anteroposterior, transverse, and two obliques. Furthermore, based on the different landmarks on the pelvic inlet, there are three different anteroposterior diameters, named conjugates: true conjugate, obstetrical conjugate, and diagonal conjugate. Only the latter can be measured directly during the obstetric examination. The shortest of these three diameters is obstetrical conjugate, which measures approximately 10.5 cm and is a distance between the sacral promontory and 1 cm below the upper border of the symphysis pubis. This measurement is clinically significant as the fetal head must pass through this diameter during the engagement phase. The transverse diameter measures about 13.5cm and is the widest distance between the innominate line on both sides. 

The shortest distance in the mid pelvis is the interspinous diameter and usually is only about 10 cm. 

Fetal Skull Diameters

There are six distinguished longitudinal fetal skull diameters:

• Suboccipito-bregmatic: from the center of anterior fontanelle (bregma) to the occipital protuberance, measuring 9.5 cm. This is the presenting diameter in vertex presentation. 
• Suboccipito-frontal: from the anterior part of bregma to the occipital protuberance, measuring 10 cm 
• Occipito-frontal: from the root of the nose to the most prominent part of the occiput, measuring 11.5cm
• Submento-bregmatic: from the center of the bregma to the angle of the mandible, measuring 9.5 cm. This is the presenting diameter in face presentation where the neck is hyperextended. 
• Submento-vertical: from the midpoint between fontanelles and the angle of the mandible, measuring 11.5cm 
• Occipito-mental: from the midpoint between fontanelles and the tip of the chin, measuring 13.5 cm. It is the presenting diameter in brow presentation. 

Cardinal Movements of Normal Labor

• Neck flexion
• Internal rotation
• Extension (delivers head)
• External rotation (Restitution)
• Expulsion (delivery of anterior and posterior shoulders)

Some of the key movements are not possible in the face or brow presentations.  

Based on the information provided above, it is obvious that labor will be arrested in brow presentation unless it spontaneously changes to face or vertex, as the occipito-mental diameter of the fetal head is significantly wider than the smallest diameter of the female pelvis. Face presentation can, however, be delivered vaginally, and further mechanisms of face delivery will be explained in later sections.

• Indications

As mentioned previously, spontaneous vaginal delivery can be successful in face presentation. However, the main indication for vaginal delivery in such circumstances would be a maternal choice. It is crucial to have a thorough conversation with a mother, explaining the risks and benefits of vaginal delivery with face presentation and a cesarean section. Informed consent and creating a rapport with the mother is an essential aspect of safe and successful labor.

• Contraindications

Vaginal delivery of face presentation is contraindicated if the mentum is lying posteriorly or is in a transverse position. In such a scenario, the fetal brow is pressing against the maternal symphysis pubis, and the short fetal neck, which is already maximally extended, cannot span the surface of the maternal sacrum. In this position, the diameter of the head is larger than the maternal pelvis, and it cannot descend through the birth canal. Therefore the cesarean section is recommended as the safest mode of delivery for mentum posterior face presentations. 

Attempts to manually convert face presentation to vertex, manual or forceps rotation of the persistent posterior chin to anterior are contraindicated as they can be dangerous.

Persistent brow presentation itself is a contraindication for vaginal delivery unless the fetus is significantly small or the maternal pelvis is large.

Continuous electronic fetal heart rate monitoring is recommended for face and brow presentations, as heart rate abnormalities are common in these scenarios. One study found that only 14% of the cases with face presentation had no abnormal traces on the cardiotocograph. [8] It is advised to use external transducer devices to prevent damage to the eyes. When internal monitoring is inevitable, it is suggested to place monitoring devices on bony parts carefully. 

People who are usually involved in the delivery of face/ brow presentation are:

• Experienced midwife, preferably looking after laboring woman 1:1
• Senior obstetrician 
• Neonatal team - in case of need for resuscitation 
• Anesthetic team - to provide necessary pain control (e.g., epidural)
• Theatre team  - in case of failure to progress and an emergency cesarean section will be required.
• Preparation

No specific preparation is required for face or brow presentation. However, it is essential to discuss the labor options with the mother and birthing partner and inform members of the neonatal, anesthetic, and theatre co-ordinating teams.

• Technique or Treatment

Mechanism of Labor in Face Presentation

During contractions, the pressure exerted by the fundus of the uterus on the fetus and pressure of amniotic fluid initiate descent. During this descent, the fetal neck extends instead of flexing. The internal rotation determines the outcome of delivery, if the fetal chin rotates posteriorly, vaginal delivery would not be possible, and cesarean section is permitted. The approach towards mentum-posterior delivery should be individualized, as the cases are rare. Expectant management is acceptable in multiparous women with small fetuses, as a spontaneous mentum-anterior rotation can occur. However, there should be a low threshold for cesarean section in primigravida women or women with large fetuses.

When the fetal chin is rotated towards maternal symphysis pubis as described as mentum-anterior; in these cases further descend through the vaginal canal continues with approximately 73% cases deliver spontaneously. [9] Fetal mentum presses on the maternal symphysis pubis, and the head is delivered by flexion. The occiput is pointing towards the maternal back, and external rotation happens. Shoulders are delivered in the same manner as in vertex delivery.

Mechanism of Labor in Brow Presentation

As this presentation is considered unstable, it is usually converted into a face or an occiput presentation. Due to the cephalic diameter being wider than the maternal pelvis, the fetal head cannot engage; thus, brow delivery cannot take place. Unless the fetus is small or the pelvis is very wide, the prognosis for vaginal delivery is poor. With persistent brow presentation, a cesarean section is required for safe delivery.

• Complications

As the cesarean section is becoming a more accessible mode of delivery in malpresentations, the incidence of maternal and fetal morbidity and mortality during face presentation has dropped significantly. [10]

However, there are still some complications associated with the nature of labor in face presentation. Due to the fetal head position, it is more challenging for the head to engage in the birth canal and descend, resulting in prolonged labor.

Prolonged labor itself can provoke foetal distress and arrhythmias. If the labor arrests or signs of fetal distress appear on CTG, the recommended next step in management is an emergency cesarean section, which in itself carries a myriad of operative and post-operative complications.

Finally, due to the nature of the fetal position and prolonged duration of labor in face presentation, neonates develop significant edema of the skull and face. Swelling of the fetal airway may also be present, resulting in respiratory distress after birth and possible intubation.

• Clinical Significance

During vertex presentation, the fetal head flexes, bringing the chin to the chest, forming the smallest possible fetal head diameter, measuring approximately 9.5cm. With face and brow presentation, the neck hyperextends, resulting in greater cephalic diameters. As a result, the fetal head will engage later, and labor will progress more slowly. Failure to progress in labor is also more common in both presentations compared to vertex presentation.

Furthermore, when the fetal chin is in a posterior position, this prevents further flexion of the fetal neck, as browns are pressing on the symphysis pubis. As a result, descend through the birth canal is impossible. Such presentation is considered undeliverable vaginally and requires an emergency cesarean section.

Manual attempts to change face presentation to vertex, manual or forceps rotation to mentum anterior are considered dangerous and are discouraged.

• Enhancing Healthcare Team Outcomes

A multidisciplinary team of healthcare experts supports the woman and her child during labor and the perinatal period. For a face or brow presentation to be appropriately diagnosed, an experienced midwife and obstetrician must be involved in the vaginal examination and labor monitoring. As fetal anomalies, such as anencephaly or goiter, can contribute to face presentation, sonographers experienced in antenatal scanning should also be involved in the care. It is advised to inform the anesthetic and neonatal teams in advance of the possible need for emergency cesarean section and resuscitation of the neonate. [11] [12]

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Disclosure: Julija Makajeva declares no relevant financial relationships with ineligible companies.

Disclosure: Mohsina Ashraf declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

• Cite this Page Makajeva J, Ashraf M. Delivery, Face and Brow Presentation. [Updated 2023 Jan 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

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• Sonographic diagnosis of fetal head deflexion and the risk of cesarean delivery. [Am J Obstet Gynecol MFM. 2020] Sonographic diagnosis of fetal head deflexion and the risk of cesarean delivery. Bellussi F, Livi A, Cataneo I, Salsi G, Lenzi J, Pilu G. Am J Obstet Gynecol MFM. 2020 Nov; 2(4):100217. Epub 2020 Aug 18.
• Review Sonographic evaluation of the fetal head position and attitude during labor. [Am J Obstet Gynecol. 2024] Review Sonographic evaluation of the fetal head position and attitude during labor. Ghi T, Dall'Asta A. Am J Obstet Gynecol. 2024 Mar; 230(3S):S890-S900. Epub 2023 May 19.
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Abnormal Fetal lie, Malpresentation and Malposition

Original Author(s): Anna Mcclune Last updated: 1st December 2018 Revisions: 12

• 1 Definitions
• 2 Risk Factors
• 3.2 Presentation
• 3.3 Position
• 4 Investigations
• 5.1 Abnormal Fetal Lie
• 5.2 Malpresentation
• 5.3 Malposition

The lie, presentation and position of a fetus are important during labour and delivery.

In this article, we will look at the risk factors, examination and management of abnormal fetal lie, malpresentation and malposition.

Definitions

• Longitudinal, transverse or oblique
• Cephalic vertex presentation is the most common and is considered the safest
• Other presentations include breech, shoulder, face and brow
• Usually the fetal head engages in the occipito-anterior position (the fetal occiput facing anteriorly) – this is ideal for birth
• Other positions include occipito-posterior and occipito-transverse.

Note: Breech presentation is the most common malpresentation, and is covered in detail here .

Fig 1 – The two most common fetal presentations: cephalic and breech.

Risk Factors

The risk factors for abnormal fetal lie, malpresentation and malposition include:

• Multiple pregnancy
• Uterine abnormalities (e.g fibroids, partial septate uterus)
• Fetal abnormalities
• Placenta praevia
• Primiparity

Identifying Fetal Lie, Presentation and Position

The fetal lie and presentation can usually be identified via abdominal examination. The fetal position is ascertained by vaginal examination.

For more information on the obstetric examination, see here .

• Face the patient’s head
• Place your hands on either side of the uterus and gently apply pressure; one side will feel fuller and firmer – this is the back, and fetal limbs may feel ‘knobbly’ on the opposite side

Presentation

• Palpate the lower uterus (above the symphysis pubis) with the fingers of both hands; the head feels hard and round (cephalic) and the bottom feels soft and triangular (breech)
• You may be able to gently push the fetal head from side to side

The fetal lie and presentation may not be possible to identify if the mother has a high BMI, if she has not emptied her bladder, if the fetus is small or if there is polyhydramnios .

During labour, vaginal examination is used to assess the position of the fetal head (in a cephalic vertex presentation). The landmarks of the fetal head, including the anterior and posterior fontanelles, indicate the position.

Fig 2 – Assessing fetal lie and presentation.

Investigations

Any suspected abnormal fetal lie or malpresentation should be confirmed by an ultrasound scan . This could also demonstrate predisposing uterine or fetal abnormalities.

Abnormal Fetal Lie

If the fetal lie is abnormal, an external cephalic version (ECV) can be attempted – ideally between 36 and 38 weeks gestation.

ECV is the manipulation of the fetus to a cephalic presentation through the maternal abdomen.

It has an approximate success rate of 50% in primiparous women and 60% in multiparous women. Only 8% of breech presentations will spontaneously revert to cephalic in primiparous women over 36 weeks gestation.

Complications of ECV are rare but include fetal distress , premature rupture of membranes, antepartum haemorrhage (APH) and placental abruption. The risk of an emergency caesarean section (C-section) within 24 hours is around 1 in 200.

ECV is contraindicated in women with a recent APH, ruptured membranes, uterine abnormalities or a previous C-section .

Fig 3 – External cephalic version.

Malpresentation

The management of malpresentation is dependent on the presentation.

• Breech – attempt ECV before labour, vaginal breech delivery or C-section
• Brow – a C-section is necessary
• If the chin is anterior (mento-anterior) a normal labour is possible; however, it is likely to be prolonged and there is an increased risk of a C-section being required
• If the chin is posterior (mento-posterior) then a C-section is necessary
• Shoulder – a C-section is necessary

Malposition

90% of malpositions spontaneously rotate to occipito-anterior as labour progresses. If the fetal head does not rotate, rotation and operative vaginal delivery can be attempted. Alternatively a C-section can be performed.

• Usually the fetal head engages in the occipito-anterior position (the fetal occiput facing anteriorly) - this is ideal for birth

If the fetal lie is abnormal, an external cephalic version (ECV) can be attempted - ideally between 36 and 38 weeks gestation.

• Breech - attempt ECV before labour, vaginal breech delivery or C-section

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Face and Brow Presentation

• Author: Teresa Marino, MD; Chief Editor: Carl V Smith, MD  more...
• Sections Face and Brow Presentation
• Mechanism of Labor
• Labor Management

At the onset of labor, assessment of the fetal presentation with respect to the maternal birth canal is critical to the route of delivery. At term, the vast majority of fetuses present in the vertex presentation, where the fetal head is flexed so that the chin is in contact with the fetal thorax. The fetal spine typically lies along the longitudinal axis of the uterus. Nonvertex presentations (including breech, transverse lie, face, brow, and compound presentations) occur in less than 4% of fetuses at term. Malpresentation of the vertex presentation occurs if there is deflexion or extension of the fetal head leading to brow or face presentation, respectively.

In a face presentation, the fetal head and neck are hyperextended, causing the occiput to come in contact with the upper back of the fetus while lying in a longitudinal axis. The presenting portion of the fetus is the fetal face between the orbital ridges and the chin. The fetal chin (mentum) is the point designated for reference during an internal examination through the cervix. The occiput of a vertex is usually hard and has a smooth contour, while the face and brow tend to be more irregular and soft. Like the occiput, the mentum can present in any position relative to the maternal pelvis. For example, if the mentum presents in the left anterior quadrant of the maternal pelvis, it is designated as left mentum anterior (LMA).

In a brow presentation, the fetal head is midway between full flexion (vertex) and hyperextension (face) along a longitudinal axis. The presenting portion of the fetal head is between the orbital ridge and the anterior fontanel. The face and chin are not included. The frontal bones are the point of designation and can present (as with the occiput during a vertex delivery) in any position relative to the maternal pelvis. When the sagittal suture is transverse to the pelvic axis and the anterior fontanel is on the right maternal side, the fetus would be in the right frontotransverse position (RFT).

Face presentation occurs in 1 of every 600-800 live births, averaging about 0.2% of live births. Causative factors associated with a face presentation are similar to those leading to general malpresentation and those that prevent head flexion or favor extension. Possible etiology includes multiple gestations, grand multiparity, fetal malformations, prematurity, and cephalopelvic disproportion. At least one etiological factor may be identified in up to 90% of cases with face presentation.

Fetal anomalies such as hydrocephalus, anencephaly, and neck masses are common risk factors and may account for as many as 60% of cases of face presentation. For example, anencephaly is found in more than 30% of cases of face presentation. Fetal thyromegaly and neck masses also lead to extension of the fetal head.

A contracted pelvis or cephalopelvic disproportion, from either a small pelvis or a large fetus, occurs in 10-40% of cases. Multiparity or a large abdomen can cause decreased uterine tone, leading to natural extension of the fetal head.

Face presentation is diagnosed late in the first or second stage of labor by examination of a dilated cervix. On digital examination, the distinctive facial features of the nose, mouth, and chin, the malar bones, and particularly the orbital ridges can be palpated. This presentation can be confused with a breech presentation because the mouth may be confused with the anus and the malar bones or orbital ridges may be confused with the ischial tuberosities. The facial presentation has a triangular configuration of the mouth to the orbital ridges compared to the breech presentation of the anus and fetal genitalia. During Leopold maneuvers, diagnosis is very unlikely. Diagnosis can be confirmed by ultrasound evaluation, which reveals a hyperextended fetal neck. [ 1 , 2 ]

Brow presentation is the least common of all fetal presentations and the incidence varies from 1 in 500 deliveries to 1 in 1400 deliveries. Brow presentation may be encountered early in labor but is usually a transitional state and converts to a vertex presentation after the fetal neck flexes. Occasionally, further extension may occur resulting in a face presentation.

The causes of a persistent brow presentation are generally similar to those causing a face presentation and include cephalopelvic disproportion or pelvic contracture, increasing parity and prematurity. These are implicated in more than 60% of cases of persistent brow presentation. Premature rupture of membranes may precede brow presentation in as many as 27% of cases.

Diagnosis of a brow presentation can occasionally be made with abdominal palpation by Leopold maneuvers. A prominent occipital prominence is encountered along the fetal back, and the fetal chin is also palpable; however, the diagnosis of a brow presentation is usually confirmed by examination of a dilated cervix. The orbital ridge, eyes, nose, forehead, and anterior fontanelle are palpated. The mouth and chin are not palpable, thus excluding face presentation. Fetal ultrasound evaluation again notes a hyperextended neck.

As with face presentation, diagnosis is often made late in labor with half of cases occurring in the second stage of labor. The most common position is the mentum anterior, which occurs about twice as often as either transverse or posterior positions. A higher cesarean delivery rate occurs with a mentum transverse or posterior [ 3 ] position than with a mentum anterior position.

The mechanism of labor consists of the cardinal movements of engagement, descent, flexion, internal rotation, and the accessory movements of extension and external rotation. Intuitively, the cardinal movements of labor for a face presentation are not completely identical to those of a vertex presentation.

While descending into the pelvis, the natural contractile forces combined with the maternal pelvic architecture allow the fetal head to either flex or extend. In the vertex presentation, the vertex is flexed such that the chin rests on the fetal chest, allowing the suboccipitobregmatic diameter of approximately 9.5 cm to be the widest diameter through the maternal pelvis. This is the smallest of the diameters to negotiate the maternal pelvis. Following engagement in the face presentation, descent is made. The widest diameter of the fetal head negotiating the pelvis is the trachelobregmatic or submentobregmatic diameter, which is 10.2 cm (0.7 cm larger than the suboccipitobregmatic diameter). Because of this increased diameter, engagement does not occur until the face is at +2 station.

Fetuses with face presentation may initially begin labor in the brow position. Using x-ray pelvimetry in a series of 7 patients, Borrell and Ferstrom demonstrated that internal rotation occurs between the ischial spines and the ischial tuberosities, making the chin the presenting part, lower than in the vertex presentation. [ 4 , 5 ] Following internal rotation, the mentum is below the maternal symphysis, and delivery occurs by flexion of the fetal neck. As the face descends onto the perineum, the anterior fetal chin passes under the symphysis and flexion of the head occurs, making delivery possible with maternal expulsive forces.

The above mechanisms of labor in the term infant can occur only if the mentum is anterior and at term, only the mentum anterior face presentation is likely to deliver vaginally. If the mentum is posterior or transverse, the fetal neck is too short to span the length of the maternal sacrum and is already at the point of maximal extension. The head cannot deliver as it cannot extend any further through the symphysis and cesarean delivery is the safest route of delivery.

Fortunately, the mentum is anterior in over 60% of cases of face presentation, transverse in 10-12% of cases, and posterior only 20-25% of the time. Fetuses with the mentum transverse position usually rotate to the mentum anterior position, and 25-33% of fetuses with mentum posterior position rotate to a mentum anterior position. When the mentum is posterior, the neck, head and shoulders must enter the pelvis simultaneously, resulting in a diameter too large for the maternal pelvis to accommodate unless in the very preterm or small infant.

Three labor courses are possible when the fetal head engages in a brow presentation. The brow may convert to a vertex presentation, to a face presentation, or remain as a persistent brow presentation. More than 50% of brow presentations will convert to vertex or face presentation and labor courses are managed accordingly when spontaneous conversion occurs.

In the brow presentation, the occipitomental diameter, which is the largest diameter of the fetal head, is the presenting portion. Descent and internal rotation occur only with an adequate pelvis and if the face can fit under the pubic arch. While the head descends, it becomes wedged into the hollow of the sacrum. Downward pressure from uterine contractions and maternal expulsive forces may cause the mentum to extend anteriorly and low to present at the perineum as a mentum anterior face presentation.

If internal rotation does not occur, the occipitomental diameter, which measures 1.5 cm wider than the suboccipitobregmatic diameter and is thus the largest diameter of the fetal head, presents at the pelvic inlet. The head may engage but can descend only with significant molding. This molding and subsequent caput succedaneum over the forehead can become so extensive that identification of the brow by palpation is impossible late in labor. This may result in a missed diagnosis in a patient who presents later in active labor.

If the mentum is anterior and the forces of labor are directed toward the fetal occiput, flexing the head and pivoting the face under the pubic arch, there is conversion to a vertex occiput posterior position. If the occiput lies against the sacrum and the forces of labor are directed against the fetal mentum, the neck may extend further, leading to a face presentation.

The persistent brow presentation with subsequent delivery only occurs in cases of a large pelvis and/or a small infant. Women with gynecoid pelvis or multiparity may be given the option to labor; however, dysfunctional labor and cephalopelvic disproportion are more likely if this presentation persists.

Labor management of face and brow presentation requires close observation of labor progression because cephalopelvic disproportion, dysfunctional labor, and prolonged labor are much more common. As mentioned above, the trachelobregmatic or submentobregmatic diameters are larger than the suboccipitobregmatic diameter. Duration of labor with a face presentation is generally the same as duration of labor with a vertex presentation, although a prolonged labor may occur. As long as maternal or fetal compromise is not evident, labor with a face presentation may continue. [ 6 ] A persistent mentum posterior presentation is an indication for delivery by cesarean section.

Continuous electronic fetal heart rate monitoring is considered mandatory by many authors because of the increased incidence of abnormal fetal heart rate patterns and/or nonreassuring fetal heart rate patterns. [ 7 ] An internal fetal scalp electrode may be used, but very careful application of the electrode must be ensured. The mentum is the recommended site of application. Facial edema is common and can obscure the fetal facial anatomy and improper placement can lead to facial and ophthalmic injuries. Oxytocin can be used to augment labor using the same precautions as in a vertex presentation and the same criteria of assessment of uterine activity, adequacy of the pelvis, and reassuring fetal heart tracing.

Fetuses with face presentation can be delivered vaginally with overall success rates of 60-70%, while more than 20% of fetuses with face presentation require cesarean delivery. Cesarean delivery is performed for the usual obstetrical indications, including arrest of labor and nonreassuring fetal heart rate pattern.

Attempts to manually convert the face to vertex (Thom maneuver) or to rotate a posterior position to a more favorable anterior mentum position are rarely successful and are associated with high fetal morbidity and mortality and maternal morbidity, including cord prolapse, uterine rupture, and fetal cervical spine injury with neurological impairment. Given the availability and safety of cesarean delivery, internal rotation maneuvers are no longer justified unless cesarean section cannot be readily performed.

Internal podalic version and breech extraction are also no longer recommended in the modern management of the face presentation. [ 8 ]

Operative delivery with forceps must be approached with caution. Since engagement occurs when the face is at +2 position, forceps should only be applied to the face that has caused the perineum to bulge. Increased complications to both mother and fetus can occur [ 9 ] and operative delivery must be approached with caution or reserved when cesarean section is not readily available. Forceps may be used if the mentum is anterior. Although the landmarks are different, the application of any forceps is made as if the fetus were presenting directly in the occiput anterior position. The mouth substitutes for the posterior fontanelle, and the mentum substitutes for the occiput. Traction should be downward to maintain extension until the mentum passes under the symphysis, and then gradually elevated to allow the head to deliver by flexion. During delivery, hyperextension of the fetal head should be avoided.

As previously mentioned, the persistent brow presentation has a poor prognosis for vaginal delivery unless the fetus is small, premature, or the maternal pelvis is large. Expectant management is reasonable if labor is progressing well and the fetal well-being is assessed, as there can be spontaneous conversion to face or vertex presentation. The earlier in labor that brow presentation is diagnosed, the higher the likelihood of conversion. Minimal intervention during labor is recommended and some feel the use of oxytocin in the brow presentation is contraindicated.

The use of operative vaginal delivery or manual conversion of a brow to a more favorable presentation is contraindicated as the risks of perinatal morbidity and mortality are unacceptably high. Prolonged, dysfunctional, and arrest of labor are common, necessitating cesarean section delivery.

The incidence of perinatal morbidity and mortality and maternal morbidity has decreased due to the increased incidence of cesarean section delivery for malpresentation, including face and brow presentation.

Neonates delivered in the face presentation exhibit significant facial and skull edema, which usually resolves within 24-48 hours. Trauma during labor may cause tracheal and laryngeal edema immediately after delivery, which can result in neonatal respiratory distress. In addition, fetal anomalies or tumors, such as fetal goiters that may have contributed to fetal malpresentation, may make intubation difficult. Physicians with expertise in neonatal resuscitation should be present at delivery in the event that intubation is required. When a fetal anomaly has been previously diagnosed by ultrasonographic evaluation, the appropriate pediatric specialists should be consulted and informed at time of labor.

Bellussi F, Ghi T, Youssef A, et al. The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations. Am J Obstet Gynecol . 2017 Dec. 217 (6):633-41. [QxMD MEDLINE Link] .

[Guideline] Ghi T, Eggebø T, Lees C, et al. ISUOG Practice Guidelines: intrapartum ultrasound. Ultrasound Obstet Gynecol . 2018 Jul. 52 (1):128-39. [QxMD MEDLINE Link] . [Full Text] .

Shaffer BL, Cheng YW, Vargas JE, Laros RK Jr, Caughey AB. Face presentation: predictors and delivery route. Am J Obstet Gynecol . 2006 May. 194(5):e10-2. [QxMD MEDLINE Link] .

Borell U, Fernstrom I. The mechanism of labour. Radiol Clin North Am . 1967 Apr. 5(1):73-85. [QxMD MEDLINE Link] .

Borell U, Fernstrom I. The mechanism of labour in face and brow presentation: a radiographic study. Acta Obstet Gynecol Scand . 1960. 39:626-44.

Gardberg M, Leonova Y, Laakkonen E. Malpresentations--impact on mode of delivery. Acta Obstet Gynecol Scand . 2011 May. 90(5):540-2. [QxMD MEDLINE Link] .

Collaris RJ, Oei SG. External cephalic version: a safe procedure? A systematic review of version-related risks. Acta Obstet Gynecol Scand . 2004 Jun. 83(6):511-8. [QxMD MEDLINE Link] .

Verspyck E, Bisson V, Gromez A, Resch B, Diguet A, Marpeau L. Prophylactic attempt at manual rotation in brow presentation at full dilatation. Acta Obstet Gynecol Scand . 2012 Nov. 91(11):1342-5. [QxMD MEDLINE Link] .

Johnson JH, Figueroa R, Garry D. Immediate maternal and neonatal effects of forceps and vacuum-assisted deliveries. Obstet Gynecol . 2004 Mar. 103(3):513-8. [QxMD MEDLINE Link] .

Benedetti TJ, Lowensohn RI, Truscott AM. Face presentation at term. Obstet Gynecol . 1980 Feb. 55(2):199-202. [QxMD MEDLINE Link] .

BROWNE AD, CARNEY D. OBSTETRICS IN GENERAL PRACTICE. MANAGEMENT OF MALPRESENTATIONS IN OBSTETRICS. Br Med J . 1964 May 16. 1(5393):1295-8. [QxMD MEDLINE Link] .

Campbell JM. Face presentation. Aust N Z J Obstet Gynaecol . 1965 Nov. 5(4):231-4. [QxMD MEDLINE Link] .

Contributor Information and Disclosures

Teresa Marino, MD Assistant Professor, Attending Physician, Division of Maternal-Fetal Medicine, Tufts Medical Center Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference Disclosure: Received salary from Medscape for employment. for: Medscape.

Carl V Smith, MD The Distinguished Chris J and Marie A Olson Chair of Obstetrics and Gynecology, Professor, Department of Obstetrics and Gynecology, Senior Associate Dean for Clinical Affairs, University of Nebraska Medical Center Carl V Smith, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists , American Institute of Ultrasound in Medicine , Association of Professors of Gynecology and Obstetrics , Central Association of Obstetricians and Gynecologists , Society for Maternal-Fetal Medicine , Council of University Chairs of Obstetrics and Gynecology , Nebraska Medical Association Disclosure: Nothing to disclose.

Chitra M Iyer, MD, Perinatologist, Obstetrix Medical Group, Fort Worth, Texas.

Chitra M Iyer, MD is a member of the following medical societies: American College of Obstetricians and Gynecologists , Society of Maternal-Fetal Medicine .

Disclosure: Nothing to disclose.

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presentation

Definition of presentation

• fairing [ British ]
• freebee
• largess

Examples of presentation in a Sentence

These examples are programmatically compiled from various online sources to illustrate current usage of the word 'presentation.' Any opinions expressed in the examples do not represent those of Merriam-Webster or its editors. Send us feedback about these examples.

Word History

15th century, in the meaning defined at sense 1a

Phrases Containing presentation

• breech presentation

Dictionary Entries Near presentation

present arms

presentation copy

Cite this Entry

“Presentation.” Merriam-Webster.com Dictionary , Merriam-Webster, https://www.merriam-webster.com/dictionary/presentation. Accessed 14 Aug. 2024.

Kids Definition

Kids definition of presentation, medical definition, medical definition of presentation, more from merriam-webster on presentation.

Nglish: Translation of presentation for Spanish Speakers

Britannica English: Translation of presentation for Arabic Speakers

Britannica.com: Encyclopedia article about presentation

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Vertex Presentation: What It Means for You & Your Baby

By Sitaram Bhartia Team | December 3, 2020 | Maternity | 2020-12-03 13 April 2023

During the course of your pregnancy, you may hear your gynecologist refer to the ‘position’ or ‘presentation’ of your baby. The ‘presentation’ of the baby is the part of the baby that lies at the lower end of the uterus (womb) or is at the entry of the pelvis. 

The ‘position’, in medical terms, indicates in which way the ‘presenting part’ of the baby lies in relation to the mother, i.e. whether it lies in the front, at the back or on the sides.  

“In layman terms, ‘presentation’ and ‘position’ are often used interchangeably,” says Dr. Anita Sabherwal Anand, Obstetrician-Gynecologist at Sitaram Bhartia Hospital in Delhi.

When a doctor says that your baby is in a head down position, it means that your baby is in vertex presentation .

What is vertex position in pregnancy? What is the difference between vertex and cephalic presentation?

In layman terms, the head down position is known as ‘cephalic presentation’ which means that the head of the baby lies towards the mouth of the uterus (cervix) and the buttocks and feet of the baby are located at the top of the uterus. Vertex is the medical term for “crown of head”. Vertex presentation indicates that the crown of the head or vertex of the baby is presenting towards the cervix.

Vertex presentation is the most common presentation observed in the third trimester.

The definition of vertex presentation , according to the American College of Obstetrics and Gynecologists is, “ A fetal presentation where the head is presenting first in the pelvic inlet.”

Is vertex presentation normal?

Yes, the vertex position of the baby is the most appropriate and favourable position to achieve normal delivery .

“About 95% of babies are in vertex presentation (head down) at 36 weeks, while 3-4% may lie in a ‘ breech position ,” says Dr. Anita.

Breech presentation is a non vertex presentation .

A baby is said to be in breech presentation when its feet and buttocks are at the bottom, on the cervix, and the head settles at the top of the uterus.

Should I be worried about a breech presentation?

“There is no need to worry because babies turn throughout pregnancy, “ explains Dr. Anita. 

In the early weeks of pregnancy, because the baby is small, it can lie in any position. As it grows heavier than 1 kg, it usually tumbles down and comes into the head down position. 

What may cause babies to be in the breech position?

There are a few situations that may increase the risk of having a breech baby even after 36 weeks of pregnancy. These are:

• Twins or multiple babies, wherein there is limited space for movement of the babies
• Low levels of amniotic fluid that prevents free movement of babies or very high volume of amniotic fluid that does not allow the baby to settle in a position
• Abnormalities in the uterus, either the presence of low lying placenta or large fibroids in the lower part of the uterus

Breech positions are higher in preterm birth where the baby is small and may not have had enough time to flip.

“Your gynecologist will place her hands on your abdomen and ascertain the baby’s position during your consultations in the third trimester.”

It was in one such consultation that Shilpa Newati found out that her baby was in breech presentation. She was consulting another hospital where her gynecologist advised a cesarean section. But Shilpa remained adamant and decided to get a second opinion. 

“When I came to Sitaram Bhartia Hospital, the gynecologist explained that babies can turn even until the last moment. Since my pregnancy was progressing well she saw no reason to rush into a cesarean section. “

“I was advised to wait and try a few simple techniques that may help the baby turn.”

Can a baby turn from being in breech presentation to vertex presentation ?

Yes. If your baby is in breech position, you could try turning your baby through these methods: 

• Daily walks (45-60 minutes) not only keep the mother fit but also help the baby tumble down into the head down position.
• Exercises like Cat and Camel or High Bridge may help turn the baby. “Be sure to learn these from a physiotherapist who can properly teach you what to do.”
• External Cephalic Version (ECV) is a maneuver to manually turn the baby to vertex presentation . It is usually done after 36 weeks by a gynecologist with the guidance of an ultrasound. ECV has a success rate of about 50% .

There are a few other methods that are not scientifically proven but may be safe to try.

• Torch: Placing a torch near your vagina may help the baby move in the direction of the light.
• Music: Playing music near the bottom of the belly may encourage the baby to move toward the sound of music.

In Shilpa’s case, the baby turned into vertex presentation at 37 weeks and she went on to have a vaginal delivery like she had hoped. 

Watch Shilpa share her story:

In very few instances, the baby may not turn into vertex presentation . In such a situation, a cesarean section may be safer for both mother and baby. 

Come in for a consultation  Please Chat with us on WhatsApp to schedule an appointment.

More Resources:

• Baby’s Head Engaged: Symptoms, Meaning & What You Can Do
• C Section Delivery: 9 Indications Where It May Be Avoidable
• How to Turn Baby’s Head Down Naturally [VIDEO]

This article has been written with and reviewed by Dr. Anita Sabherwal Anand , who has over 20 years of experience in Obstetrics and Gynecology. 

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What Are Effective Presentation Skills (and How to Improve Them)

Presentation skills are essential for your personal and professional life. Learn about effective presentations and how to boost your presenting techniques.

At least seven out of 10 Americans agree that presentation skills are essential for a successful career [ 1 ]. Although it might be tempting to think that these are skills reserved for people interested in public speaking roles, they're critical in a diverse range of jobs. For example, you might need to brief your supervisor on research results.

Presentation skills are also essential in other scenarios, including working with a team and explaining your thought process, walking clients through project ideas and timelines, and highlighting your strengths and achievements to your manager during performance reviews.

Whatever the scenario, you have very little time to capture your audience’s attention and get your point across when presenting information—about three seconds, according to research [ 2 ]. Effective presentation skills help you get your point across and connect with the people you’re communicating with, which is why nearly every employer requires them.

Understanding what presentation skills are is only half the battle. Honing your presenting techniques is essential for mastering presentations of all kinds and in all settings.

What are presentation skills?

Presentation skills are the abilities and qualities necessary for creating and delivering a compelling presentation that effectively communicates information and ideas. They encompass what you say, how you structure it, and the materials you include to support what you say, such as slides, videos, or images.

You'll make presentations at various times in your life. Examples include:

Making speeches at a wedding, conference, or another event

Making a toast at a dinner or event

Explaining projects to a team 

Delivering results and findings to management teams

Teaching people specific methods or information

Proposing a vote at community group meetings

Pitching a new idea or business to potential partners or investors

Why are presentation skills important? 

Delivering effective presentations is critical in your professional and personal life. You’ll need to hone your presentation skills in various areas, such as when giving a speech, convincing your partner to make a substantial purchase, and talking to friends and family about an important situation.

No matter if you’re using them in a personal or professional setting, these are the skills that make it easier and more effective to convey your ideas, convince or persuade others, and experience success. A few of the benefits that often accompany improving your presentation skills include:

Enriched written and verbal communication skills

Enhanced confidence and self-image

Boosted critical thinking and problem-solving capabilities

Better motivational techniques

Increased leadership skills

Expanded time management, negotiation, and creativity

The better your presenting techniques, the more engaging your presentations will be. You could also have greater opportunities to make positive impacts in business and other areas of your life.

Effective presentation skills

Imagine yourself in the audience at a TED Talk or sitting with your coworkers at a big meeting held by your employer. What would you be looking for in how they deliver their message? What would make you feel engaged?

These are a few questions to ask yourself as you review this list of some of the most effective presentation skills.

Verbal communication

How you use language and deliver messages play essential roles in how your audience will receive your presentation. Speak clearly and confidently, projecting your voice enough to ensure everyone can hear. Think before you speak, pausing when necessary and tailoring the way you talk to resonate with your particular audience.

Body language

Body language combines various critical elements, including posture, gestures, eye contact, expressions, and position in front of the audience. Body language is one of the elements that can instantly transform a presentation that would otherwise be dull into one that's dynamic and interesting.

Voice projection

The ability to project your voice improves your presentation by allowing your audience to hear what you're saying. It also increases your confidence to help settle any lingering nerves while also making your message more engaging. To project your voice, stand comfortably with your shoulders back. Take deep breaths to power your speaking voice and ensure you enunciate every syllable you speak.

How you present yourself plays a role in your body language and ability to project your voice. It also sets the tone for the presentation. Avoid slouching or looking overly tense. Instead, remain open, upright, and adaptable while taking the formality of the occasion into account.

Storytelling

Incorporating storytelling into a presentation is an effective strategy used by many powerful public speakers. It has the power to bring your subject to life and pique the audience’s curiosity. Don’t be afraid to tell a personal story, slowly building up suspense or adding a dramatic moment. And, of course, be sure to end with a positive takeaway to drive your point home.

Active listening

Active listening is a valuable skill all on its own. When you understand and thoughtfully respond to what you hear—whether it's in a conversation or during a presentation—you’ll likely deepen your personal relationships and actively engage audiences during a presentation. As part of your presentation skill set, it helps catch and maintain the audience’s attention, helping them remain focused while minimizing passive response, ensuring the message is delivered correctly, and encouraging a call to action.

Stage presence

During a presentation, projecting confidence can help keep your audience engaged. Stage presence can help you connect with your audience and encourage them to want to watch you. To improve your presence, try amping up your normal demeanor by infusing it with a bit of enthusiasm. Project confidence and keep your information interesting.

Watch your audience as you’re presenting. If you’re holding their attention, it likely means you’re connecting well with them.

Self-awareness

Monitoring your own emotions and reactions will allow you to react well in various situations. It helps you remain personable throughout your presentation and handle feedback well. Self-awareness can help soothe nervousness during presentations, allowing you to perform more effectively.

Writing skills

Writing is a form of presentation. Sharp writing skills can help you master your presentation’s outline to ensure you stay on message and remain clear about your objectives from the beginning until the end. It’s also helpful to have strong writing abilities for creating compelling slides and other visual aids.

Understanding an audience

When you understand your audience's needs and interests, you can design your presentation around them. In turn, you'll deliver maximum value to them and enhance your ability to make your message easy to understand.

Learn more about presentation skills from industry experts at SAP:

How to improve presentation skills

There’s an art to public speaking. Just like any other type of art, this is one that requires practice. Improving your presentation skills will help reduce miscommunications, enhance your time management capabilities, and boost your leadership skills. Here are some ways you can improve these skills:

Work on self-confidence.

When you’re confident, you naturally speak more clearly and with more authority. Taking the time to prepare your presentation with a strong opening and compelling visual aids can help you feel more confident. Other ways to improve your self-confidence include practicing positive self-talk, surrounding yourself with positive people, and avoiding comparing yourself (or your presentation) to others.

Develop strategies for overcoming fear.

Many people are nervous or fearful before giving a presentation. A bad memory of a past performance or insufficient self-confidence can contribute to fear and anxiety. Having a few go-to strategies like deep breathing, practicing your presentation, and grounding can help you transform that fear into extra energy to put into your stage presence.

Learn grounding techniques.

Grounding is any type of technique that helps you steer your focus away from distressing thoughts and keeps you connected with your present self. To ground yourself, stand with your feet shoulder-width apart and imagine you’re a large, mature tree with roots extending deep into the earth—like the tree, you can become unshakable.

Learn how to use presentation tools.

Visual aids and other technical support can transform an otherwise good presentation into a wow-worthy one. A few popular presentation tools include:

Canva: Provides easy-to-design templates you can customize

Powtoon: Animation software that makes video creation fast and easy

PowerPoint: Microsoft's iconic program popular for dynamic marketing and sales presentations

Practice breathing techniques.

Breathing techniques can help quell anxiety, making it easier to shake off pre-presentation jitters and nerves. It also helps relax your muscles and get more oxygen to your brain.  For some pre-presentation calmness, you can take deep breaths, slowly inhaling through your nose and exhaling through your mouth.

While presenting, breathe in through your mouth with the back of your tongue relaxed so your audience doesn't hear a gasping sound. Speak on your exhalation, maintaining a smooth voice.

Gain experience.

The more you practice, the better you’ll become. The more you doanything, the more comfortable you’ll feel engaging in that activity. Presentations are no different. Repeatedly practicing your own presentation also offers the opportunity to get feedback from other people and tweak your style and content as needed.

Tips to help you ace your presentation

Your presentation isn’t about you; it’s about the material you’re presenting. Sometimes, reminding yourself of this ahead of taking center stage can help take you out of your head, allowing you to connect effectively with your audience. The following are some of the many actions you can take on the day of your presentation.

Arrive early.

Since you may have a bit of presentation-related anxiety, it’s important to avoid adding travel stress. Give yourself an abundance of time to arrive at your destination, and take into account heavy traffic and other unforeseen events. By arriving early, you also give yourself time to meet with any on-site technicians, test your equipment, and connect with people ahead of the presentation.

Become familiar with the layout of the room.

Arriving early also gives you time to assess the room and figure out where you want to stand. Experiment with the acoustics to determine how loudly you need to project your voice, and test your equipment to make sure everything connects and appears properly with the available setup. This is an excellent opportunity to work out any last-minute concerns and move around to familiarize yourself with the setting for improved stage presence.

Listen to presenters ahead of you.

When you watch others present, you'll get a feel for the room's acoustics and lighting. You can also listen for any data that’s relevant to your presentation and revisit it during your presentation—this can make the presentation more interactive and engaging.

Use note cards.

Writing yourself a script could provide you with more comfort. To prevent sounding too robotic or disengaged, only include talking points in your note cards in case you get off track. Using note cards can help keep your presentation organized while sounding more authentic to your audience.

Learn to deliver clear and confident presentations with Dynamic Public Speaking from the University of Washington. Build confidence, develop new delivery techniques, and practice strategies for crafting compelling presentations for different purposes, occasions, and audiences.

Article sources

Forbes. “ New Survey: 70% Say Presentation Skills are Critical for Career Success , https://www.forbes.com/sites/carminegallo/2014/09/25/new-survey-70-percent-say-presentation-skills-critical-for-career-success/?sh=619f3ff78890.” Accessed December 7, 2022.

Beautiful.ai. “ 15 Presentation and Public Speaking Stats You Need to Know , https://www.beautiful.ai/blog/15-presentation-and-public-speaking-stats-you-need-to-know. Accessed December 7, 2022.

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Malpresentations and malpositions.

Published on 09/03/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 09/03/2015

This article have been viewed 9561 times

Introduction

Malpresentation.

Malposition

During pregnancy, abdominal palpation should aim to define the lie, presentation and position of the fetus. The lie refers to the long axis of the fetus in relation to the long axis of the uterus. Usually, the fetus is longitudinal, but occasionally it may be transverse or oblique. The presentation is that part of the fetus which is at the pelvic brim, in other words the part of the fetus presenting to the pelvic inlet. Normal presentation is the vertex of the fetal head and the word ‘malpresentation’ describes any non-vertex presentation. This may be of the face, brow, breech, or some other part of the body if the lie is oblique or transverse.

The position of the fetus refers to the way in which the presenting part is positioned in relation to the maternal pelvis. Strictly speaking this refers to any presenting part, but here it will be considered in relation to those fetuses presenting head first (cephalic). As we have seen, the head is usually occipitotransverse at the pelvic brim and rotates to occipitoanterior at the pelvic floor. ‘Malposition’ is when the head, coming vertex first, does not rotate to occipitoanterior, presenting instead as persistent occipitotransverse or occipitoposterior.

As described above, ‘malpresentation’ is a term used to describe any non-vertex presentation. Over 95% of fetuses are in cephalic presentation at term. Malpresentations include face presentation, brow presentation and breech presentation. When the fetus has a cephalic presentation, the presenting diameter is dependent on the degree of flexion or extension of the fetal head – deflexed and brow presentations offer a wide diameter to the pelvic inlet ( Table 45.1 and Fig. 45.1 ).

Presenting diameters of the fetal head

Fig. 45.1 The presenting diameter is dependent on the degree of flexion or extension of the fetal head.

As the fetal skull is made up of individual bony plates (the occipital, sphenoid, temporal and ethmoid bones), which are joined by cartilaginous sutures (the frontal, sagittal, lambdoid and coronal sutures), it has the potential to be ‘moulded’ during labour. This allows the head to fit the birth canal more closely (Fig. 45.2) . Moulding should be distinguished from caput succedaneum, which refers to oedema of the presenting part of the scalp. Both moulding and caput can occur in any cephalic presentation, but are more likely to occur in malpresentation. The presence or absence of moulding and caput should be documented during each vaginal examination in labour; excessive moulding and caput are suggestive of an obstructed labour due to cephalopelvic disproportion.

Fig. 45.2 ‘Moulding’ refers to the change in shape of the fetal skull during labour as it ‘moulds’ to the birth canal.

Caput refers to oedema of the presenting part of the scalp.

Face presentation

This occurs in about 1:500 births and occurs when the fetal head extends right back (hyperextended so that the occiput touches the fetal back) (Fig. 45.3 A) . It is associated with prematurity, tumours of the fetal neck, loops of cord around the fetal neck, fetal macrosomia and anencephaly. Face presentation is usually only recognized after the onset of labour and, if the face is swollen (Fig. 45.3 B) , it is easy to confuse this presentation with that of a breech. The position of the face is described with reference to the chin, using the prefix ‘mento’. The presenting diameter is submentobregmatic (9.5 cm) (Fig. 45.1) .

Fig. 45.3 Face presentation.

(A) The head enters the pelvic brim in the transverse position. (B) Most rotate to the mentoanterior position and deliver without problems. (C) Those that rotate to mentoposterior will obstruct. (D) Face presentation is often associated with oedema and bruising. This baby recovered without problems.

The face usually enters the pelvis with the chin in the transverse position (mentotransverse) and 90% rotate to mentoanterior so that the head is born with flexion (Fig. 45.3 C) . If mentoposterior, the extending head presents an increasingly wider diameter to the pelvis, leading to worsening relative cephalopelvic disproportion and impacted obstruction (Fig. 45.3 D) . A caesarean section is usually required.

Brow presentation

This occurs in only approximately 1:700 and 1:1500 births and is the least favourable for delivery (Fig. 45.4) . The presenting diameter is mentovertical, measuring 14 cm. The supraorbital ridges and the bridge of the nose will be palpable on vaginal examination. The head may flex to become a vertex presentation or extend to a face presentation in early labour. If the brow presentation persists, a caesarean section will be required.

Fig. 45.4 Brow presentation.

Breech presentation

Breech presentation describes a fetus presenting bottom first. The incidence is around 40% at 20 weeks, 25% at 32 weeks and only 3–4% at term. The chance of a breech presentation turning spontaneously after 38 weeks is < 4%. Breech presentation is associated with multiple pregnancy, bicornuate uterus, fibroids, placenta praevia, polyhydramnios and oligohydramnios. It may also rarely be associated with fetal anomaly, particularly neural tube defects, neuromuscular disorders and autosomal trisomies. At term, 65% of breech presentations are frank (extended) with the remainder being flexed or footling (Fig. 45.5) . Footling breech carries a 5–20% risk of cord prolapse ( p. 367 ).

Fig. 45.5 Breech presentation.

Those presenting by the breech may be (A) extended (or frank); (B) flexed; or (C) footling.

Mode of delivery

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Clinical Obstetrics and Gynaecology

Fetal Presentation, Position, and Lie (Including Breech Presentation)

• Key Points |

Abnormal fetal lie or presentation may occur due to fetal size, fetal anomalies, uterine structural abnormalities, multiple gestation, or other factors. Diagnosis is by examination or ultrasonography. Management is with physical maneuvers to reposition the fetus, operative vaginal delivery , or cesarean delivery .

Terms that describe the fetus in relation to the uterus, cervix, and maternal pelvis are

Fetal presentation: Fetal part that overlies the maternal pelvic inlet; vertex (cephalic), face, brow, breech, shoulder, funic (umbilical cord), or compound (more than one part, eg, shoulder and hand)

Fetal position: Relation of the presenting part to an anatomic axis; for vertex presentation, occiput anterior, occiput posterior, occiput transverse

Fetal lie: Relation of the fetus to the long axis of the uterus; longitudinal, oblique, or transverse

Normal fetal lie is longitudinal, normal presentation is vertex, and occiput anterior is the most common position.

Abnormal fetal lie, presentation, or position may occur with

Fetopelvic disproportion (fetus too large for the pelvic inlet)

Fetal congenital anomalies

Uterine structural abnormalities (eg, fibroids, synechiae)

Multiple gestation

Several common types of abnormal lie or presentation are discussed here.

Transverse lie

Fetal position is transverse, with the fetal long axis oblique or perpendicular rather than parallel to the maternal long axis. Transverse lie is often accompanied by shoulder presentation, which requires cesarean delivery.

Breech presentation

There are several types of breech presentation.

Frank breech: The fetal hips are flexed, and the knees extended (pike position).

Complete breech: The fetus seems to be sitting with hips and knees flexed.

Single or double footling presentation: One or both legs are completely extended and present before the buttocks.

Types of breech presentations

Breech presentation makes delivery difficult ,primarily because the presenting part is a poor dilating wedge. Having a poor dilating wedge can lead to incomplete cervical dilation, because the presenting part is narrower than the head that follows. The head, which is the part with the largest diameter, can then be trapped during delivery.

Additionally, the trapped fetal head can compress the umbilical cord if the fetal umbilicus is visible at the introitus, particularly in primiparas whose pelvic tissues have not been dilated by previous deliveries. Umbilical cord compression may cause fetal hypoxemia.

Predisposing factors for breech presentation include

Preterm labor

Uterine abnormalities

Fetal anomalies

If delivery is vaginal, breech presentation may increase risk of

Umbilical cord prolapse

Birth trauma

Perinatal death

Face or brow presentation

In face presentation, the head is hyperextended, and position is designated by the position of the chin (mentum). When the chin is posterior, the head is less likely to rotate and less likely to deliver vaginally, necessitating cesarean delivery.

Brow presentation usually converts spontaneously to vertex or face presentation.

Occiput posterior position

The most common abnormal position is occiput posterior.

The fetal neck is usually somewhat deflexed; thus, a larger diameter of the head must pass through the pelvis.

Progress may arrest in the second phase of labor. Operative vaginal delivery or cesarean delivery is often required.

Position and Presentation of the Fetus

If a fetus is in the occiput posterior position, operative vaginal delivery or cesarean delivery is often required.

In breech presentation, the presenting part is a poor dilating wedge, which can cause the head to be trapped during delivery, often compressing the umbilical cord.

For breech presentation, usually do cesarean delivery at 39 weeks or during labor, but external cephalic version is sometimes successful before labor, usually at 37 or 38 weeks.

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Definition of presentation noun from the Oxford Advanced Learner's Dictionary

presentation

• presentation on/about somebody/something The sales manager will give a presentation on the new products.
• Several speakers will be making short presentations .
• The conference will begin with a keynote presentation by a leading industry figure.
• a slide/video/multimedia presentation
• presentation on

Definitions on the go

Look up any word in the dictionary offline, anytime, anywhere with the Oxford Advanced Learner’s Dictionary app.

• noun the activity of formally presenting something (as a prize or reward) “she gave the trophy but he made the presentation ” see more see less type of: ceremony the proper or conventional behavior on some solemn occasion
• noun the act of presenting a proposal see more see less types: first reading the first presentation of a bill in a legislature second reading the second presentation of a bill in a legislature; to approve its general principles (Britain) or to discuss a committee's report and take a vote (US) type of: proposal , proposition the act of making a proposal
• noun the act of making something publicly available; presenting news or other information by broadcasting or printing it “he prepared his presentation carefully in advance” see more see less types: unveiling putting on display for the first time production a presentation for the stage or screen or radio or television staging , theatrical production the production of a drama on the stage type of: display exhibiting openly in public view
• noun formally making a person known to another or to the public synonyms: intro , introduction see more see less types: debut the presentation of a debutante in society reintroduction an act of renewed introduction type of: informing , making known a speech act that conveys information
• noun a show or display; the act of presenting something to sight or view “the presentation of new data” synonyms: demonstration , presentment see more see less types: show 19 types... hide 19 types... exhibition the act of exhibiting exposure presentation to view in an open or public manner performance the act of presenting a play or a piece of music or other entertainment lecture demonstration presentation of an example of what the lecturer is discoursing about counterdemonstration a demonstration held in opposition to another demonstration dramatic performance , dramatic production the act of performing a drama encore an extra or repeated performance; usually given in response to audience demand extemporisation , extemporization , improvisation a performance given extempore without planning or preparation juggle , juggling throwing and catching several objects simultaneously conjuration , conjuring trick , deception , illusion , legerdemain , magic , magic trick , thaumaturgy , trick an illusory feat; considered magical by naive observers musical performance the act of performing music one-night stand a performance in one place on one night only interpretation , rendering , rendition the act of interpreting something as expressed in an artistic performance last hurrah , swan song a final performance or effort (especially before retirement) debunking , repudiation the exposure of falseness or pretensions production (law) the act of exhibiting in a court of law rodeo an exhibition of cowboy skills program , programme a performance (or series of performances) at a public presentation reprise the act of performing a role again type of: show the act of publicly exhibiting or entertaining
• noun a visual representation of something synonyms: display see more see less types: show 5 types... hide 5 types... float an elaborate display mounted on a platform carried by a truck (or pulled by a truck) in a procession or parade Snellen chart display consisting of a printed card with letters and numbers in lines of decreasing size; used to test visual acuity spectacle an elaborate and remarkable display on a lavish scale bullfight , corrida a Spanish or Portuguese or Latin American spectacle; a matador baits and (usually) kills a bull in an arena before many spectators naumachia , naumachy a naval spectacle; a mock sea battle put on by the ancient Romans type of: representation a creation that is a visual or tangible rendering of someone or something
• noun (obstetrics) position of the fetus in the uterus relative to the birth canal “Cesarean sections are sometimes the result of abnormal presentations ” see more see less type of: attitude , position , posture the arrangement of the body and its limbs

Vocabulary lists containing presentation

To improve your fluency in English Language Arts and Reading (ELAR), learn this academic vocabulary list that includes words selected from the Texas Essential Knowledge and Skills (TEKS) state standards.

Vocabulary is key to performing well on Common Core-aligned tests for English Language Arts as well as for building literacy in social studies, science, and technical subjects. This collection features common tier-2 words that are taught and tested in Grades 9 and 10. These words are used in a variety of contexts, exhibit different shades of meaning based on those contexts, and appear commonly in classroom instruction and on standardized assessments. Here are links to our lists for the collection: List 1 , List 2 , List 3 , List 4 , List 5 , List 6 , List 7 , List 8

Vocabulary is key to performing well on Common Core-aligned tests for English Language Arts as well as for building literacy in social studies, science, and technical subjects. This collection features common tier-2 words that are taught and tested in Grade 6. These words are used in a variety of contexts, exhibit different shades of meaning based on those contexts, and appear commonly in classroom instruction and on standardized assessments. Here are links to our lists for the collection: List 1 , List 2 , List 3 , List 4 , List 5 , List 6 , List 7 , List 8

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Farm Animal Final > 40. Definition of the presentation, position, and posture of the foetus in cattle. Normal and abnormal presentations in cattle. > Flashcards

40. Definition of the presentation, position, and posture of the foetus in cattle. Normal and abnormal presentations in cattle. Flashcards

Normal presentation?

Presentation, position, and posture describes how the foetus lays in the pregnant uterus or within the birth canal

1.Presentation

Relation of the long axis of the foetus to that of the dam

Normal: longitudinal presentation

Longitudinal anterior presentation

Normal presentation

Abnormal presentation

Dorso-transverse presentation

ventro -transverse presentation

abnormal presentation

Oblique ventro vertical presentation

and no pic oblique dorso vertical presentation

Differentiation of normal presentations?

(Anterior presentation)

Differentiation of Normal (longitudinal) Presentations

Anterior presentation

• Metacarpophalangeal joint (fetlock) and the carpus joint are flexed to the same direction
• Bony knob (tuber olecrani) is present at the second joint proximal to the fetlock
• In dorsal position of the foetus the palmar sides of the forelimbs are facing vertical
• Recognition of the head and neck (mouth, nose, ears, trachea, mane)

Differentation of normal presentation?

(Posterior presentation)

Posterior presentation

• Metatarsophalangeal joint (fetlock) and the first joint proximal (tarsal) to that are flexed to the opposite

• Bony knob (tarsus) is present at the first joint proximal to the fetlock
• In dorsal position of the foetus the plantar sides of the hind limbs are facing dorsally
• Recognition of tail, anus, umbilical cord, testis, scrotum

Relation of the vertebral column of the foetus to that of the dam

Normal: dorsal (upright) position

Relation of the head, neck, and legs of the foetus to its trunk

Normal: a) during pregnancy: flexed

b) during parturition: extended

Predisposing factors for abnormal postures

• Premature birth
• Any type of uterine inertia
• Reduction in the intrauterine space

Abnormal head positions?

Abnormal forelimb presentations?

Abnormal Hindlimb presentation?

Normal presentations?

Normal presentations.

• During pregnancy; longitudinal presentation (anterior or posterior)

Dorsal (upright) position (ventral in equine)

Flexed posture

• During parturition; same as above but extended posture

Farm Animal Final (116 decks)

• 1.Skin diseases of cattle
• 2. Diseases of the lungs and upper airways in ruminants
• 3. Disease of the oral cavity and the oesophagus in ruminants
• 4. Diseases of the intestines in ruminants
• 5. Diagnostics and treatment of liver diseases in ruminants.
• 6. Cardiologic and hemopoietic diseases in ruminants
• 7. Diseases of the kidney and the excretory system in ruminants
• 8. Neurological diseases in cattle
• 9. Biochemical disorders of the rumen
• 10. Metabolic diseases in ruminants
• 11. Deficiencies of certain antioxidants (beta carotene, vitamin E) in cattle.
• 12. Rumenotomy in cattle
• 13. Hardware disease (traumatic reticuloperitonitis): incidence, etiology/cause, predisposing factors and pathogenesis
• 14. Hardware disease (traumatic reticuloperitonitis): clinical signs, local and/or systemic consequences, diagnosis, and treatment
• 15. Hoflund syndrome
• 16. Anatomy of the abomasum, diseases of the abomasum (list), abomasal displacement: forms, incidence, etiology/causes, and predisposing factors
• 17. Pathogenesis of the abomasal displacement, general and local consequences of abomasal displacement
• 18. Clinical signs and diagnosis of the left sided abomasal displacement
• 19. Clinical signs and diagnosis of the right sided abomasal displacement
• 20. Abomasitis, abomasal ulcer
• 21. Abomasal impaction and reflux syndrome
• 22. Therapeutic approaches of abomasal displacement
• 23. Proximal lumbar paravertebral nerve block in cattle
• 24. Distal lumbar paravertebral nerve block in cattle
• 25. Inverted L paralumbar anaesthesia, anaesthesia of the distal limb via vascular (IV) infusion, anaesthesia of the horn (cornual nerve block) in cattle
• 26. Anaesthesia of the teat in cattle
• 27. Epidural anaesthesia in cattle
• 28. Forms of general anaesthesia in cattle, commonly used drugs, and drug combinations
• 29. Approaches, indications, and contraindications of cattle abdominal surgery
• 30. The bony and the soft birth canal in cattle
• 31. Anatomy and examination techniques of the genital tract of the cow
• 32. Ancillary diagnostics (bacteriology, cytology, biopsy) in the diagnostics of the female genital tract in cattle.
• 33. Pharmacological treatment of the reproductive cycle in cattle
• 34. Pregnancy determination in cattle
• 35. Clinical features of pregnancy proteins in cattle
• 36. Clinical management of cattle twin pregnancy
• 37. Embryonic and foetal losses in cattle
• 38. Dislocations of the pregnant uterus, labour activity and uterine inertia in cattle
• 39. Enlargement of the soft birth canal in cattle. Instruments of obstetrical aid in cattle.
• 40. Definition of the presentation, position, and posture of the foetus in cattle. Normal and abnormal presentations in cattle.
• 41. Deviations of the head and clinical management in cattle.
• 42. Deviations of the forelimbs and clinical management in cattle
• 43. Deviations of the hindlimbs and clinical management in cattle.
• 44. Lubricants and labour pain management in cattle
• 45. Caesarean section in cows: indications, contraindications, surgical restraint, preparation of abdominal wall
• 46. Caesarean section in cows: anaesthesia of the abdominal wall, incision, abdominal manipulation, closure of the abdominal wall
• 47. Fetotomy: conditions, equipment, preparation, and steps of the most often used techniques in cows
• 48. Pathophysiology, classification, and treatment of vaginal prolapse in cows
• 49. Pathophysiology, clinical aspects, and treatment of uterine prolapse in cows
• 50. The management of retained foetal membranes in cattle
• 51. Phases, processes and influencing factors of involution in cattle
• 52. Bacterial complications of involution in cattle (cause, symptoms, diagnostics, treatment)
• 53. Foetal monsters in cattle
• 54. The most important elements of calf care in the perinatal period
• 55. Examination, drug administration and sample collection in calves
• 56. The importance of automatic systems in the diagnostics of diseases in cattle
• 57. The importance of automatic systems in the prediction of calving in cattle
• 58. Anatomy of the udder and clinical consequences. Defence mechanisms of the udder in cattle.
• 59. Mastitis diagnosis and treatment in cattle
• 60. Surgery of the bovine mammary gland in cattle
• 61. Clinical practice of drying off in cattle
• 62. Anatomical features of the bovine hoof. Locomotion scoring
• 63. Infectious hoof diseases in cattle
• 64. Non-infectious hoof diseases in cattle
• 65. Treatment of arthritis and traumatic injuries of the hoof in cattle
• 66. Elements of foot care in small ruminants on individual and herd leve
• 67. Causes of lameness in small ruminants (symptoms, characteristics, treatment)
• 68. Anaesthesia in small ruminants
• 69. Small ruminant medicine: lambing and dystocia
• 70. Small ruminant medicine: incomplete cervical dilation, uterine torsion, uterine inertia
• 71. Caesarean section in small ruminants
• 72. Small ruminant medicine: prolapse of the uterus and vagina
• 73. Small ruminant medicine: metritis
• 74. Mastitis in small ruminants
• 75. Small ruminant medicine: rupture of the prepubic tendon, rupture of the uterus, evisceration through vaginal tear, rectal prolapse
• 76: Hypovitaminosis in swine- RARE (intensive farming and nutrition)
• Topic 77. PSS (Porcine stress syndrome)- Metabolic Disease
• 78. Cardiological and haemopoietic disease of swine
• 79. Diseases of the GI tract in Swine
• 80. Disease of Respiratory tract in Swine
• 83. Locomotor diseases in piglets and growers
• 84. Locomotor diseases in sows
• 85. Arthritis in swine, septic laminitis
• 86. Viral and bacterial diseases of the nervous system in swine
• 87. Congenital tremors, salt poisoning in swine
• 88. Congenital skin diseases in swine
• 89. Infectious skin diseases in swine
• 90. Non-infectious skin diseases in swine
• 91. Parenteral drug administration and sample collection techniques in swine
• 92. Oral drug administration in swine
• 93. Types of anaesthesia in swine
• 94. Drugs of anaesthesia in swine
• 95. Teasing boars (use, operations)
• 96. Main features of the boar’s ejaculate. Method of boar semen collection and preservation
• 97. Age of puberty of boars, ’on farm’ use of boars, proper ’on farm’ boar: sow rate
• 98. Most frequent morphological defects of boar semen and diagnostic methods of them
• 99. Mating behaviour and symptoms of heat in swine, including differences of gilts and sows
• 100.Methods of searching for gilts and sows in heating
• 101.Oestrous induction and synchronization methods in swine
• 102.Steps of artificial insemination in pig practice
• 103. Reproductive management at the pig farm.
• 104.Most frequent disturbances of sexual maturation in gilts. ’On farm’ diagnostic methods and methods of prevention/therapy
• 105.Pregnancy diagnosis in pigs
• 106.Implantation of sows in the farrowing unit. Traditional and modern farrowing buildings
• 107.Aims and methods of farrowing synchronization at the pig farm
• 108.Phases of farrowing
• 109.Caesarean Section in sows (indication, anaesthesia, preparation)
• 110.Caesarean Section in sows (from laparotomy until aftercare)
• 111.Uterine and cervical prolapse in swine
• 112.Prolapse of rectum and vulval haematoma in swine
• 113.Phases of puerperium in sows
• 114.Most important disturbances in the farrowing unit
• 115.Caring for new-born piglets (umbilical haemorrhage, artificial feeding, iron supplementation)
• 116.Caring for new-born piglets (docking (tail clipping), teeth-clipping, castration)
• 117.Castration of grower-finisher pig and boar
• 118.Cryptorchidism and castration of piglets with inguinal hernia
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Svetoslava Ivanova

Digital Marketer

Aug 05, 2024 • 12 min read

How To Write The Best Promotional Emails in 2024 (With Examples)

Table of contents.

Today, online businesses are increasingly leveraging email marketing as a vital tool to promote their products and services to a wide array of clients, prospects, and leads. This is because promotional emails are an effective method for companies to deliver personalized messages directly to their subscribers’ inboxes , showcasing their latest products, services, and exclusive offers. Therefore, increasing their sales and boosting brand awareness.

In 2024, as consumers’ inboxes become even more crowded with promotional emails the competition for their attention grows stronger. This makes it crucial for marketers to master the art of creating effective promotional emails. Standing out depends on the ability to thoughtfully craft emails that are engaging, valuable, visually appealing, and relevant to the audience.

In this article, we’ll explore how to write promotional emails to enhance your email marketing campaigns successfully.

What are Promotional Emails?

At their core, promotional emails are a type of marketing communication sent via email to engage and persuade recipients to take specific actions . These emails are designed to promote products, services, or events and can effectively drive sales and customer engagement. Key characteristics of promotional emails include a clear objective, a compelling subject line and preheader, engaging content, eye-catching design with high-quality images, a clearly stated offer, a feeling of urgency, and a strong call-to-action (CTA). 

There are different types of promotional emails such as:

• product launch announcements 
• discount and sale notifications 
• seasonal and holiday promotions 
• event invitations 
• back-in-stock alerts 
• exclusive subscriber offers
• abandoned cart reminders
• upsell or cross-sell suggestions. 

By crafting targeted and compelling promotional emails, businesses effectively connect with their audience, boost sales, and build customer loyalty. 

Make Your Emails Stand Out in Your Subscribers’ Inboxes

In response to the impact of emails on people’s purchasing decisions, Google introduced categorized inboxes in 2013, including the Promotions tab. Despite some marketers’ concerns about losing visibility, this feature is appreciated by many users for helping organize promotional emails. In fact, 45.1% of users with this feature enabled check it daily, and those who do are more likely to engage and make purchases.

However, marketers and business owners naturally aim for their emails to land in subscribers’ primary inboxes in order to increase visibility and engagement chances, which can lead to more purchases. Achieving this requires focusing on the quality and relevance of the content because Gmail’s algorithm favors user engagement , promoting emails that are consistently opened and interacted with to the primary tab. Therefore, sending valuable, straightforward promotional emails to an engaged subscriber list is the most effective strategy to ensure your emails reach the primary inbox, enhancing visibility and interaction rates.

Ultimately, the success of a promotional email lies in its ability to capture the recipient’s attention from the subject line to the incentive that will encourage them to take action. With the right approach, these emails can significantly increase client engagement and drive sales. However, the strategy behind crafting promotional emails must also be tailored to a specific occasion and audience. 

How to Write Promotional Emails?

Writing the perfect promotional emails starts before hitting the keyboard. You need to prep the ground by defining your business objectives, your target audience and your offer, which should be positioned at the right time and in line with your target’s interests and needs. Once you are clear on these, you can proceed with writing your email.

Set clear business objectives and define your offer

Before crafting your promotional email, define what you want to achieve with it – whether it’s increasing sales (during a slow season, for a specific product or event, or else); boosting average customer spend and order value; clearing old inventory; or else. 

When crafting your promotional emails, it’s crucial to define and then communicate compelling offers that resonate with your audience and your specific business goals. These could be all sorts of things such as:

• Free shipping offer – for example: “Get Free shipping with orders above $100”. This aims to incentivize higher average order value.
• Limited-time discounts – these could be percentage discounts such as “20% OFF all bags this weekend only” or flat-fee discounts such as “Get 20$ OFF on all purchases above 200$,” which boost the number of sales you’ll get over a specified period of time. 
• Giveaways – such as “Submit an order by the end of the month and automatically enter our giveaway for a pair of free BRAND sunglasses.”These could work great to stimulate purchases for a limited time. 
• Discounts for repeat purchases – offer a discount for your clients’ next purchases, which would effectively enhance customer retention and the average revenue generated per client. 
• Milestone and loyalty rewards – when you offer a special discount or other incentive to customers achieving certain milestones (like purchase volume, birthday event, or else), they feel appreciated and tend to spend more with you.
• Bundle offers – such as “Buy One, Get One Half Off” or “Buy Three, Get One Free” help increase transaction volumes. 
• No offer, just a reminder – that’s actually quite effective! You don’t always need to make a discount or offer something special to stimulate purchases. Sometimes it’s about announcing the existence of a product or service, or reminding your clients that there are other interesting items in your store.

Whatever offer you decide to present to your target audience, make sure it is clear and timed to match with relevant buying periods for maximum engagement and campaign results. By tailoring your promotional emails to specific occasions with clear communication about the benefits, timeframe, and details on how to take advantage of the offers you can significantly enhance the relevance and success of your campaigns. 

Create a compelling subject line (with your offer included)

Don’t forget that your subject line makes the first impression and is directly responsible for the email open rate. The higher the open rate, the higher the engagement with your content. 

Make your subject count by clearly stating the promotion or the benefit for your subscriber. This not only grabs attention but also sets expectations, which can lead to higher open rates. For instance, the subject line “Exclusive Offer: 20% Off Only for Our Subscribers” is direct and enticing, and is more likely to make people want to open the email than a subject line like “Socks on Discount”. 

Use preheader text

The preheader of an email is the brief text that appears after the subject line in an email inbox. It’s your second chance to catch the reader’s attention , so make sure you use this space to add context or further entice the reader to open the email, like “Unlock your subscriber-exclusive discount inside!”

Make your content engaging

Communicate your offer in the email header.

Crafting an effective header for your promotional emails is crucial in capturing your subscribers’ attention. The header is often the first element your recipients notice and it sets the tone for the entire email. That is why seasoned marketers aim to communicate their offer as early as the email header. By doing so they immediately highlight the offer and encourage the readers to continue engaging with the email content. 

Include clear and visible CTAs

Your CTA (call-to-action) bridges your email content and the desired action you want the recipient to take. It should be action-oriented and create a sense of value or urgency , without being too pushy. Whether it’s ‘Shop Now,’ ‘Learn More,’ or ‘Claim Your Gift,’ make sure it’s clear and easy to find.  

It’s important to know the difference between a ‘Learn More’ and a ‘Shop Now’ button. If you really want to urge users to take action, choose a more specific button such as ‘Shop Now,’ which includes a strong verb that requests action. ‘Learn More’ is more informative and not that compelling when your goal is to drive immediate conversions. 

The design of your CTA, be it a button or a hyperlinked text, should make it jump off the page. Use contrasting colors, bold fonts, or a distinctive shape to ensure it doesn’t get lost in the rest of your email content. Ideally, it should be positioned high enough in the email that readers won’t have to scroll too much to find it, or at the end of the content so that it feels like a logical next step.

Mind the email length

When writing promotional emails, the less is more. Try to keep your text short and to the point, allowing the reader to focus on the offer and not get overwhelmed by details that might put them off.

Make your emails visually appealing

An aesthetically appealing email should capture readers’ attention and also hold it , guiding them through your message and towards your CTA. 

Use high-quality images

To achieve this, start by using high-quality images of your product or visuals that resonate with your brand and your email message. 

If you are running a promotion on a product, it is advisable to use real, high-quality photos of the product(s) you’re discounting. Don’t go for generic product images, but try to show your item(s) from their best angle to highlight key features and engage the readers visually. These photos must look professional and represent the product accurately . 

Use a color scheme in line with your brand identity

The color scheme of your email is another critical element. Choose email colors that reflect your brand identity and complement each other well. A harmonious palette can evoke the right emotions and make your content more digestible. For instance, using a calming blue color for a wellness center’s promotional email can reinforce the idea of relaxation.

Balance all elements (text vs. visuals)

Make sure you leave space between the elements of your email as it gives your content room to breathe and helps avoid a cluttered or overwhelming look. Proper use of white space can improve readability and focus the reader’s attention on the most important parts of your email, such as the headline, key benefits, and CTA.

Finally, consider the overall layout of your email . It should have a logical flow that naturally leads the reader from the email opening to the CTA. Break up text into short paragraphs and use headings and bullet points to organize the information. By creating a visually appealing and easy-to-navigate layout, you’ll help the readers digest the content of your promotional email more easily and enhance the likelihood that your message will be read and acted upon.

Strategically position your email elements for maximum engagement

The layout of your promotional email plays a crucial role in capturing and retaining the reader’s attention. Start with a compelling header that includes an eye-catching image of the product(s) on offer. Position your main offer or discount prominently at the top of the email , where it’s immediately visible upon opening. 

Use bullet points or short paragraphs to outline key benefits and features, making the content easy to scan. Include clear, bold calls to action at multiple points within the email to guide readers towards making a purchase. 

Optimize Image Placement

• Header image – use a high-quality, relevant image at the top to grab attention
• Supporting images – place images alongside text to visually break up content and maintain interest
• Product images – position product images near descriptions to provide context and entice readers

Content Positioning

• Main offer –  place your primary offer or discount at the top for immediate visibility
• Benefits and features – use bullet points or short paragraphs to make the content digestible.
• CTA  – include clear, bold calls to action at multiple points to guide reader actions.

If you are building your email campaigns on SiteGround Email Marketing platform , you can choose from predefined email layouts and professionally crafted promotional templates , specifically designed to meet email marketing best practices. With it, you can easily send emails by simply adding your content and images, while also having the flexibility to edit templates and layouts and craft your campaigns in a way that best resonates with your audience.

Finally, ensure that contact information and links to your social media are easily accessible, encouraging further interaction. 

Advanced Tips on Promotional Emails

Create a sense of urgency.

Creating a sense of urgency in your email campaigns is a powerful tactic to compel readers to act quickly . The psychological principle behind this is simple – consumers tend to place a higher value on opportunities that are available for a limited time. 

To effectively create this sense of urgency, use time-sensitive language in both your email copy and CTA. Phrases such as “Offer ends in 24 hours”, “Grab yours before they’re gone,” or “Last chance to claim your exclusive discount” suggest that delaying could result in missing out on something desirable.

Build trust when promoting services

When promoting a service via email, building trust with your audience is key. Unlike products, services require you to illustrate the benefits and reliability through compelling images and content. 

Use photos that illustrate real people enjoying the service, delighted customers, or the service being performed. These pictures should represent professionalism and inspire pleasant emotions. Include testimonials or comments from your current clients to demonstrate authenticity and reliability. 

Highlight testimonials, awards or endorsements your service has received to further establish authority. Additionally, enhance the value of your email by providing useful tips on how readers can maximize the benefits of your service, or explain how to use it properly. This not only educates your audience but also demonstrates your commitment to their satisfaction and success. 

Make it personal

Personalization in email marketing goes beyond just using the customer’s name. It’s about crafting a message that feels tailor-made for the recipient. By referencing their past interactions with your brand, such as previous purchases or items they’ve shown interest in, you can show that you’re paying attention to their individual needs and preferences. Celebrate their milestones, like the anniversary of their first purchase, with a personalized offer or a simple congratulatory note. By making your emails more relevant and personal, you can turn a generic campaign into a meaningful conversation that resonates with your subscribers.

Don’t over-do your promotional offers

While promotional emails are effective at driving sales, bombarding your subscribers with constant offers might have a negative result. Overloading their inboxes may lead to decreased engagement, with subscribers either ignoring your messages and (and having your emails moved to Gmail’s Promotions tab for those who use it) or, in the worst-case scenario, unsubscribing altogether. It’s essential to find the balance between providing value and respecting your audience’s inbox space to maintain a healthy subscriber relationship.

A/B test and analyze email performance 

Continuously improve your email strategy by testing different elements such as subject lines, images, and CTAs. By comparing two versions of an email, each with one varying element, you can gather data on what drives better engagement and conversion rates with your audience. Afterward, analyze the results to understand what resonates best with your audience and refine your approach accordingly. 

Now that we’ve covered the essential steps for crafting a promotional email, let’s explore some examples that effectively combine these tips to create compelling campaigns that drive sales!

7 Types of Promotional Emails (with examples)

Emails about product offers & limited-time deals.

Product sales emails are promotional emails that focus on driving sales for specific products or services. They often include a direct call to action, enticing visuals of the product, and information on pricing or discounts. 

Promotional emails about product offers and limited-time deals can be particularly effective when they are aligned with specific occasions that encourage higher customer activity, as we mentioned above. Adding a sense of urgency can prompt your subscribers to act quickly, leading to faster results.

But what’s also important for your product promotional email is to ensure that it includes all the essential components. This includes a compelling subject line that grabs attention, a clear and engaging message that highlights the benefits of your offer, attractive visuals that complement the text, and a strong call to action that encourages recipients to take the next step. 

Upsell Emails

Following a customer’s purchase, strategically timed follow-up emails can be an effective way to introduce items that complement or enhance their recent purchase. This practice, known as upselling, involves suggesting products that are related to the initial purchase , aiming to provide the customer with an even more satisfying user experience. Upsell emails should be helpful and informative, detailing the benefits of each additional product and how it integrates with the original purchase, thereby creating a more comprehensive solution for the customer.

Back-in-Stock Emails 

Back-in-stock emails are ideal for triggering immediate action from customers who previously missed out on popular items. These emails serve as timely reminders, creating urgency and excitement , which can lead to quick conversions. Notifying customers that a product is available again is a great opportunity to re-engage them and encourage revisits to your store.

To maximize effectiveness, include high-quality images, a compelling subject line, and clear calls to action. Personalizing these emails based on previous interactions can enhance their impact.

Holiday and Seasonal Emails 

Holiday and seasonal promo emails are the ones designed to tap into the festive spirit when customers are more likely to shop . 

These emails can cover holidays such as Christmas, Valentine’s Day, Diwali, or any other holiday you can think of. Often, they feature special, limited-time deals to encourage quick action, ensuring consumers receive their products or services in time for the holiday.

Holiday promo emails should also reflect the spirit of the holiday they are sent for. For example, if you’re sending a promo email around Christmas, make sure it contains festive colors like red and green. For New Year’s, consider using black and gold, while for Halloween orange and purple are suitable choices. The more you align your offer with the specific holiday, the more effectively you can influence your subscribers.

Seasonal shifts are also perfect times for businesses to reach out to their subscribers with a great deal. As each season unfolds, it brings a fresh backdrop for campaigns that can resonate with the collective mood of consumers. Seasonal store clean-ups are another excellent opportunity for promotion by offering exclusive discounts to clear out last season’s stock.

Emails For New Features or Product Launch 

When you introduce a new product or feature, it’s essential to generate excitement and awareness through email marketing. Start with a compelling subject line that teases the new feature’s benefits, such as “Discover Our Latest Feature – Upgrade Your Experience Today!”

In the email, highlight the innovative aspects of the new feature or product, use high-quality visuals and offer a pre-order, a limited-time discount or a free trial to encourage quick adoption. Include clear calls to action (CTAs) like “Try It Now” or “Learn More” to guide readers towards exploring the new product or feature. 

Emails For Exclusive Subscriber Offers and Personal Milestone Celebrations

Rewarding loyalty is a great way to keep subscribers engaged and feeling valued. These emails offer special deals that are not available to the general public, creating a sense of privilege and appreciation among your subscribers.

Exclusive offers can include members only access, special discounts, limited-time promotions, and unique bundles. Recognizing and rewarding customer loyalty helps maintain a positive relationship and encourages continued engagement. Customers who feel appreciated are more likely to stay committed to your brand.

Celebrating personal milestones such as birthdays, anniversaries, or significant achievements with personalized promotional emails can make customers feel valued as individuals . Including a unique offer, such as a discount or complimentary product, can enhance their experience with your brand.

Event Promotions

Whether you’re hosting an in-person seminar, a workshop, or an online webinar, the goal of event promotion emails is to boost attendance and excitement among your audience. These emails should capture the essence of the event, highlighting key speakers, topics, and activities that will engage potential attendees. By providing a glimpse into the unique experiences and valuable insights that await them, you can create a buzz that encourages recipients to register. 

Ensuring Success with Strategically Crafted Promotional Emails

As we come to the end of our guide through the art of creating captivating promotional emails for 2024, it becomes evident that staying ahead of the curve in the constantly improving world of email marketing requires imagination, flexibility, and a deep understanding of your audience. If you want your promotional emails to stand out in your recipients’ inboxes and have an impact on your subscribers, you need a strong strategy, and the examples and tips above can really help you build one .

Whether you’re announcing a new product, celebrating a milestone, or simply offering a seasonal discount, each email is an opportunity to reinforce the trust and appreciation your customers have for your brand. With these best practices in hand, you’re well-equipped to craft promotional emails that captivate and convert, setting the stage for a successful and dynamic relationship with your audience in 2024 and beyond.

Happy emailing, and here’s to your success in connecting with your customers in more meaningful ways!

Enthusiastic about adopting new ways of storytelling Gen Z-er who lives and breathes digital marketing.

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US Army Soldier wins Olympic silver in 50-meter rifle 3 positions

By Army Marksmanship Unit August 2, 2024

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CHATEAUROUX, France — Sgt. Sagen Maddalena won the silver medal in women’s 50-meter rifle three positions at the Paris 2024 Olympics.

Maddalena earned a place in the finals of the top eight competitors after setting an Olympic qualification record with a score of 593-45x. China’s Qiongyue Zhang followed close behind with a 593-40x.

Once in the Final, the U.S. Army Marksmanship Unit Soldier took the lead after the first five kneeling shots with a 52.2 and held her first-place lead after 10 shots with 104.4. Austria’s Nadine Ungerank followed with a 104. Moving into the prone position, with 15 shots in, the Groveland, California native slipped down to fourth with a 155.9 as Switzerland’s Chiara Leone took the lead with a 156.2. Ungerank and Zhang followed in second and third.

However, after another five shots, Maddalena took the lead again with a 208.2, with China just .1 away. Maddalena spread the gap after 25 shots with a score of 261.2 while Zhang held second with a 260.4. With 30 shots into the final, Maddalena continued to lead with 314.0 points.

After five shots in the standing position, Maddalena slipped down to fifth with a 361.8 while Zhang moved into first place with a 364.7. Norway, Switzerland and Austria followed respectively. With five more shots into the standing position, the Fort Moore Soldier moved up to fourth. By shot 42, Maddalena had taken the lead again with 433.6 points, a .2 lead over Leone.

Shot 43 brought Maddalena into the final three competitors, ensuring an Olympic medal. At that moment, she had 443.0 points while Zhang was in second with a .2 point lead and Leone was first with .9 point lead.

After two more shots, Maddalena secured the Silver Medal over China with 463.0 points while Switzerland claimed the Gold.

This was not the first Olympics for Maddalena. She competed in the three-position rifle, or smallbore, at the 2020 Tokyo Olympics placing fifth.

Maddalena is a marksmanship instructor and competitive shooter for the U.S. Army Marksmanship Unit stationed out of Fort Moore.

The last time Team USA medaled in this event was 2012 when Jamie Beverley won Gold in London.

To see the 2024 finals from the 50-meter rifle 3 positions, visit the official Olympic Games website .

To see more photographs from the Sgt. Maddalena's competition, visit the Army Marksmanship Unit's Flickr page .

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U.S. Army Sgt. Sagen Maddalena Silver medalist Women's 50m 3 position Rifle

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What Is a Carry Trade, and How Did a Small Rate Hike in Japan Just Trigger a Global Sell-Off?

• A Bank of Japan rate hike triggered an abrupt gain in value for the yen.
• That in turn impacted a huge global "carry trade" involving trillions of dollars.
• Markets around the world are seeing heavy selling as investors rush to unwind the carry trade.
• Motley Fool Issues Rare “All In” Buy Alert

How a seemingly small move by the Bank of Japan roiled global markets.

Why did markets around the world drop sharply on Monday? What does it have to do with the Bank of Japan? And what is a carry trade?

It turns out those questions are all closely related. Read on for the answers.

Why a carry trade may be responsible for the market's current turmoil

For months, market observers have been talking about a popular trade in which investors borrowed in Japanese yen at very low interest rates, and then invested the borrowed money in high-growth investments like the " Magnificent Seven " stocks.

Borrowing cheaply to buy higher-returning investments is called a " carry trade ." It's a common strategy for a good reason: Carry trades can be very profitable as long as they work.

But when a popular carry trade abruptly stops working, the effects can be widespread.

Concerns about the carry trade had been rising for weeks, in part because of the enormous amount of money involved in it -- an estimated $4 trillion. Those concerns soared on July 31, when the Bank of Japan raised interest rates from 0.1% to 0.25%.

That rate is still very low, of course, and in and of itself not a big deal for the carry trade. But it was the bank's largest rate hike since 2007, and currency traders took note of the implications.

Image source: Getty Images.

A small-sounding rate hike had a big effect on exchange rates

The yen reacted almost immediately to the rate hike, rising to about 150 to the U.S. dollar from about 162 to the dollar earlier in July. (We say that the yen "rose" because it gained value relative to the dollar.) The yen has risen even further since, trading at around 143 to the dollar on Monday morning.

If you borrow in yen and then trade in dollars (or euros, which have similarly fallen versus the yen), and then the yen gains value, you have to earn more dollars or euros to pay back your yen-denominated loan.

Consider: If you had borrowed 10 million yen a month ago and immediately converted it to U.S. dollars, you'd have had about $62,000. But given the way the yen has surged recently, you would need about $70,000 to pay back that loan today -- even without taking interest and fees into account.

Put another way, you need to have made roughly 13% on that borrowed money in one month just to break even on the loan. That's a much bigger deal than the Bank of Japan's 0.15% interest rate hike.

Why investors are rushing to unwind the carry trade now

Now consider that the Bank of Japan has signaled that more rate hikes are possible. That suggests the yen could rise even further against the dollar in the near future. That's a big incentive to unwind that carry trade in order to pay back the yen-denominated loans as soon as possible.

Given that there was an enormous amount of money involved in this particular carry trade, the unwinding is having massive effects in markets around the world as investors sell stocks and other assets in order to repay those loans.

That's not all that's driving markets lower, of course. There are legitimate concerns about the U.S. economy, after several leading indicators last week suggested that its growth has slowed. But the $4 trillion unwinding is certainly having a major effect. It probably already triggered more selling by investors who weren't involved in the carry trade but who saw big names like Nvidia  and Tesla  selling off sharply.

Some of the big growth names might bounce in the near term as investors "buy the dips." That's not necessarily a bad idea. Just remember that the selling could resume: $4 trillion is a lot of money.

John Rosevear has no position in any of the stocks mentioned. The Motley Fool has positions in and recommends Nvidia and Tesla. The Motley Fool has a disclosure policy .

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Finally, US figure skaters will get Beijing Olympic gold medals — under Eiffel Tower

PARIS — The Kamila Valieva doping saga , one of the most controversial, arduous and infuriating scandals in Olympic history, reaches its long-awaited conclusion Wednesday evening at the base of the Eiffel Tower when, for the first time in history, Winter Olympians will receive their gold medals at the Summer Olympics.

Exactly 2½ years to the day after the team figure skating competition ended at the 2022 Beijing Winter Olympics, U.S. figure skaters will get their gold medals and their Japanese counterparts their silvers at the 2024 Paris Summer Olympics . 

Russia dropped from first place to third after Valieva was suspended for four years and her Olympic results were disqualified, but since Russia is not allowed at the Paris Olympics due to the war in Ukraine, their skaters will not be allowed at the medal ceremony and will receive their bronze medals elsewhere, probably in Russia at some later date. 

All nine skaters on the U.S. team, their coaches and several members of each of their families flew to Paris on Tuesday courtesy of the U.S. Olympic & Paralympic Committee and the International Olympic Committee. 

Medal ceremony outfits have been made for the Americans by the USOPC, which the skaters will wear at the Paris Olympics’ Champions Park for the ceremony beginning at 5 p.m. Wednesday. 

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“It’s so magical that we get this opportunity,” Nathan Chen, who also won the gold medal in the men’s figure skating competition at the 2022 Olympics, said in a phone interview Tuesday after arriving in Paris. 

Then, alluding to all the stops and starts over the past 30 months in this bizarre international doping scandal, Chen added slyly, “Obviously, it hasn’t happened yet, so I’ll check back with you once it’s happening.”

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While the Valieva saga deprived the American and Japanese skaters of their moment on the podium at the 2022 Olympics, and the wait has been an annoying series of twists and turns, there is a silver lining to this gold-medal finale in France. 

“What better place to get a medal than Paris?” said Chen, who has graduated from Yale since those Olympics and is heading into a post-grad program this fall. 

Had the Americans received their then-silver medals when they were supposed to in Beijing, they would have been given them in the eerie isolation of Beijing’s COVID Olympics. They would have been wearing masks, and they would have been all alone except for their teammates. None of their families and friends were allowed to travel to China for those Games due to the stringent COVID restrictions at the time. 

“My parents didn’t get to share the Beijing (men’s gold) medal with me so it’s cool to be able to have this alternative that now allows us to have a chance to have my family in attendance,” said Chen, who said his “whole family,” 10 in total, is with him in Paris.

“I’m really excited for the team, I’m excited to have this opportunity, I’m excited to share this with my family. For me, it’s just joy, glad that we get to have this opportunity. Given the situation, I’m happy that we’re able to have this opportunity just to share with our friends and family and of course the team. That’s really cool.”

On Feb. 7, 2022, Chen and his teammates won the silver medal behind Valieva and the Russians, and ahead of then-third-place Japan. The next day, they were getting ready for the medal ceremony in Beijing when it was abruptly called off, throwing the results of the competition into disarray, when the then-15-year-old Valieva was found to have tested positive for the banned heart medication trimetazidine (TMZ) six weeks earlier at the Russian championships. 

After many months of dithering and delays, mostly by Russian officials, the Court of Arbitration for Sport (CAS) ruled against Valieva in January 2024, paving the way for the U.S. team to move up to the gold medal. 

However, that wasn’t the end of the story. The Russians filed three appeals of that decision with CAS — one from the Russian Olympic Committee, another from the Russian figure skating federation and the third from the six skaters who comprised the Russian team. 

As the weeks wore on, there was concern that if CAS did not rule on the appeals in time, the Paris medal ceremony could not take place, leaving the skaters without their medals for who knew how much longer.

Finally, less than two weeks ago, on the day before the Paris Olympics' opening ceremony, CAS dismissed all three Russian appeals and the figure skating medal ceremony was on. 

Follow Christine Brennan on social media  @cbrennansports

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