presentation for face

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

Variations in Fetal Position and Presentation |

During pregnancy, the fetus can be positioned in many different ways inside the mother's uterus. The fetus may be head up or down or facing the mother's back or front. At first, the fetus can move around easily or shift position as the mother moves. Toward the end of the pregnancy the fetus is larger, has less room to move, and stays in one position. How the fetus is positioned has an important effect on delivery and, for certain positions, a cesarean delivery is necessary. There are medical terms that describe precisely how the fetus is positioned, and identifying the fetal position helps doctors to anticipate potential difficulties during labor and delivery.

Presentation refers to the part of the fetus’s body that leads the way out through the birth canal (called the presenting part). Usually, the head leads the way, but sometimes the buttocks (breech presentation), shoulder, or face leads the way.

Position refers to whether the fetus is facing backward (occiput anterior) or forward (occiput posterior). The occiput is a bone at the back of the baby's head. Therefore, facing backward is called occiput anterior (facing the mother’s back and facing down when the mother lies on her back). Facing forward is called occiput posterior (facing toward the mother's pubic bone and facing up when the mother lies on her back).

Lie refers to the angle of the fetus in relation to the mother and the uterus. Up-and-down (with the baby's spine parallel to mother's spine, called longitudinal) is normal, but sometimes the lie is sideways (transverse) or at an angle (oblique).

For these aspects of fetal positioning, the combination that is the most common, safest, and easiest for the mother to deliver is the following:

Head first (called vertex or cephalic presentation)

Facing backward (occiput anterior position)

Spine parallel to mother's spine (longitudinal lie)

Neck bent forward with chin tucked

Arms folded across the chest

If the fetus is in a different position, lie, or presentation, labor may be more difficult, and a normal vaginal delivery may not be possible.

Variations in fetal presentation, position, or lie may occur when

The fetus is too large for the mother's pelvis (fetopelvic disproportion).

The uterus is abnormally shaped or contains growths such as fibroids .

The fetus has a birth defect .

There is more than one fetus (multiple gestation).

Position and Presentation of the Fetus

Toward the end of pregnancy, the fetus moves into position for delivery. Normally, the presentation is vertex (head first), and the position is occiput anterior (facing toward the pregnant person's spine) and with the face and body angled to one side and the neck flexed.

Variations in fetal presentations include face, brow, breech, and shoulder. Occiput posterior position (facing forward, toward the mother's pubic bone) is less common than occiput anterior position (facing backward, toward the mother's spine).

Variations in Fetal Position and Presentation

Some variations in position and presentation that make delivery difficult occur frequently.

Occiput posterior position

In occiput posterior position (sometimes called sunny-side up), the fetus is head first (vertex presentation) but is facing forward (toward the mother's pubic bone—that is, facing up when the mother lies on her back). This is a very common position that is not abnormal, but it makes delivery more difficult than when the fetus is in the occiput anterior position (facing toward the mother's spine—that is facing down when the mother lies on her back).

When a fetus faces up, the neck is often straightened rather than bent,which requires more room for the head to pass through the birth canal. Delivery assisted by a vacuum device or forceps or cesarean delivery may be necessary.

Breech presentation

In breech presentation, the baby's buttocks or sometimes the feet are positioned to deliver first (before the head).

When delivered vaginally, babies that present buttocks first are more at risk of injury or even death than those that present head first.

The reason for the risks to babies in breech presentation is that the baby's hips and buttocks are not as wide as the head. Therefore, when the hips and buttocks pass through the cervix first, the passageway may not be wide enough for the head to pass through. In addition, when the head follows the buttocks, the neck may be bent slightly backwards. The neck being bent backward increases the width required for delivery as compared to when the head is angled forward with the chin tucked, which is the position that is easiest for delivery. Thus, the baby’s body may be delivered and then the head may get caught and not be able to pass through the birth canal. When the baby’s head is caught, this puts pressure on the umbilical cord in the birth canal, so that very little oxygen can reach the baby. Brain damage due to lack of oxygen is more common among breech babies than among those presenting head first.

In a first delivery, these problems may occur more frequently because a woman’s tissues have not been stretched by previous deliveries. Because of risk of injury or even death to the baby, cesarean delivery is preferred when the fetus is in breech presentation, unless the doctor is very experienced with and skilled at delivering breech babies or there is not an adequate facility or equipment to safely perform a cesarean delivery.

Breech presentation is more likely to occur in the following circumstances:

Labor starts too soon (preterm labor).

The uterus is abnormally shaped or contains abnormal growths such as fibroids .

Medical Information

Delivery, Face Presentation, and Brow Presentation: Understanding Fetal Positions and Birth Scenarios

Introduction:.

During childbirth, the position of the baby plays a significant role in the delivery process. While the most common fetal presentation is the head-down position (vertex presentation), variations can occur, such as face presentation and brow presentation. This comprehensive article aims to provide a thorough understanding of delivery, face presentation, and brow presentation, including their definitions, causes, complications, and management approaches.

Delivery Process:

Normal Vertex Presentation: In a typical delivery, the baby is positioned head-down, with the back of the head (occiput) leading the way through the birth canal.
Engagement and Descent: Prior to delivery, the baby's head engages in the pelvis and gradually descends, preparing for birth.
Cardinal Movements: The baby undergoes a series of cardinal movements, including flexion, internal rotation, extension, external rotation, and restitution, which facilitate the passage through the birth canal.

Face Presentation:

Definition: Face presentation occurs when the baby's face is positioned to lead the way through the birth canal instead of the vertex (head).
Causes: Face presentation can occur due to factors such as abnormal fetal positioning, multiple pregnancies, uterine abnormalities, or maternal pelvic anatomy.
Complications: Face presentation is associated with an increased risk of prolonged labor, difficulties in delivery, increased fetal malposition, birth injuries, and the need for instrumental delivery.
Management: The management of face presentation depends on several factors, including the progression of labor, the size of the baby, and the expertise of the healthcare provider. Options may include closely monitoring the progress of labor, attempting a vaginal delivery with careful maneuvers, or considering a cesarean section if complications arise.

Brow Presentation:

Definition: Brow presentation occurs when the baby's head is partially extended, causing the brow (forehead) to lead the way through the birth canal.
Causes: Brow presentation may result from abnormal fetal positioning, poor engagement of the fetal head, or other factors that prevent full flexion or extension.
Complications: Brow presentation is associated with a higher risk of prolonged labor, difficulty in descent, increased chances of fetal head entrapment, birth injuries, and the potential need for instrumental delivery or cesarean section.
Management: The management of brow presentation depends on various factors, such as cervical dilation, progress of labor, fetal size, and the presence of complications. Close monitoring, expert assessment, and a multidisciplinary approach may be necessary to determine the safest delivery method, which can include vaginal delivery with careful maneuvers, instrumental assistance, or cesarean section if warranted.

Delivery Techniques and Intervention:

Obstetric Maneuvers: In certain situations, skilled healthcare providers may use obstetric maneuvers, such as manual rotation or the use of forceps or vacuum extraction, to facilitate delivery, reposition the baby, or prevent complications.
Cesarean Section: In cases where vaginal delivery is not possible or poses risks to the mother or baby, a cesarean section may be performed to ensure a safe delivery.

Conclusion:

Delivery, face presentation, and brow presentation are important aspects of childbirth that require careful management and consideration. Understanding the definitions, causes, complications, and appropriate management approaches associated with these fetal positions can help healthcare providers ensure safe and successful deliveries. Individualized care, close monitoring, and multidisciplinary collaboration are crucial in optimizing maternal and fetal outcomes during these unique delivery scenarios.

Hashtags: #Delivery #FacePresentation #BrowPresentation #Childbirth #ObstetricDelivery

On the Article

Krish Tangella MD, MBA

Alexander Enabnit

Alexandra Warren

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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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Management of face presentation, face and lip edema in a primary healthcare facility case report, Mbengwi, Cameroon

Nzozone henry fomukong.

1 Microhealth Global Medical Centre, Mbengwi, Cameroon

2 Department of Medicine and Surgery, Faculty of Health Sciences University of Buea, Buea, Cameroon

Ngouagna Edwin

Mandeng ma linwa edgar, ngwayu claude nkfusai.

3 Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon

4 Cameroon Baptist Convention Health Services (CBCHS), Yaoundé, Cameroon

Yunga Patience Ijang

5 Department of Public Health, School of Health Sciences, Catholic University of Central Africa, Box 1110, Yaoundé, Cameroon

Joyce Shirinde

6 School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria Private Bag X323, Gezina, Pretoria, 0001, Pretoria, South Africa

Samuel Nambile Cumber

7 Institute of Medicine, Department of Public Health and Community Medicine (EPSO), University of Gothenburg, Box 414, SE - 405 30 Gothenburg, Sweden

8 Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa

Face presentation is a rare obstetric event and most practitioners will go through their carriers without ever meeting one. Face presentation can be delivered vaginally only if the foetus is in the mentum anterior position. More than half of the cases of face presentation are delivered by caesarean section. Newborn infants with face presentation usually have severe facial oedema, facial bruising or ecchymosis. These syndromic facial features usually resolved within 24-48 hours.

Introduction

Face presentation is a rare unanticipated obstetric event characterized by a longitudinal lie and full extension of the foetal head on the neck with the occiput against the upper back [ 1 - 3 ]. Face presentation occurs in 0.1-0.2% of deliveries [ 3 - 5 ] but is more common in black women and in multiparous women [ 5 ]. Studies have shown that 60 per cent of face presentations have one or more of the following risk factors: small fetus, large fetus, high parity, previous caesarean section (CS), contracted pelvis, fetopelvic disproportion, cord around the neck multiple pregnancy, hypertensive disorders of pregnancy, polyhydramnios, uterine or nuchal cord anomaly. But 40 per cent of face presentations occur with none of these factors [ 6 , 7 ]. A vaginal birth at term is possible only if the fetus is in the mentum anterior position. More than half of cases of face presentation are delivered by caesarean section [ 4 ]. Newborn infants with face presentation usually have severe facial edema, facial bruising or ecchymosis [ 8 ]. Repeated vaginal examination to assess the presenting part and the progress of labor may lead to bruises in the face as well as damage to the eyes.

Patient and observation

Case presentation: a 21 year old primigravida at 40 weeks gestation from the last normal menstrual period referred to our facility for prolonged second stage of labor after visiting two health centres. She labored for a total of 14hrs, membrane ruptured spontaneously 12hrs before referral. Amniotic fluid was documented by midwife to be clear. She attended antenatal clinics in Mbengwi health centre 5 times, was diagnosed of hepatitis B during antenatal consultations, received no treatment. She did not do any ultrasound due to financial constraints. On examination, she was healthy, in painful distress, blood pressure 131/76mmhg, pulse 85 beats/min, temperature 37.2 o C SPO2 98%. On abdominal exams, uterus was gravid, fundal height 35cm, lie longitudinal, fetal heart rate 137bpm, cephalic presentation, engaged 2/5, with moderate contractions of 2 in 10 minutes. On vaginal examination, cervix was fully dilated, membranes ruptured, presenting part was face, mentum anterior. The conclusion made was mento-anterior face presentation ( Figure 1 ). Paturient was counseled, labor was augmented with 1 amp of oxytocin in 500ml of glucose 5% and started at 10drops/mins. Ten minutes later she delivered a male baby with Apgar score 6/10, 8/10 on the first and fifth minute. The baby weighed 3.2kg, length was 50cm, and head circumference was 41cm. Syndromic facial appearance with marked edema at the baby's lips, face and scalp was evident and he had bruising on the right nasolabial groove and right cheeks ( Figure 2 ). Physical examination of the infant's respiratory system, cardiovascular system, and his abdominal examination were normal, as was his neurological examination. Placenta was delivered by controlled cord traction 5mins later with all cotyledons. Delivery was complicated by a second degree perineal tear. Perineal tear was repaired with absorbable suture under local anaesthesia. Estimated blood lost was 350ml. baby received Hepatitis B immunoglobulins, hepatitis B vaccine and vitamin K were administered to the baby. 24 hours later, facial swellings resolved ( Figure 3 ), baby breast feeds well. Baby and mother were discharged on day 3 postpartum all fine.

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Men-tum anterior face presentation

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Bruising, marked lip and facial edema

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Baby 24 hours later with all syndromic facial features resolved

Ethics : informed consent: written informed consent was obtained from the patient's parents for the publication of this case report.

Face presentation is a rare obstetric event and most practitioner will go through their carriers without ever meeting one [ 3 ]. We presented a case of face presentation noticed in the delivery room on digital examination in a patient with no risk factors. In a poor resource setting as ours where ultrasound is not readily available, this event is often scary and confusing to most midwives and nurses. This may prompt repeated vaginal exams for confirmation of presentation. This intend will lead to bruising of the baby's face and delay effective management [ 8 ]. Exact knowledge about the fetal position and level is important for providing the correct management of this malpresentation. When face presentation is diagnosed, around 60% of cases are in the mentum anterior position, 25% are mentum posterior and 15% are mentum transverse [ 5 ]. The patient presented the most common form of face presentation (mentum anterior). Labor was augmented, vaginal delivery was attempted and successfully conducted. Facial bruising, lip and face edema are very common complication of face presentation. These complications usually resolve within 24-48 hours [ 9 , 10 ] in this case facial edema completely resolved within 24hours ( Figure 3 ) and baby breastfeed well.

Repeated vaginal exams should be avoided when presenting part is unsure. Vaginal delivery should be attemped only on mentum anterior face presentation, in other cases, emergency ceserian section should be performed. Syndromic facial features in babies born from face presentation resolve completely within 24-48 hours.

Competing interests

The authors declare no competing interests.

Acknowledgements

We thank the participant of this study.

Authors’ contributions

NHF, NE, MMLE, NCN, YPI, FB, JS and SNC conceived the case series, assisted with the study design and participant enrollment, designed the study protocol and collected the data. NE, MMLE, NCN and SNC assisted in interpretation of results and wrote the manuscript. All authors read and approved the final manuscript.

2022 New Pearls of Exxcellence Articles

Management of Brow, Face, and Compound Malpresentations

Author: Meera Kesavan, MD

Mentor: Lisa Keder MD Editor: Daniel JS Martingano DO MBA PhD

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Fetal malpresentation, including brow, face, or compound presentations, complicates around 3-4% of all term births. Because these abnormal fetal presentations still are cephalic, many such cases result in vaginal deliveries, yet there are increased risks for adverse outcomes, including cesarean delivery resultant surgical complications, persistent malpresentation precluding vaginal delivery, and abnormal labor resulting in arrest of dilation or descent.

These fetal malpresentation are differentiated in the following ways:

In face presentations, the presenting part is the mentum, which is further divided based on its position, including mentum posterior, mentum transverse or mentum anterior positions. This typically occurs because of hyperextension of the neck and the occiput touching the fetal back. Mentum anterior malpresentations can potentially achieve vaginal deliveries, whereas mentum posterior malpresentations cannot.
In brow presentations, there is less extension of the fetal neck as in face presentations making the leading fetal part being the area between the anterior fontanelle and the orbital ridges. These presentations are uncommon and are managed similarly to face presentations. Brow presentation can be further described based on the position of the anterior fontanelle as frontal anterior, posterior, or transverse.
Compound presentation is defined as the leading fetal part, including a fetal extremity, alongside a cephalic or breech presentation. Management of compound presentations is expected (and often incidentally noted following delivery) because the extremity will often either retract as the head descends or will feasibly allow for delivery in its current position, with manipulation attempts to reduce the compound presentation usually avoided.

Risk factors for brow and face presentations include fetal CNS malformations, congenital or chromosomal anomalies, advanced maternal age, low birthweight, abnormal maternal pelvic anatomy (e.g. contracted pelvis, cephalopelvic disporotion, platypelloid pelvis, etc.) and nulliparity. non-Hispanic White women have the highest risk for malpresentation, whereas non-Hispanic Black women have the lowest risk.

Diagnosis usually is made during the second stage of labor while performing routine vaingla examinations and involves palpation of the abnormal leading fetal part (forehead, orbital ridge, orbits, nose, etc.) Obstetric ultrasound can additionally provide complimentary information to support these diagnoses and distinguish from other fetal malpresentations or malpositions. In face presentation, the mentum (chin) and mouth are palpable.

Management considerations for face, brow, and compounds presentations are unique with compound presentations having higher rates of vaginal delivery and lower complications as compared to either brow or face presentations.

For brow presentations, approximately 30-40% of brow presentations will convert to a face presentation, and about 20% will convert to a vertex presentation. Anterior positions have the possibility of vaginal deliveries and can be managed by usual labor management principles, whereas mentum posterior positions are indications for cesarean delivery.
For face presentations, the likelihood of vaginal delivery depends on the orientation of the mentum, with mentum anterior being most suitable for vaginal delivery. If the fetus is mentum posterior, flexion of the neck is precluded and results in the inability of fetal descent.
For compound presentations, management is expectant and manipulation of the leading extremities should be avoided. Most cases of compound presentation result in vaginal deliveries. For term deliveries, compound presentations with parts other than the hand are unlikely to result in safe vaginal delivery.

Labor management for brow and face presentation overall involves continuous fetal heart rate monitoring and repeat clinical assessments, given the increased potential of fetal complications as noted. Caution should be used with internal monitoring devices, which can cause ophthalmic injury or trauma to the presenting fetal parts, with the use of fetal scalp electrodes discouraged and intrauterine pressure catheters acceptable with appropriate clinical judgment and feasibility.

Midforceps, breech extraction, and manual manipulation are not recommended and increase the risk of maternal and neonatal morbidity.

Neonatal outcomes for both face and brow presentations include facial edema, bruising, and soft tissue trauma. Complications of compound presentation specifically include umbilical cord prolapse and injury to the presenting limb. With appropriate management, neonatal and maternal morbidity for face, brow, and compound presentations are low.

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Delivery, Face and Brow Presentation

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]

Gardberg M,Leonova Y,Laakkonen E, Malpresentations--impact on mode of delivery. Acta obstetricia et gynecologica Scandinavica. 2011 May; [PubMed PMID: 21501123]

Tapisiz OL,Aytan H,Altinbas SK,Arman F,Tuncay G,Besli M,Mollamahmutoglu L,Danışman N, Face presentation at term: a forgotten issue. The journal of obstetrics and gynaecology research. 2014 Jun; [PubMed PMID: 24888918]

Zayed F,Amarin Z,Obeidat B,Obeidat N,Alchalabi H,Lataifeh I, Face and brow presentation in northern Jordan, over a decade of experience. Archives of gynecology and obstetrics. 2008 Nov; [PubMed PMID: 18283473]

Bashiri A,Burstein E,Bar-David J,Levy A,Mazor M, Face and brow presentation: independent risk factors. The journal of maternal-fetal [PubMed PMID: 18570114]

Shaffer BL,Cheng YW,Vargas JE,Laros RK Jr,Caughey AB, Face presentation: predictors and delivery route. American journal of obstetrics and gynecology. 2006 May; [PubMed PMID: 16647888]

Bellussi F,Ghi T,Youssef A,Salsi G,Giorgetta F,Parma D,Simonazzi G,Pilu G, The use of intrapartum ultrasound to diagnose malpositions and cephalic malpresentations. American journal of obstetrics and gynecology. 2017 Dec; [PubMed PMID: 28743440]

Ghi T,Eggebø T,Lees C,Kalache K,Rozenberg P,Youssef A,Salomon LJ,Tutschek B, ISUOG Practice Guidelines: intrapartum ultrasound. Ultrasound in obstetrics [PubMed PMID: 29974596]

Benedetti TJ,Lowensohn RI,Truscott AM, Face presentation at term. Obstetrics and gynecology. 1980 Feb; [PubMed PMID: 7352081]

Ducarme G,Ceccaldi PF,Chesnoy V,Robinet G,Gabriel R, [Face presentation: retrospective study of 32 cases at term]. Gynecologie, obstetrique [PubMed PMID: 16630740]

Cruikshank DP,Cruikshank JE, Face and brow presentation: a review. Clinical obstetrics and gynecology. 1981 Jun; [PubMed PMID: 7307363]

Domingues AP,Belo A,Moura P,Vieira DN, Medico-legal litigation in Obstetrics: a characterization analysis of a decade in Portugal. Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia. 2015 May; [PubMed PMID: 26107576]

. Intrapartum care for healthy women and babies. 2022 Dec 14:(): [PubMed PMID: 32212591]

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7.9 Face presentation

7.9.1 diagnosis.

Palpation of the mother's abdomen at the start of labour: palpate the occipital region; a cleft between the head and the back will be palpable, due to hyperextension of the head.
On vaginal examination: no suture or fontanelle can be felt; orbits, nose, mouth, ears and chin palpable. Palpation of the chin is essential to confirm the diagnosis.

7.9.2 Management

Determine the orientation of the chin—anterior (at the mother's pubis) or posterior.

The chin is anterior

Vaginal delivery is possible. Labour may be slow, patience is required. If uterine contractions are inadequate, oxytocin may be used. Episiotomy is usually needed during delivery (Figures 7.4), given the maximum amount the perineum can stretch. If instrumental delivery is necessary, use forceps. Vacuum extraction is contra-indicated for a live fœtus.

Figures 7.4 - Chin anterior: delivery possible

The chin is posterior

Vaginal delivery is not possible (Figure 7.5). A caesarean section must be arranged. Refer if necessary.

Figure 7.5 - Chin posterior: impaction

If caesarean section is not feasible and referral is not possible, attempt the following manoeuvres:

Flex the head to obtain a vertex presentation: with one hand in the vagina, grasp the top of the skull and flex the neck, using the other hand, on the abdomen, to apply pressure to the foetal chest and buttocks. Obviously, the presenting part must not be engaged, and it is often hard—or impossible—to keep the head flexed (Figures 7.6).

Rotate the head to bring the chin anteriorly: push the face and chin back to free the shoulders from the pelvic inlet then, turn the head within the pelvic cavity, using a hand on the abdomen to help the rotation by applying pressure to the shoulders. In this way, the chin is brought to the front (Figures 7.7).

Version: internal podalic version, then total breech extraction (Figure 7.8).

All these manoeuvres are difficult and pose a significant risk of uterine rupture. They must be done when the uterus is not contracting. Whenever possible, caesarean section should be performed instead.

Presentation Training Institute

A division of bold new directions training, how to use gestures and facial expressions effectively in presentations.

Many presenters spend the majority of their time preparing what to say during their presentation. In doing so, they fail to pay attention to their body language and how it can impact their presentation. The truth is, body language can be the difference between a dull presentation and a dynamic one. Your gestures and facial expressions can greatly affect how your audience perceives and responds to your speech. Here we will take a look at how to use your body language to enhance your message and make the most of your presentation.Â

Why Gestures and Facial Expressions Matter

Gestures and facial expressions are part of your nonverbal communication, which accounts for more than half of the impact of your message. It helps to establish rapport, credibility, and emotion with your audience. By using gestures and facial expressions effectively, you can make your presentation more memorable and engaging.Â

1. Find a Neutral Place for Your Hands

Many presenters find it difficult to know what to do with their hands when they are nervous. They end up fidgeting, crossing their arms, gripping the lectern, or putting their hands in their pockets, all of which are signs of nervousness. Instead, focus on finding a comfortable resting position such as letting your hands relax by your side or using them to add emphasis to your points. This will help you appear more confident and at ease.Â

2. Use Gestures to Create Visual Imagery

Your hands can be an effective prop throughout your presentation to help the audience visualize what you are saying. For example, if profits rose over the last quarter, lift your hands up to show that. If you are encouraging your audience to work together, reach out with your hands and pull them back in to demonstrate. Your hand gestures should align with what you are saying and when used properly, can really enhance your message and make your presentation more engaging.Â

3. Let Your Face Tell the Story

There is a reason that a face-to-face meeting is more effective than over the phone. When it comes to interacting with others, our facial expressions help tell our story. They help us express emotion, emphasize key points, and connect with our audience. Keep this in mind when giving a presentation. Presenting with a blank face is like talking in a monotone voice. Things like raising your eyebrows, widening your eyes, and giving a smile can make a huge difference and set the tone for your presentation. If your facial expressions fall in line with your words, the information you are presenting will come across more clearly and you will appear more sincere.Â

4. Make Eye Contact

Eye contact is one of the most important elements of good communication. When you make eye contact with your audience, it makes the presentation feel more personal and it allows you to connect with the audience on a deeper level. Throughout your presentation, try to make eye contact with as many people as you can, as prolonged eye contact can be a powerful mode of communication.Â

Perfect presentations: Face-to-face and virtual

Business leaders are determining how to host successful meetings in this “new normal” environment created by the COVID-19 pandemic.

While people have been holding virtual meetings during lockdown, hybrid meetings look set to be a popular trend in the future.

The challenge is to create perfect presentations for both face-to-face and virtual settings. The importance of presentations within meetings can’t be over-emphasised, as they grab delegates’ interest and inspire people to reach team goals.

Honing presentation skills

Presentation skills will help the speaker to communicate often complex information in an interesting and simple way that will keep the audience engaged. Rather than just talking all the time, they can use different means, such as audio-visual content and images.

With many companies booking a meeting room for later in the year, when hopefully the pandemic will have abated, it seems likely that more hybrid meetings will be taking place, to avoid packing too many delegates into the venue and to enable people who may not be able to attend, due to travel or other restrictions, to take part.

You can create the perfect presentations for both face-to-face and virtual settings with some careful planning. If you’re preparing for a presentation, always consider you may need to speak to delegates who are there in person and others that might be taking part through a video link.

Face-to-face meetings

One of the key elements of a good presentation is maintaining an audible tone so that every audience member can hear you, no matter where they are in the room. This might sound obvious, but make a conscious effort to articulate the words as carefully and clearly as possible, maintaining an easily-audible voice-level throughout.

Also, maintain an optimal pace, giving listeners time to understand and absorb the information. Learn not to speak too fast, as people may switch off. Similarly, don’t speak too slowly, or it will appear to drag. Maintain a normal speaking pace, without racing through the speech.

Vary your tone of voice, putting the emphasis on enthusiasm and using gestures appropriately to keep the audience involved. No amount of technology, no matter how good, will ever replace an enthusiastic and articulate speaker who’s a great communicator. This encourages the audience to ask questions, collaborate and communicate, as it makes them feel more motivated.

Using gestures emphasises the points you’re making as a speaker. If you stand still in one spot and communicate in a flat tone, it won’t keep the audience’s interest for long. Obviously, don’t move about and gesture so much that it becomes a distraction. Just keep the tone and your manner professional and enthusiastic, without going over the top.

Virtual meetings

When you’re presenting to a virtual audience as well, there are other factors you must take into account. One is getting the lighting right, to make sure your audience can see you properly. Of course, this applies to the in-person delegates too.

You need bright front-lighting, so the light shines on your face. If your back is to a window, your face can appear to be in the shade, unless you close the blinds. Natural light is a popular choice, as it’s less harsh, but if your meeting room doesn’t have windows, use the appropriate artificial lighting to enhance your face.

Choose a background that looks professional, avoiding clutter and distractions. Find out whether your virtual presentation platform permits the use of virtual backgrounds, such as Zoom, or whether it can blur your background, as with Microsoft Teams.

It’s important to understand your technology in general, as nothing will spoil your presentation faster than a blip with the technical side. Have a dry run, so you’ll feel comfortable with the platform you’re using.

It’s preferable to have someone assist you with the tech during the actual meeting, allowing you to focus on your presentation. Make sure the camera is placed at eye-level – if it’s too low, you may appear to have a double chin if you’re continually looking down. If too high, it won’t seem like you’re talking directly to virtual delegates.

Being animated and enthusiastic will enhance a virtual presentation too. In fact, it’s even more important to be lively and grab delegates’ interest when you’re video-conferencing, as it’s easier for people at remote locations to just switch off when they’re looking at a computer screen.

Whether you’re presenting in-person or virtually, or even at a hybrid meeting merging both styles, remember it’s like giving a performance. People’s time is valuable, so make sure you create an authentic audience connection and don’t leave them feeling short-changed.

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15 Essential Presentation Techniques for Winning Over Any Audience

The Speaker Lab
April 13, 2024

Ever found yourself standing before an audience, your heart racing? That’s the moment when knowing effective presentation techniques can prove to be your unwavering ally. But what are presentation techniques? And what makes them so powerful? In this article, we’re going to answer those questions.

Before we can talk about presentation techniques, though, we first have to talk about good communication. The power of effective communication isn’t just in what you say. It’s how you say it; it’s in those deep breaths that steady nerves, and in maintaining eye contact. It’s about turning a room full of strangers into an engaged audience hanging onto your every word. When it comes to public speaking, real success comes from mastering non-verbal cues to punctuate our words and using visual aids not as crutches but as tools for engagement.

As you hone your communication skills, you will begin to form effective presentation techniques. Expect rough patches as you get the hang of things, but view them as mere footholds propelling you towards your ultimate triumph. Keep pushing forward.

Mastering Presentation Techniques for Impactful Delivery

Presentation techniques are more than just standing in front of a crowd and talking. They’re about making connections, telling stories that resonate, and leaving your audience with something to remember you by.

Elements of an Effective Presentation

For your presentation to resonate, ensure the visuals are straightforward and supportive, rather than distracting. Your message should be concise yet powerful enough to stick. And let’s not forget engagement; keeping your audience on their toes is key.

Visuals: Keep them simple but impactful.
Message: Make every word count.
Engagement: Interact with your audience, ask questions, make them think.

We’ve all seen those slides crammed with text or charts. When you make your slides, don’t cram information, because nobody wants to squint at tiny fonts or decipher complex graphs while trying to listen to you speak. This resource suggests focusing on clarity and simplicity when designing slides—advice worth taking.

Strategies for Delivering a Successful Presentation

To deliver a knockout presentation, start strong. Grab attention from the get-go with an intriguing fact or story related directly back into the topic at hand. Maintain eye contact across the room so everyone feels included in the conversation. Finally, end on a memorable note, either with a call to action or insight gained during the time together. Leave them wanting more information and eager to learn about the subject matter discussed today.

The opener: Hook your audience with a relevant fact or anecdote.
Maintain connection: Eyes up, engage everyone around.
Closing remarks : Last chance for impact–what’s your mic drop?

As author Lilly Walters once said, “The success of your presentation will be judged not by the knowledge you send but by what the listener receives.” This quote reminds us that the true goal of any speech is the understanding achieved between the speaker and the listeners.

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Engaging Your Audience with Nonverbal Communication

As the name implies, nonverbal communication denotes all of the ways you communicate without using words. This includes eye contact, body language, and facial expressions. Although nonverbal communication might not be the first presentation technique that comes to mind, it’s nevertheless a very powerful tool to have in your arsenal. Let’s take a look.

The Power of Eye Contact, Body Language, and Facial Expressions

Making eye contact isn’t just about looking someone in the eye; it’s about forging a connection. Aim for brief moments of eye contact across different sections of your audience throughout your presentation. Establishing fleeting eye connections across diverse audience segments fosters a sense of trust and keeps them hooked, all while ensuring no one feels on edge.

Body language is similarly important. Stand tall with good posture; it exudes confidence even when you feel nervous. As you grow more confident, mix up standing still with moving around subtly. This dynamic shift holds attention better than being rooted to one spot or nervous pacing. Use your hands to gesture naturally as you speak—it adds emphasis and keeps things lively.

If there’s one thing people can spot from miles away, it’s insincerity. So let those facial expressions match your words. Smile when you share something amusing, and furrow your brow when diving into serious stuff. After all, it’s not just what you say but how visually engaged and passionate you appear while saying it that counts.

Tying these elements together helps you deliver impactful, memorable talks. When done right, folks will leave feeling more connected, understood, and fired up by your presentation, all thanks to your techniques.

Designing Compelling Presentation Materials

Knowing how to design engaging presentation materials is one technique you can’t do without. Far from mere embellishments, these implements are crafted to hammer your message home. Hence, it’s vital to select these aids with great care and discernment.

Tips for Creating Effective Slides

When it comes to crafting slides, think of each as a billboard advertisement for your idea. You want it clear, impactful, and memorable.

Keep it simple : One idea per slide keeps confusion at bay and attention locked in.
Use bullet points : Break down your points so your audience can track.
Pick a font size : Generally speaking, bigger is better.
Use color : Harness colors that pop without blinding anyone; contrast is key.
Use images with purpose : A good picture or chart can help illustrate your point, but keep it relevant and don’t overdo it.

With a few helpful visuals, your presentation can go from good to great. For more on creating slides, check out this link here .

Handling Questions and Interactions Professionally

For some speakers, it’s not the presentation itself that makes them nervous—it’s the Q&A session that follows. This is the moment where you get to shine or stumble based on how well you handle those curveballs from your audience. If you want to round off your presentation well, you’re going to want to learn a few techniques for fielding these questions. Let’s look at a few ways of doing this.

Preparing for Audience Questions and How to Address Them Effectively

Below are six techniques that will help you address audience questions effectively.

Listen Up : The first rule of thumb is to listen like it’s a superpower. When someone throws a question at you, don’t just hear them out—really listen. Demonstrating this level of attentiveness not only conveys your respect but also affords you a brief moment to collect your ideas.
Stay Calm : You’ve got this. Even if a question catches you off guard, take a deep breath before diving into your answer. No one expects perfection, but showing confidence matters.
Practice Beforehand : Before presentation day arrives, think about potential questions folks might ask and prep some responses in advance. Practice makes perfect, after all.
Vary Your Techniques : Not every question needs an essay as an answer; sometimes short and sweet does the trick. Mix up how detailed or brief your answers are depending on what’s asked.
Show You Care : If you ever get a question that leaves you stumped, say so honestly—but add that magical line: “Let me find out more and I’ll get back to you.” Then actually do it.
Appreciate Audience Curiosity : Remember that the reason you audience is asking questions is because they’re interested. So no matter what questions you get, keep engaging with enthusiasm.

Go forth with confidence, knowing not only can these moments boost credibility—they make connections too. So next time when facing down those queries remember to listen hard, stay calm & always engage warmly. With these techniques under your belt, answering audience questions after your presentation will feel much less daunting.

Techniques for a Memorable and Effective Presentation

No matter what topic you cover in your presentation, you can easily add in a story, and more likely than not you can add a little humor too. Together, these two presentation techniques are perfect for making your speech memorable.

Incorporating Storytelling into Your Presentation

One great technique for making your presentation stick is telling stories. Stories have the power to touch people profoundly, especially when they depict relatable experiences. So, when you’re up there presenting, kick things off with a story that ties into your main message. It could be personal, something from history, or even an anecdote that gets your point across. Stories are not just fluff; they’re the glue of your presentation. They make complex ideas digestible and memorable.

Using Humor to Connect with the Audience

Another great way of engaging your audience is by using humor. But here’s the deal—use humor wisely. Keep it tasteful and tied closely to the content at hand so it enhances rather than detracts from your message.

Pick universal themes everyone can relate to.
Avoid anything potentially offensive.
Tie jokes back to your key points to make them relevant.

If humor isn’t your thing, or you’re worried about your comedic timing, it’s perfectly okay to skip the jokes. Especially if you’re new to public speaking, humor can be hard to nail immediately. But as you grow and hone your presentation techniques, consider stretching yourself a bit. By starting small, you can practice using humor to connect with your audience. That is your goal, after all—to leave a positive, memorable impression on your audience.

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Overcoming Public Speaking Anxiety

For some speakers, stepping in front of a crowd to speak causes immediate anxiety. But fear not! Conquering public speaking anxiety is entirely within your grasp.

Techniques to Manage Stage Fright and Boost Confidence

First off, feeling nervous before taking the stage is completely normal. Even Mark Twain admitted, “There are two types of speakers. Those who get nervous and those who are liars.” So take that flutter in your stomach as a sign you care deeply about delivering value to your audience. In addition, consider the following tips as you prepare to hit the stage.

Breathe Deep: Before stepping up, take some deep breaths. In through the nose, out through the mouth. Feel every muscle relax with each exhale.
Mind Over Matter: Visualization is key. Picture yourself nailing that presentation, because if you can see it, you can achieve it.
Keep It Simple: Stick to what you know best; this isn’t the time for surprises or untested waters.
Pace Yourself: Speak slowly but surely—there’s no rush here.

Believe it or not, acting relaxed often leads to actually being relaxed. Remember when we said mind over matter? Well, it applies here big time. The power pose backstage might just be what turns those nerves into excitement.

So next time you feel stage fright coming on, fight back with these techniques. With these tricks up your sleeve, you’re more than ready. So go ahead, breathe deep, and step onto that stage. You’ve got this.

Using Different Presentation Methods to Engage Your Audience

While learning styles is “ little more than urban myth ,” presenting your material in a variety of ways is a great technique for engaging your audience. By switching it up, you increase your chances of explaining something in a way that clicks with individual audience members. This is especially helpful for more complex topics that might be hard to grasp.

There are three main ways of presenting your material to your audience: through visuals, audio, and hands-on activities.

Visuals: Use slides packed with images, graphs, and bullet points.
Audio: Tell stories, play audio clips or engage in discussions.
Hands-on Activities: Include activities or demonstrations that allow audience members to participate physically.

Making sure everyone gets something from your presentation means considering these techniques when planning content. Not only can incorporating various methods increase audience engagement, but it can also elevate your presentation from decent to memorable.

Essential Tips for First-Time Presenters

Stepping onto the stage or logging into that webinar platform as a first-time presenter can feel nerve-wracking. But fear not! With these tips on how to dress appropriately, arrive early, and make your presentation shine, you’ll be ready to confidently nail that presentation.

Dress Appropriately

Your outfit is your armor. Choose something professional yet comfortable. Whether it’s in-person or online, dressing one notch above what you expect your audience to wear usually hits the sweet spot. Aim for solid colors that won’t distract your audience.

Arriving Early

If possible, arrive at the venue before your audience does. This gives you time to settle in, test any tech gear like microphones or projectors, and take those deep breaths. This extra time also lets you chat with early birds. By connecting with people before taking center stage, you can ease nerves significantly.

Making Presentation Time Count

You only have the audience’s attention for so long. Keep an eye on the clock as you present, but avoid rushing through content. It especially helps to pause after key points, letting information sink in. Your end goal? Leave you’re audience wanting more. You’ll know if you succeeded based on the number of questions you get during the Q&A.

So there you have it—the techniques you need to deliver an engaging presentation. By honing nonverbal communication, like eye contact and posture, you can captivate your audience with your energy. And visual aids? They’re not just ornamental; they help bolster your point and drive it home.

We also learned that tackling audience questions is not an art reserved for the eloquent few but a skill sharpened by preparation and presence. While it takes a little work to nail good storytelling and well-timed humor, the ultimate outcome is worth it.

So while standing before an audience may set your heart racing, know that arming yourself with knowledge and technique can transform not just your presentation, but you yourself. So don’t be afraid to try your hand at these skills; in doing so, you build your own confidence and become a better speaker in the process.

Last Updated: April 11, 2024

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Facial expressions matter when presenting, here’s why

Nicole Lowenbraun

About 8 years ago, while visiting my parents in New Jersey for the weekend, I got bored enough to peruse my mother’s Prevention magazine. Actress Amy Brenneman of ABC’s “Private Practice” was being interviewed on her beauty secrets. Boring.

As a speaker coach, what did interest me were her comments on Botox. She boldly admitted having tried it and said she probably wouldn’t do it again. Why? “I’ve experimented … but Botox kind of freaked me out because I couldn’t move my face. Isn’t it my job to make facial expressions?”

Yes, Amy, yes, it is.

Whether on camera, on stage presenting, or communicating in a meeting, your facial expressions send messages that are just as important as the content itself. They give you the chance to enhance your point, distract from it, or confuse the heck out of your audience .

Here are some key concepts to keep in mind when it comes to facial expressions.

1. You need your face and the movements it makes

A flat affect, just like a monotone voice will be interpreted as a lack of passion, whether the message is positive or negative.

Facial expressions create dynamism. They give the impression that you stand behind your ideas and believe in them.

Recent research shows that when you use your face, specifically the little lines around your eyes (known as Duchenne markers) you’re perceived as conveying more intense and sincere emotions.

2. Your facial expressions must match your content

If you say, “I’m so excited about these new initiatives!” your face better tell the same story .

I worked with a senior HR executive at a tech company a few years back. She exuded warmth and I got the sense she really cared about her employees.

When it came time to fire one, she wasn’t happy about it. The directive came from the top down and she disagreed with the decision. To soften the blow, she delivered the news with a smiley, “We’re letting you go.” It was not received well.

The woman being forced out responded with, “F you and your smile.” Yikes. While well-intentioned, my client’s facial expression didn’t match the content and was interpreted as belittling and condescending.

3. It’s okay to smile at work

Of course, when the content allows and it’s appropriate, smiling is wonderful.

I’ve worked with too many people who fear smiling will rob them of their authority in the workplace. Smiling doesn’t make you look weak — it makes you look approachable. And NOT smiling can be interpreted as cold.

4. Pay attention to your audience’s facial expressions

Your audience’s facial expressions are just as important to pay attention to as your own.

If you took Public Speaking 101 you were probably taught to “scan the room.” Guess what? It’s not a great strategy for building meaningful connections, and it prevents you from reading the faces of your audience members.

How do you know if they’re smiling and nodding in agreement with your point or if they’re giving you a skeptical reaction? Reading faces ensures that you can respond appropriately.

Try saying, “I’m so glad to see you all agree” or “You might be questioning my methods and I understand why. Let me tell you why this is the best way to go.”

If you’re scanning the room, you won’t be able to read and adjust to the audience’s needs.

Side note : When nerves kick in, we tend to focus our attention on the people who are smiling and nodding. While it’s great that you notice facial expressions (it means you’re paying attention and attempting to empathize with your audience), know that some people are just … smilers and nodders.

You still need to speak to the skeptics in the room.

Oh, also, “Resting bitch face” (RBF) — scientists say it’s a real thing .

I had a former colleague who was passionate, loud, and dynamic on stage. While delivering a speech , he was thrown off by a scowling guy in the front row. Much to my colleague’s surprise, Scowling Guy approached him post speech to say how much he loved the talk and to pepper him with questions.

How could this be? Simple. Scowling Guy had RBF. He didn’t disagree or disapprove. He just looked that way.

There are people in your audience whose facial expressions will appear cold, skeptical, even nasty. While you certainly need to read the audience’s faces, take their reactions with a grain of salt.

If you need to confirm the meaning behind their facial expressions, just ask. “I’m sensing some concern, what questions do you have?” Or “Please let me know if we’re not all in agreement on this.”

facial expressions matter - remote video

5. Facial expressions on video are extremely important

When communicating remotely on camera, note that the only tools you have to sound convincing and sincere are your voice and your facial expressions.

Your audience can’t see your entire body, they don’t have direct in-person eye contact to form a connection, and they can rarely see gestures because of the small allotted space. This means that facial expressions can go a long way in persuading your audience.

6. Practice in front of a mirror

Not sure what your face is doing when you’re speaking? Try practicing in front of a mirror.

As a coach, I don’t always recommend using mirrors. They can be distracting, and it’s important that you FEEL yourself using good public speaking techniques in order to solidify them as your new normal.

In real life, you won’t get that immediate feedback. But until you are able to internalize your facial expressions, a mirror is a great tool. You have to see what your face is doing in order to make necessary changes. I suggest practicing while on a conference call having a real conversation, but when no one can see you.

You have important ideas to convey. Don’t allow your facial expressions to diminish your message. Use them as a tool to solidify your point. And perhaps avoid the botulism injections.

In-line illustrations by Ash Oat

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The 6 reasons why face-to-face presenting is more persuasive

by Olivia Mitchell | 3 comments

Seth Godin recently posted that as online methods of engaging and interacting improve, the expectations for face-to-face interactions such as sales calls, presentations and conferences will increase:

In other words, “I flew all the way here for this?” is going to be far more common than it used to be.

This got me thinking about whether we will continue to have face-to-face presentations. Does face-to-face presenting have an edge over video-conferencing and other online presentation technology?

I think so. Face-to-face presenting is inherently more persuasive. For many of us this is intuitive . If you want to persuade someone, going to see them is likely to be more effective than the phone, and the phone is likely to be more effective than sending them an e-mail.

Social psychologist Robert Cialdini in his classic work Influence: The Psychology of Persuasion identifies six weapons of influence . Here’s how these factors can be more effective in a face-to-face setting:

1. Reciprocation – we feel some obligation to return favors.

If a person has made the effort to prepare and deliver a face-to-face presentation, we are likely to reciprocate by carefully considering what they say. We owe them that. When I watch a presentation online and the presenter fails to engage me I have no hesitation in clicking away. I’ve only once left a live presentation – and I felt awful doing it.

2. Commitment and consistency – if people make a commitment, they are likely to follow through on it.

Attending a live presentation and devoting time to it, is a form of commitment. So in order to act consistently with that commitment, audience members may be more likely to take action based on the presentation.

3. Social proof – we look to other people as guidance on how to act.

Being part of an audience is a very different experience to watching a video of the same presentation online by yourself. Could this be because the behaviour of other people helps us form our own response to the presenter.

4. Authority – we tend to obey authority figures.

Are we more likely to judge someone as authoritative when we see them face to face? I think this is likely.

5. Liking – we’re more easily persuaded by people we like.

Deciding whether we like someone we’ve seen or met online, takes time. Meeting people face-to-face, we can make millisecond judgments about whether we like them.

6. Scarcity – believing something is scarce makes us want it.

A live presentation is by definition scarce – being part of it is to feel part of something exclusive and special. When we see something on the internet, in most cases, we know that it’s also available to millions of other people – nothing special or exclusive about that.

You’ve likely visited the TED website. Hundred of good quality videos of fantastic presentations. It’s almost like being there! But it’s not. And despite the fact that I can watch all the presentations online, I would still love to be invited and I would pay to go.

Humans evolved in a face-to-face world. We are optimised for the face-to-face situation. I believe face-to-face presenting will continue to have a persuasive edge. What do you think?

I wrote all this and then I read Guy Kawasaki’s post about amazing new technology from Cisco and Musion Systems. See it in action here . Three people on stage in Bangalore, India, but only one of them is really there – two of them are “holographic presences” beamed in from San Jose, California. From an audience point of view, there appears to be no distinction between the three men. I believe we would be fooled into reacting as if they were all face-to-face with us.

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Comment from Terry Gault

You are definitely right: face-time is more persuasive for the reasons you gave.

It is much easier to form accurate general impressions of a speaker in person, even if we may not be able to articulate the behaviors and techniques that led us to form them. After all, we’ve all spent a good portion of our lives gaging the truthfulness of the people with whom we interact.

In his book, “Strangers to Ourselves,” Timothy Wilson of the University of Virginia notes that the brain can absorb about 11 million pieces of information a second, of which it can process about 40 consciously. The unconscious brain handles the rest.

Our unconscious brains are gathering up thousands of subtle signals from the speakers that we observe regularly and forming general impressions such as, “He’s lying.” or “She’s arrogant.”

Body-language is often lost on-line, as is tone of voice in e-mail. Thus, we lose a lot of information about a speaker which makes it much harder to be persuaded by them.

Thanks for the post!

Today’s technology does keep us connected. We can attend video conferences, webinars, Second Life events, etc. They serve a purpose.

But they are substitutes that can never supplant the depth, the ability to hear what isn’t being said and opportunity to “read” people that face to face contact offers. We just need to become adept at it. And I am biased as my new book will be out in October: Face to FAce: How to REclaim he Personal Touch in a Digital World.

One techie blogger wrote that there is no such thing as sharing a “virtual beer”.

We must all be digitally adept but those who succeed in the 21st Century will be the people who can “talk to other people” according to Dr. Nathan Keyfitz, of Harvard. Whether it’s the sales call, the delicate conversation, the chance meeting —face to face communication reigns.

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How to Tame your Fear of Public Speaking

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How to Record a Presentation with Your Face (Audio and Video)

How to record a presentation with your face? This article offers three ways: video record all presentations without limits by using EaseUS RecExperts, record a PowerPoint presentation with its default recording function, and record Google slideshows via its built-in recorder.

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Updated on Jun 19, 2024

The development of technology enriches communication forms. From professors to business consultants, college to company, and school assignments to work reports, self-presenting has become indispensable in our study and work.

Adding narration in Google Slides, meetings, and other scenarios not only enhances audience engagement but also conveys ideas efficiently. So, users are more inclined to record presentations with their faces and audio.

This guide will teach you how to record a presentation with your face in PowerPoint, Google Slides, and other video narration forms. Read this article and get free video recording software to record slide about yourself easily and effectively.


🔥	- No time limit; no license or signup; no lag or watermark
⭐	- Need a Microsoft Office license; recordings saved on each slide separately; record the PPT area only; saved video file size super large
👍	- Need a Google account; recording length up to 30 minutes; affected by the Google Drive storage

How to Record Presentation with Face Using EaseUS RecExperts

A professional screen recorder like EaseUS RecExperts would be the best way to record PPT with video. It helps you record yourself presenting a PowerPoint , including your face and audio.

Narrators can record PowerPoint with webcam and audio, easily record presentations on Google Slides, and effectively record a presentation on Zoom with face. This easy-to-use presentation recorder can simplify the experience of recording presentations with faces.

EaseUS RecExperts

Record Google Slides , MS PowerPoint, Zoom meetings, and other presentations with face, audio, and video using a webcam and microphone.
Record about me presentation, self-presenting videos, and slide about yourself without time limit, lag, or watermark.
Record full screen , part of screen, and any region of screen on computer.
Save a PowerPoint as a video in high-quality. The AI-empowered function can reduce noise naturally.

Now, let's see how to record a presentation with your face.

Step 1. Launch EaseUS RecExperts on your computer. Choose a recording mode from "Full Screen" or "Region" . To record a part of the screen, select the recording area manually.

Step 2. After selecting the recording mode, click on the camera sign on the interface. This will let the tool record your screen and the webcam at the same time.

Step 3. You can also change the background with the AI Recognition ot green screen feature. Classroom, blur, studio, or your local images are supported. Just click "Webcam" > "Settings" > "Remove Background" to download and use these modules. Then, click the "REC" button to start recording.

Step 4. After recording, the recording list window will open. Here you can view, split, delete, manage your recordings easily.

How to Record a PowerPoint Presentation with Your Face via the Internal Recorder

If you want to record yourself talking in Microsoft PowerPoint, an inbuilt screen recorder is provided. You can record PowerPoint presentations with audio and video through its Record Slide Show or Screen Recording feature.

Before learning how to record on PowerPoint, pay attention to the following tips:

➤ You need to have a license for Microsoft Office to use PowerPoint.

➤ Check if the webcam and microphone are pre-placed well before recording.

➤ A new recording is saved on each slide separately. So, you should cover everything on one slide and not go back, otherwise the new recording will replace the previous one.

➤ Microsoft PowerPoint only records the PPT area, not supporting full-screen recording.

➤ The saved videos are very large. Make sure your computer has enough space.

After reading the perquisites, let's see how to record a PowerPoint presentation with your face.

Step 1. On the toolbar, tap Record Slide Show or Screen Recording .

Step 2. Click Record . Then, you can select Record from Current Slide… or Record from Beginning… .

choose recording from current slide or from beginning

Step 3. You have entered the recording screen. In the bottom right corner, turn on the microphone and webcam.

Step 4. Click Record in the upper left corner. It starts recording the PPT on yourself with audio. Click the arrow to move to the next slide, and use the pen to write notes on the slide if needed.

Step 5. To stop recording in PPT, click Stop .

Step 6. To save a PowerPoint as a video, go to Files > Export > Create a Video in the upper left corner. The recording file will be saved in MP4 format.

Share this post on your social platform to help more people!

How to Record a Presentation with Your Face Google Slides via the Default Recorder

Google Slides is another popular presentation tool that allows users to record video with face. Unlike MS, Google Slides is a cloud-based software that requires no installation or license. But there are some limitations you need to pay attention to:

➤ Each presentation can be recorded for up to 30 minutes.

➤ You need a Google account to use this function.

➤ There is a storage limit. You cannot record new videos if the Google Cloud has insufficient space.

After reading the perquisites, let's see how to record a presentation with your face Google Slides:

Step 1. Open a browser, sign into your Google account, and visit Google Slides .

Step 2. Create or open a PPT, click the Rec button in the upper right corner, and tap Record new video .

Step 3. You will enter the screen recording interface. Press the red button to start recording.

Step 4. In the coming prompt, click Allow and toggle on Also allow tab audio to enable the camera and microphone. Now, you can record your face and voice.

Step 5. To end the recording, press the red button again. Here, you can click Re-record to start over or click Save to Drive to save the presentation as a video.

Extra Tip: How to Record a PowerPoint Presentation with Your Face on Mac

Since there is not a Mac version of MS PowerPoint, users may ask what is the best way to record a presentation for Mac ?

For how to record a PowerPoint presentation with your face Mac, you have two options:

Way 1. Use the Mac built-in recorder - QuickTime Player

Although Mac has a default presentation recorder, it cannot capture internal sound. If you want to record screen on Mac with audio , you need to download and install an extra add-on extension: Soundflower.

Step 1. Open the Soundflower download page . Then, download and install Soundflower on your Mac.

Step 2. Launch Soundflower and go to System Preferences > Volume . Click the Gear icon at the bottom-left panel. Tap Create a Mult-Output Device > Built-in Output > Soundflower (2ch) .

Step 3. Click the Gear button again and click Use This Device for Sound Output .

Step 4. Open QuickTime Player, navigate to File > New Screen Recording , tap the down-arrow icon next to the record button, and choose Soundflower (2ch) as the microphone device.

Step 5. Now, open the presentation PPT and locate the slide you want to record.

Step 6. Click Record to start recording slide about yourself.

Step 7. To stop recording in PPT, the Stop button.

Way 2. Try another presentation recorder - EaseUS RecExperts for Mac

To record presentation with face and audio directly, you can use a Mac screen recorder . Compared with QuickTime Player, it offers an easier and more straightforward solution.

Step 1. Firstly, launch EaseUS RecExperts on your Mac. There are two options, "Full Screen" and "Region," for you to select the recording area.

Step 2. Then, click on the "Webcam" button at the bottom. When a "Record webcam" window pops up, click the button to activate the webcam, and you can select the device you want to use from the dropdown menu.

Step 3. If you want to capture the screen with audio, the "Sound" button beside "Webcam" can help. You can click on the two buttons on the "Select recording sound" window to choose the audio source, such as the system sound, the microphone audio, or two of them.

After adjusting the settings appropriately, click on the "REC" button to start recording.

Step 4. Now, you can record the Mac screen and your webcam at the same time. After capturing all the content you need, hit the "Stop" button to end it, and this software will offer you a built-in video player to view the video you captured.

Guess now you have known how to record a presentation with your face . To summarize, both the internal recording functions in PowerPoint and Google Slides are limited. If you want to record PowerPoint, Google Slides, Zoom, or other presentations without any limits, use EaseUS RecExperts.

It allows narrators to record their PPT with face easily. No time limit, no screen size limit, and no sophisticated steps. Download this free presentation recorder to your computer and give it a shot.

FAQs on How to Record a Presentation with Your Face

Learn more frequently asked questions on how to record presentation with face.

1. Is there a free recording app?

Yes, there is a free recording app called EaseUS RecExperts. This versatile screen recorder lets you record everything you want, including presentation, video conference, streaming video, gameplay, YouTube, and more. You can record full screen or part of screen to your liking.

2. Why can't I record my face on PowerPoint?

Recording face on PowerPoint not working can be caused by:

The microphone not enabled. Go to Settings on PowerPoint to check if you give access to your microphone.
Insufficient disk space. You need to free up your drive and leave more storage space.

3. How do you present yourself in PowerPoint?

To present yourself in PowerPoint, you can use the built-in recorder in MS PowerPoint. Here are the steps:

Step 1. Go to Record Slide Show or Screen Recording .

Step 2. Click Record > Record from Current Slide… or Record from Beginning… .

Step 3. Click Record on the upper left corner to video record yourself presenting a PowerPoint.

Step 4. Click Stop to end recording the introduction slide about yourself.

One-click to capture anything on screen!

No Time Limit, No watermark

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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.

[Featured Image]: The marketing manager, wearing a yellow top, is making a PowerPoint presentation.

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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Diagnosis and management of face presentation

PMID: 7005774

Face presentation is an unusual complication of pregnancy; it occurs once in every 500 to 600 deliveries. Prematurity, fetal macrosomia, anencephaly, and cephalopelvic disproportion (CPD) are the major obstetric factors that predispose the fetus to face presentation. Although the mechanisms of labor in face presentation are different from those of simple vertex presentation, there is no consistent alteration in the duration of labor in the absence of underlying CPD. When disproportion does not exist and gross anomalies are not present, the prognosis for spontaneous vaginal delivery is excellent. The majority of perinatal losses reported in face presentation have resulted from traumatic operative vaginal deliveries, specifically version and extraction and midforceps rotations. Recent experience at this institution with a limited series of face presentations demonstrates that, with careful intrapartum surveillance, delivery can be accomplished with no increase in risk to either mother or fetus.

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How to make your presentation sound more like a conversation.

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The main difference between strong, confident speakers and speakers who seem nervous in front of the room is in how relaxed and conversational they appear. Here are some basic pointers that will help you create a conversational tone when speaking, regardless of the size of your audience.

1. Avoid using the word, “presentation.” Every time you say, “I’m here to give you a presentation on X,” or, “In this presentation, you’ll see…,” you are emphasizing the formal, structured, sometimes artificial nature of the interaction. No one wants to be “presented” to. Instead, use language that emphasizes a natural, conversational exchange. “We’re here today to talk about X,” or “Today I’ll be sharing some ideas regarding Y.” You can even go so far as to say, “I’m glad we have time together today to discuss Z.” Even if your talk is not going to truly be a dialogue, you can use language that suggests engagement with the audience.

2. If you are using PowerPoint, avoid using the word “slide.” Instead of talking about the medium, talk about the concepts. Swap out, “This slide shows you…,” for, “Here we see….” Instead of saying, “On that slide I showed you a moment ago,” say, “A moment ago we were discussing X. Here’s how that issue will impact Y and Z.” Casual conversations don’t usually involve slide decks. Just because your complicated presentation on tax exposure, supply chain issues, or new health care regulations requires you to use slides, doesn’t mean you have to draw attention to that fact that the setting is formal and structured.

3. For many large-group events, speakers are provided with what’s called a “confidence monitor,” a computer screen that sits on the floor at the speaker’s feet showing the slide that appears on the large screen above the speaker’s head. Avoid using confidence monitors. Our natural inclination when using a confidence monitor is to gesture at the bullet point we’re discussing at the moment. However, we are pointing to a bullet point on the screen at our feet, which the audience can’t see, so it creates a disconnect between us and the audience. Instead, stand to the side of the large screen and gesture at the bullet point you’re talking about so that the audience knows which point you are discussing at the moment.

4. Don’t tell your audience, “I want this to be interactive.” It’s your job to make it interactive. If you are delivering the type of presentation where your audience size allows you to create true engagement with your listeners, create that connecting in stages to “warm up” the audience. Stage One engagement is to ask the audience a question relevant to your topic that you know most of the audience members can respond to affirmatively. “Who here has ever bought a new car?” or, “How many of you have ever waited more than 5 minutes on hold on a customer service line?” Raise your hand as you ask the question to indicate to the audience how to respond. Whoever has raised their hand has now participated in the discussion. They have indicated a willingness to engage. Stage Two engagement is calling on one of the people who raised their hand and asking a specific, perfunctory question. Again, it needs to be a question they can answer easily. If your first questions is, “Who here has bought a new car?” you can then call on someone and ask, “How long ago,” or “What kind of car did you buy most recently?” If your first question was, “Have you ever waited on hold for more than 5 minutes,” you can’t ask, “What company were you calling at the time?” The people who raised their hands weren’t thinking of a specific instance; they were just thinking broadly about that type of experience. You could, however, call on someone and ask, “Do you prefer when they play music or ads for the company’s products?” Anyone can answer that question. At that point, you are in an actual dialogue with that person. Stage Three engagement is asking them a question where they need to reveal something more personal. “How does that make you feel when you hear those ads?” You’ve warmed up your audience and drawn them in with baby steps. Now you have actual, meaningful audience participation.

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5. Use gestures. When we’re speaking in an informal setting, we all use hand gestures; some people use more than others, but we all use them. When we try to rein in our gestures, two things happen that diminish our speaking style. First, we look stiff and unnatural. We look like we are presenting a guarded or cautious version of ourselves; we look less genuine. Second, hand gestures burn up the nervous energy we all have when speaking in front of a large group. That’s good. When we try to minimize our hand gestures, we tie up that nervous energy and it starts to leak out on odd ways, where we start to tap our foot, fidget with our notes or microphone, or tilt our head side to side to emphasize key points. Just let the gestures fly. It’s unlikely they will be too large or distracting. I have coached people on their presentation skills for 26 years. In that time, I have met three people who gestured too much. Everyone else would benefit from using their gestures more freely.

The impact we have as communicators is based on the cumulative effect of many different elements of our delivery. These suggestions alone won’t make you a terrific presenter. They will, however, add to the overall package your present of yourself when speaking to large audiences.

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Face Presentation Attack Detection

First Online: 30 December 2023

Cite this chapter

Zitong Yu 4 ,
Chenxu Zhao 5 &
Zhen Lei 6 , 7 , 8

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Face recognition technology has been widely used in daily interactive applications such as checking-in and mobile payment due to its convenience and high accuracy. However, its vulnerability to presentation attacks (PAs) limits its reliable use in ultra-secure application scenarios.

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Introduction to Face Presentation Attack Detection

Introduction to Presentation Attack Detection in Face Biometrics and Recent Advances

Recent advances in face presentation attack detection.

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This work was supported by the National Natural Science Foundation of China (No. 62276254, 62176256, 62206280, 62106264, and 62306061) and the InnoHK program.

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Yu, Z., Zhao, C., Lei, Z. (2024). Face Presentation Attack Detection. In: Li, S.Z., Jain, A.K., Deng, J. (eds) Handbook of Face Recognition. Springer, Cham. https://doi.org/10.1007/978-3-031-43567-6_7

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FactChecking the Biden-Trump Debate

In the first debate clash of the 2024 campaign, the two candidates unleashed a flurry of false and misleading statements.

By Robert Farley , Eugene Kiely , D'Angelo Gore , Jessica McDonald , Lori Robertson , Catalina Jaramillo , Saranac Hale Spencer and Alan Jaffe

Posted on June 28, 2024

The much-anticipated first debate of 2024 between President Joe Biden and former President Donald Trump featured a relentless barrage of false and misleading statements from the two candidates on immigration, the economy, abortion, taxes and more.

Both candidates erred on Social Security, with Biden incorrectly saying that Trump “wants to get rid” of the program, and Trump falsely alleging that Biden will “wipe out” Social Security due to the influx of people at the border.
Trump misleadingly claimed that he was “the one that got the insulin down for the seniors,” not Biden. Costs were lowered for some under a limited project by the Trump administration. Biden signed a law capping costs for all seniors with Medicare drug coverage.
Trump warned that Biden “wants to raise your taxes by four times,” but Biden has not proposed anything like that. Trump was also mostly wrong when he said Biden “wants the Trump tax cuts to expire.” Biden said he would extend them for anyone making under $400,000 a year.
Biden repeated his misleading claim that billionaires pay an average federal tax rate of 8%. That White House calculation factors in earnings on unsold stock as income.
Trump repeated his false claim that “everybody,” including all legal scholars, wanted to end Roe v. Wade’s constitutional right to abortion.
Trump falsely claimed that “the only jobs” Biden “created are for illegal immigrants and bounced back jobs that bounced back from the COVID.” Total nonfarm employment is higher than it was before the pandemic, as is the employment level of native-born workers.
Biden claimed that Trump oversaw the “largest deficit of any president,” while Trump countered that “we now have the largest deficit” under Biden. The largest budget deficit was under Trump in fiscal year 2020, but that was largely because of emergency spending due to COVID-19.
Biden misleadingly said that “Black unemployment is the lowest level it has been in a long, long time.” The rate reached a record low in April 2023, and it was low under Trump, too, until the pandemic.
Biden said Trump called U.S. veterans killed in World War I “suckers and losers,” which Trump called a “made up quote.” The Atlantic reported that, based on anonymous sources. A former Trump chief of staff later seemed to confirm Trump said it.
Trump claimed that Biden “caused the inflation,” but economists say rising inflation was mostly due to disruptions to the economy caused by the pandemic.
Trump grossly inflated the number of immigrants who have entered the country during the Biden administration — putting the number at 18 million to 20 million — and he said, without evidence, that many of them are from prisons and mental institutions.
Trump claimed that “we had the safest border in history” in the “final months” of his presidency. But apprehensions of those trying to cross illegally in the last three full months of his presidency were about 50% higher than in the three months before he took office.
Biden criticized Trump for presiding over a loss of jobs when he was president, but that loss occurred because of the COVID-19 pandemic.
Trump falsely claimed that “some states” run by Democrats allow abortions “after birth.” If it happened, it would be homicide, and that’s illegal.
Trump made the unsupported claim that the U.S. border with Mexico is “the most dangerous place in the world,” and suggested that it has opened the country to a violent crime wave. The data show a reduction in violent crime in the U.S.
Trump overstated how much food prices have risen due to inflation. Prices are up by about 20%, not double or quadruple.
Trump boasted his administration “had the best environmental numbers ever.” Trump reversed nearly 100 environmental rules limiting pollution. Although greenhouse gas emissions did decline from 2019 to 2020, the EPA said that was due to the impacts of the pandemic on travel and the economy.
Biden said he joined the Paris Agreement because “if we reach the 1.5 degrees Celsius, and then … there’s no way back.” Limiting global warming to 1.5 degrees would reduce the damages and losses of global warming, but scientists agree that climate action is still possible after passing the threshold.
Trump said immigrants crossing the border illegally were living in “luxury hotels.” New York City has provided hotel and motel rooms to migrant families, but there is no evidence that they are being placed in “luxury” hotels.
Trump falsely claimed that there was “no terrorism, at all” in the U.S. during his administration. There were several terrorist acts carried out by foreign-born individuals when he was president.
While talking about international trade, Trump falsely claimed that the U.S. currently has “the largest deficit with China.” In 2023, the trade deficit in goods and services with China was the lowest it has been since 2009.
Trump wrongly claimed that prior to the pandemic, he had created “the greatest economy in the history of our country.” That’s far from true using economists’ preferred measure — growth in gross domestic product.
As he has many times before, Trump wrongly claimed, “I gave you the largest tax cut in history.” That’s not true either as a percentage of gross domestic product or in inflation-adjusted dollars.
Trump contrasted his administration with Biden’s by misleadingly noting that when he left office, the U.S. was “energy independent.” The U.S. continues to export more energy than it imports.

The debate was hosted by CNN in Atlanta on June 27.

Social Security

Biden claimed that Trump “wants to get rid” of Social Security, even though the former president has consistently said he will not cut the program and has advised Republicans against doing so.

Earlier this year, Biden and his campaign based the claim on Trump saying in a March 11 CNBC interview that “there is a lot you can do in terms of entitlements in terms of cutting and in terms of also the theft and the bad management of entitlements.” As we’ve said , in context, instead of reducing benefits, Trump was talking about cutting waste and fraud in those programs — although there’s not enough of that to make the program solvent over the long term.

“I will never do anything that will jeopardize or hurt Social Security or Medicare,” Trump later said in a March 13 Breitbart interview . “We’ll have to do it elsewhere. But we’re not going to do anything to hurt them.”

During the GOP presidential primary, Trump also criticized some of his Republican opponents for proposing to raise the retirement age for Social Security, which budget experts have said would reduce scheduled benefits for those affected.

Some critics of Trump have argued that he cannot be expected to keep his promise because of his past budget proposals. But, as we’ve written , Trump did not propose cuts to Social Security retirement benefits.

Meanwhile, Trump claimed during the debate that Biden “is going to single handedly destroy Social Security” because of illegal immigration. “These millions and millions of people coming in, they’re trying to put them on Social Security. He will wipe out Social Security,” Trump said of Biden.

As we and others have explained before, immigrants who are not authorized to be in the U.S. aren’t eligible for Social Security. In fact, because many such individuals pay into Social Security via payroll taxes but cannot receive benefits, illegal immigrants bolster rather than drain the finances of the program.

In referring to what seniors pay for insulin, Trump misleadingly claimed, “I heard him say before ‘insulin.’ I’m the one that got the insulin down for the seniors. I took care of the seniors.” Insulin costs went down for some beneficiaries under a limited project under Trump; Biden signed a more expansive law affecting all seniors with Medicare drug coverage.

Under Trump, out-of-pocket costs were lowered to $35 for some Medicare Part D beneficiaries under a two-year pilot project in which some insurers could voluntarily reduce the cost for some insulin products. KFF, a nonpartisan health policy research organization, explained earlier this month that under this model, in effect from 2021 to 2023, “participating Medicare Part D prescription drug plans covered at least one of each dosage form and type of insulin product at no more than $35 per month,” and “less than half of all Part D plans chose to participate in each year.”

But in 2022, Biden signed a law that required all Medicare prescription drug plans to cap all insulin products at $35. The law also capped the out-of-pocket price for insulin that’s covered under Medicare Part B, which covers drugs administered in a health care provider’s office. The caps went into effect last year.

STAT, a news site that covers health care issues, reported that the idea for a $35 cap for seniors initially came from Eli Lilly, the pharmaceutical company, which proposed it in 2019.

Trump on Biden Tax Plan

“He’s the only one I know he wants to raise your taxes by four times,” Trump said of Biden. “He wants to raise everybody’s taxes by four times. He wants the Trump tax cuts to expire. So everybody … [is] going to pay four to five times – nobody ever heard of this before.”

Trump regularly warns of massive tax hikes for “everybody,” should Biden be reelected. That doesn’t jibe with anything Biden has proposed.

In his more than three years as president, Biden’s major tax changes have included setting a minimum corporate tax rate of 15% and lowering taxes for some families by expanding the child tax credit and, for a time, making it fully refundable, meaning families could still receive a refund even if they no longer owe additional taxes.

As we wrote in 2020, when Trump made a similar claim, Biden proposed during that campaign to raise an additional $4 trillion in taxes over the next decade, although the increases would have fallen mainly on very high-income earners and corporations. The plan would not have doubled or tripled people’s taxes at any income level (on average), according to analyses of Biden’s plan by the Penn Wharton Budget Model , the Tax Policy Center and the Tax Foundation .

In March 2023, the TPC’s Howard Gleckman wrote that Biden proposed a 2024 budget that would, on average, increase after-tax incomes for low-income households and “leave them effectively unchanged for middle-income households.” The Tax Policy Center noted, “The top 1 percent, with at least roughly $1 million in income, would pay an average of $300,000 more than under current law, dropping their after-tax incomes by 14 percent.”

This March, Biden released his fiscal year 2025 budget , which contains many of the same proposals and adds a few new wrinkles. But it still does not contain any “colossal tax hikes” on typical American families, as Trump has said.

Biden’s latest plan proposes — as he has in the past — to increase the corporate income tax rate from 21% to 28%, and to restore the top individual tax rate of 39.6% from the current rate of 37%. It would also increase the corporate minimum tax rate from 15% to 21% for companies that report average profits in excess of $1 billion over a three-year period. And the plan would impose a 25% minimum tax on very wealthy individuals. The plan also proposes to extend the expanded child tax credit enacted in the American Rescue Plan through 2025, and to make the child tax credit fully refundable on a permanent basis.

Trump is also mostly wrong that Biden “wants the Trump tax cuts to expire.”

As he has said since the 2020 campaign, Biden’s FY 2025 budget vows not to increase taxes on people earning less than $400,000.

In order to keep that pledge, Biden would have to extend most of the individual income tax provisions enacted in the Tax Cuts and Jobs Act that are set to expire at the end of 2025. And that’s what Biden says he would do — but only for individual filers earning less than $400,000 and married couples making less than $450,000. (In order to pass the TCJA with a simple Senate majority, Republicans wrote the law to have most of the individual income tax changes expire after 2025 .)

The Biden budget plan “would raise marginal income tax rates faced by higher earners and corporations while expanding tax credits for lower-income households,” according to a Tax Foundation analysis of the tax provisions in Biden’s budget. “The budget would redistribute income from high earners to low earners. The bottom 60 percent of earners would see increases in after-tax income in 2025, while the top 40 percent of earners would see decreases.”

Biden on Taxes Paid by Billionaires

In arguing that wealthy households should pay a minimum tax, Biden repeated his misleading claim that billionaires pay an average federal tax rate of 8%.

“We have a thousand … billionaires in America, and what’s happening?” Biden said . “They’re in a situation where they in fact pay 8.2% in taxes.”

That’s not the average rate in the current tax system; it’s a figure calculated by the White House and factors in earnings on unsold stock as income. When only considering income, the top-earning taxpayers, on average, pay higher tax rates than those in lower income groups, as we’ve written before.

The top 0.1% of earners pay an average rate of 25.1% in federal income and payroll taxes, according to an analysis by the Tax Policy Center in October 2022 for the 2023 tax year.

The point that Biden tried to make is that earnings on assets, such as stock, currently are not taxed until that asset is sold, which is when the earnings become subject to capital gains taxes. Until stocks and assets are sold, the earnings are referred to as “unrealized” gains. Unrealized gains, the White House has argued , could go untaxed forever if wealthy people hold on to them and transfer them on to heirs when they die.

Roe v. Wade

As he has before , Trump wildly exaggerated the popularity of ending Roe v. Wade — even going so far as to claim that it was “something that everybody wanted.”

“51 years ago, you had Roe v. Wade and everybody wanted to get it back to the states,” he said , referring to the 1973 Supreme Court ruling that established a constitutional right to abortion, which was overturned in 2022.

Trump: Everybody, without exception: Democrats, Republicans, liberals, conservatives. Everybody wanted it back — religious leaders. And what I did is I put three great Supreme Court justices on the court and they happened to vote in favor of killing Roe v. Wade, and moving it back to the states. This is something that everybody wanted. Now 10 years ago or so they started talking about how many weeks and how many this and getting into other things. But every legal scholar throughout the world — the most respected — wanted it brought back to the states. I did that.

In fact, a majority of Americans have disagreed with ending Roe v. Wade, including plenty of legal scholars, as we’ve explained before . While some scholars criticized aspects of the legal reasoning in Roe, it did not necessarily mean they wanted the ruling overturned. Legal experts told us that Trump’s claim was “utter nonsense” and “patently absurd.”

Trump Wrong on Jobs

After Biden talked about job creation during his administration, Trump falsely claimed that “the only jobs [Biden] created are for illegal immigrants and bounced back jobs that bounced back from the COVID.”

In fact, as of May, total nonfarm employment in the U.S. had gone up about 6.2 million from the pre-pandemic peak in February 2020, according to figures from the Bureau of Labor Statistics. The increase is about 15.6 million if you count from when Biden took office in January 2021 until now — but that would include some jobs that were temporarily lost during the pandemic and then came back during the economic recovery.

Furthermore, there is no evidence that only “illegal immigrants” have seen employment gains.

Since Biden became president in January 2021, employment of U.S.-born workers has increased more than employment of foreign-born workers, a category that includes anyone who wasn’t a U.S. citizen at birth, as we’ve written before . BLS says the foreign-born population includes “legally-admitted immigrants, refugees, temporary residents such as students and temporary workers, and undocumented immigrants.” There is no employment breakdown for just people in the U.S. illegally.

In looking at employment since the pre-pandemic peak, the employment level of foreign-born workers was up by about 3.2 million, from roughly 27.7 million in February 2020 to nearly 30.9 million in May. Employment for the U.S.-born population increased by about 125,000 — from nearly 130.3 million in February 2020 to 130.4 million, as of May.

Conflicting Budget Deficit Claims

Biden and Trump accused each other of presiding over the largest budget deficit in the U.S.

After talking about Trump’s plans for additional tax cuts, Biden said Trump already had the “largest deficit of any president in American history.” When he got a chance to respond, Trump said, “We now have the largest deficit in the history of our country under this guy,” referring to Biden.

Biden is correct: The largest budget deficit on record was about $3.1 trillion in fiscal year 2020 under Trump. However, that was primarily because of trillions of dollars in emergency funding that both congressional Republicans and Democrats approved to address the COVID-19 pandemic. Before the pandemic, the largest budget deficit under Trump was about $1 trillion in fiscal 2019.

Meanwhile, the most recent budget deficit under Biden was about $1.7 trillion in fiscal 2023. As of June, the nonpartisan Congressional Budget Office projected that the deficit for fiscal 2024, which ends on Sept. 30, would be about $2 trillion.

Black Unemployment

Biden boasted that on his watch, “Black unemployment is the lowest level it has been in a long, long time.”

It’s true that the unemployment rate for Black or African American people reached a record low of 4.8% in April 2023, but it is currently 6.1%, according to the Bureau of Labor Statistics, which has data going back to 1972.

Also, the unemployment rate was low under Trump, too, until the pandemic.

Under Trump, the unemployment rate for Black Americans went down to 5.3% in August 2019 – the lowest on record at that time. It shot up to 16.9% in April 2020, when the economic effects of the pandemic took hold. When Trump left office in January 2021, amid the pandemic, the rate was 9.3%.

The rate has been 6% or less in only 29 months since 1972, and it happened only under two presidents: 21 times under Biden and eight times under Trump.

‘Suckers and Losers’

Biden said Trump called U.S. veterans killed in World War I “suckers and losers,” which Trump called a “made up quote … that was in a third-rate magazine.”

It was first reported by a magazine — the Atlantic — but Trump’s former chief of staff, John F. Kelly , a retired four-star Marine general, later seemed to confirm it.

Biden was referring to a trip Trump made to France in November 2018, where he reportedly declined to visit the Aisne-Marne American Cemetery near the location of the Battle of Belleau Wood. “He was standing with his four-star general and he told him, ‘I don’t want to go in there because they’re a bunch of losers and suckers.’”

The Atlantic wrote about this alleged incident in 2020, citing unnamed sources. The magazine wrote that Trump made his remark about “losers” when he declined to visit the Aisne-Marne American Cemetery, and his remark about “suckers” during that same trip.

The Atlantic, Sept. 3, 2020: In a conversation with senior staff members on the morning of the scheduled visit, Trump said, “Why should I go to that cemetery? It’s filled with losers.” In a separate conversation on the same trip, Trump referred to the more than 1,800 marines who lost their lives at Belleau Wood as “suckers” for getting killed.

In October 2023, Kelly – who was on that trip and visited the Aisne-Marne Cemetery — gave a statement to CNN that seemed to confirm those remarks. CNN published Kelly’s statement.

CNN, Oct. 3, 2023: “What can I add that has not already been said?” Kelly said, when asked if he wanted to weigh in on his former boss in light of recent comments made by other former Trump officials. “A person that thinks those who defend their country in uniform, or are shot down or seriously wounded in combat, or spend years being tortured as POWs are all ‘suckers’ because ‘there is nothing in it for them.’ A person that did not want to be seen in the presence of military amputees because ‘it doesn’t look good for me.’ A person who demonstrated open contempt for a Gold Star family – for all Gold Star families – on TV during the 2016 campaign, and rants that our most precious heroes who gave their lives in America’s defense are ‘losers’ and wouldn’t visit their graves in France.”

Trump said, “We had 19 people who said I didn’t say it.” One of those who said that he didn’t hear Trump make those remarks is John Bolton, Trump’s former national security adviser who was also on the trip and said he was there when the decision was made not to visit the cemetery.

“I didn’t hear that,” Bolton told the New York Times in 2020 after the magazine story first appeared. “I’m not saying he didn’t say them later in the day or another time, but I was there for that discussion.”

Biden Misleads on Jobs

Biden ignored the economic impact of the COVID-19 pandemic when he criticized Trump for employment going down over Trump’s time in office.

“He’s the only president other than Herbert Hoover that lost more jobs than he had when he began,” Biden said.

Job growth during Trump’s term was positive until the economy lost 20.5 million jobs in April 2020, as efforts to slow the spread of the novel coronavirus led to business closures and layoffs. By the time Trump left office in January 2021, employment had partly rebounded, but was still 9.4 million jobs below the February 2020 peak, according to the Bureau of Labor Statistics .

Trump repeatedly claimed that Biden “caused the inflation” and that “I gave him a country with no essentially no inflation. It was perfect. It was so good.”

It’s true that inflation was relatively modest when Trump was president. The Consumer Price Index rose 7.6% under Trump’s four years — continuing a long period of low inflation. And inflation has been high over the entirety of Biden’s time in office. The Consumer Price Index for all items rose 19.3% between January 2021 and May.

For a time, it was the worst inflation in decades. The 12 months ending in June 2022 saw a 9% increase in the CPI (before seasonal adjustment), which the Bureau of Labor Statistics said was the biggest such increase since the 12 months ending in November 1981.

Inflation has moderated more recently. The CPI rose 3.3% in the 12 months ending in May, the most recent figure available.

Although Trump claims that Biden is entirely responsible for massive inflation, economists we have spoken to say Biden’s policies are only partly to blame. The economists placed the lion’s share of the blame for inflation on disruptions to the economy caused by the pandemic, including supply shortages, labor issues and increased consumer spending on goods. Inflation was then worsened by Russia’s attack on Ukraine, which drove up oil and gas prices, experts told us.

Indeed, inflation has been a worldwide problem post-pandemic.

However, many economists say Biden’s policies — particularly aggressive stimulus spending early in his presidency to offset some of the economic damage caused by the pandemic — played a modest role.

Jason Furman , a former economic adviser to President Barack Obama and now a Harvard University professor, told us in June 2022 that he estimated about 1 to 4 percentage points worth of the inflation was due to Biden’s stimulus spending in the American Rescue Plan — a $1.9 trillion pandemic relief measure that included $1,400 checks to most Americans; expanded unemployment benefits; and money for schools, small businesses and states. Mark Zandi , chief economist of Moody’s — whose work is often cited by the White House — said the impact of the stimulus measure now “has largely faded.”

Economists note that the American Rescue Plan came after two other pandemic stimulus laws enacted under Trump that were worth a total of $3.1 trillion. That spending, too, could have contributed to inflation.

Immigrants Entering U.S. Under Biden

Trump grossly inflated the number of immigrants who have entered the country during the Biden administration — putting the number at 18 million to 20 million. The number, by our calculation, is about a third of that. Trump also claimed, without evidence, that many of those immigrants are from prisons and mental institutions.

“It could be 18, it could be 19, and even 20 million people,” Trump said of the immigrants who have entered the U.S. during the Biden administration. Later in the debate, Trump asked Biden why there had been no accountability “for allowing 18 million people many from prisons, many from mental institutions” into the country.

That’s a greatly exaggerated number. We took a deep dive into the immigration numbers in February , and again in mid-June , and we came up with an estimate of at most a third of Trump’s number.

Here’s the breakdown:

Department of Homeland Security data show nearly 8 million encounters at the U.S.-Mexico border between February 2021, the month after Biden took office, and May, the last month of available statistics . That’s a figure that includes both the 6.9 million apprehensions of migrants caught between legal ports of entry – the number typically used for illegal immigration – and nearly 1.1 million encounters of migrants who arrived at ports of entry without authorization to enter the U.S.

DHS also has comprehensive data, through February, of the initial processing of these encounters. That information shows 2.9 million were removed by Customs and Border Protection and 3.2 million were released with notices to appear in immigration court or report to Immigration and Customs Enforcement in the future, or other classifications, such as parole. (Encounters do not represent the total number of people, because some people attempt multiple crossings. For example, the recidivism rate was 27% in fiscal year 2021, according to the most recent figures from CBP.)

As we’ve explained before , there are also estimates for “gotaways,” or migrants who crossed the border illegally and evaded the authorities. Based on an average annual apprehension rate of 78%, which DHS provided to us, that would mean there were an estimated 1.8 million gotaways from February 2021 to February 2024. The gotaways plus those released with court notices or other designations would total about 5 million.

There were also 407,500 transfers of unaccompanied children to the Department of Health and Human Services and 883,000 transfers to ICE. The ICE transfers include those who are then booked into ICE custody, enrolled in “ alternatives to detention ” (which include technological monitoring) or released by ICE. We don’t know how many of those were released into the country with a court notice. But even if we include those figures, it still doesn’t get us to anywhere near 18 to 20 million.

And we should note that these figures do not reflect whether a migrant may ultimately be allowed to stay or will be deported, particularly since there is a yearslong backlog of immigration court cases.

Also, as we have written repeatedly , Trump has provided no credible support for his incendiary claim that countries are emptying their prisons and mental institutions and sending those people to the U.S. Experts tell us they have seen no evidence to substantiate it.

Earlier this month, we looked into Trump’s claim as it relates to Venezuela, because Trump has repeatedly cited a drop in crime there to support his claim about countries emptying their prisons and sending inmates to the U.S. Reported crime is trending down in Venezuela, but crime experts in the country say there are numerous reasons for that — including an enormous out-migration of citizens and a consolidation of gang activity — and they have nothing to do with sending criminals to the U.S.

“We have no evidence that the Venezuelan government is emptying the prisons or mental hospitals to send them out of the country, whether to the USA or any other country,” Roberto Briceño-León, founder and director of the independent Venezuelan Observatory of Violence, told us.

Border Under Trump

Trump claimed that “we had the safest border in history” in the “final months” of his presidency, according to Border Patrol. But according to data provided by Customs and Border Protection, apprehensions of those trying to cross illegally into the U.S. in the last three full months of Trump’s presidency were about 50% higher than in the three months before he took office.

In fact, as we wrote in our piece, “ Trump’s Final Numbers ,” illegal border crossings, as measured by apprehensions at the southwest border , were 14.7% higher in Trump’s final year in office compared with the last full year before he was sworn in.

But these statistics tell only part of the story. The number of apprehensions fluctuated wildly during Trump’s presidency, from a monthly low of 11,127 in April 2017 to a high of 132,856 in May 2019.

Back in April, we wrote about a misleading chart that Trump showed to the crowd during a speech in Green Bay, Wisconsin. “See the arrow on the bottom? That was my last week in office,” Trump said. “That was the lowest number in history.” But Trump was wrong on both points.

The arrow was pointing to apprehensions in April 2020, when apprehensions plummeted during the height of the pandemic.

“The pandemic was responsible for a near-complete halt to all forms of global mobility in 2020, due to a combination of border restrictions imposed by countries around the world,” Michelle Mittelstadt , director of communications for the Migration Policy Institute, told us.

After apprehensions reached a pandemic low in April 2020, they rose every month after that. In his last months in office, apprehensions had more than quadrupled from that pandemic low and were higher than the month he took office.

Trump falsely claimed that “some states” run by Democrats allow abortions “after birth.” As we have written , that’s simply false. If it happened, it would be homicide , and that’s illegal .

“No such procedure exists,” the American College of Obstetricians and Gynecologists says on its website.

The former president has wrongly said that abortions after birth were permitted under Roe v. Wade — the Supreme Court ruling that established a constitutional right to abortion until it was reversed in 2022. It was not.

Under Roe, states could outlaw abortion after fetal viability, but with exceptions for risks to the life or health of the mother. Many Republicans have objected to the health stipulation, saying it would allow abortion for any reason. Democrats say exceptions are needed to protect the mother from medical risks. We should note, late-term abortions are rare . According to the Centers for Disease Control and Prevention , less than 1% of abortions in the U.S. in 2020 were performed after 21 weeks gestational time.

In June 2022, after Trump had appointed three conservative justices to the Supreme Court, the court overturned Roe in a 5-4 ruling. Biden supports restoring Roe as “the law of the land,” as he said in his State of the Union address in March.

Trump Calls Border ‘The Most Dangerous Place’

In his focus on the U.S. border with Mexico, Trump made the unsupported claim that it is “the most dangerous place in the world.”

It’s true that unauthorized border crossings can be dangerous — 895 people died while doing so in fiscal year 2022, which is the most recent year for which the Customs and Border Protection has data . Most of those deaths were heat related.

And the International Organization for Migration called calendar year 2022 “the deadliest year on record” for migration in the Americas, with a total of 1,457 fatalities throughout South America, Central America, North America and the Caribbean. The organization began tracking deaths and disappearances related to migration in 2014.

“Most of these fatalities are related to the lack of options for safe and regular mobility, which increases the likelihood that people see no other choice but to opt for irregular migration routes that put their lives at risk,” the organization said in its 2022 report .

Trump suggested that the border crossings imperil Americans when he went on to say, “these killers are coming into our country, and they are raping and killing women.”

But, as we’ve written before , FBI data show a downward trend in violent crime in the U.S., and there’s no evidence to support the claim that there’s been a crime wave driven by immigrants.

Crime analyst Jeff Asher, co-founder of the New Orleans firm AH Datalytics , told us in May that there’s no evidence in the data to indicate a migrant crime wave.

Similarly, Jeffrey Butts, director of the Research and Evaluation Center at the John Jay College of Criminal Justice, told the New York Times in February there was no evidence of a migrant crime wave in New York City after Texas Gov. Greg Abbott began busing migrants there in April 2022.

“I would interpret a ‘wave’ to mean something significant, meaningful and a departure from the norm,” Butts said at the time. “So far, what we have are individual incidents of crime.”

Also, it’s worth noting that the Institute for Economics and Peace’s Global Peace Index — which measures the safety of 163 countries based on 23 indicators, including violent crime, deaths from internal conflict and terrorism — said the “least peaceful country” is Afghanistan, followed by Yemen, Syria, South Sudan and the Democratic Republic of the Congo.

In discussing inflation, the former president embellished the degree to which food prices have increased.

“It’s killing people. They can’t buy groceries anymore,” Trump said. “You look at the cost of food, where it’s doubled, tripled and quadrupled. They can’t live.”

According to the Bureau of Labor Statistics, the Consumer Price Index for food has gone up 17.5% — not 100% to 300% — since January 2021. The Consumer Price Index specifically for groceries, or “food at home,” has risen 20.8% .

Climate Change

During a short exchange about climate change, Trump boasted that during his tenure “we had the best environmental numbers ever.” It is not clear what he was referring to exactly, but he said if elected president he wanted to have “absolutely immaculate clean water and I want absolutely clean air — and we had it.” He might have been referring to a talking point that Andrew Wheeler, Trump’s former Environmental Protection Agency administrator, had recommended Trump mention during the debate: “CO2 emissions went down” during his administration, as the Hill reported .

Greenhouse gas emissions, which are responsible for global warming, did decline from 2019 to 2020. But that was “largely due to the impacts of the coronavirus (COVID-19) pandemic on travel and economic activity,” according to the EPA. Emissions increased by 5.7% from 2020 to 2022, once the economy started getting reactivated again, the agency said.

According to an analysis by the New York Times , Trump’s administration reversed nearly 100 environmental rules, including 28 regulations on air pollution and emissions, and eight rules that limited water pollution. Reportedly, Trump recently asked oil executives and lobbyists to donate to his campaign, promising he would roll back other environmental rules that hurt fossil fuel interests.

“He’s not done a damn thing for the environment,” Biden said in response, pointing out that Trump had pulled the U.S. out of the Paris Agreement . “I immediately joined it because if we reach the 1.5 degrees Celsius … there’s no way back,” Biden said.

As we’ve reported , although reaching 1.5 degrees Celsius, or 2.7 degrees Fahrenheit, of warming comes with a number of very serious impacts, it is not a point of no return. Scientists agree that every increment of global warming increases these negative impacts, but 1.5 degrees is not a magic number after which everything is doomed, they say.

Immigrants Living in Hotels

During the debate, Trump mentioned twice that while immigrants crossing the border illegally were “living in luxury hotels,” in New York City and other cities “our veterans are living in the street.”

While it is true that New York City has provided hotel rooms to migrant families as a temporary shelter solution, there is no evidence that immigrants are being placed in “luxury” hotels.

In 2023, Mayor Eric Adams signed a $275 million contract with the Hotel Association of New York City to house 5,000 migrants. The deal was intended to help struggling hotels impacted by the pandemic and did not expect to include luxury hotels. “There are no gold-plated rooms that are being given away contrary to any reports that you may have seen,” the association president told NY1 at the time. In January, the city signed another $77 million contract to shelter migrant families in hotels.

In April, social media posts falsely claimed immigrants had stormed New York City Hall to demand luxury hotel accommodations. But as the Associated Press reported , the immigrants were there for a hearing about racial inequities in shelter and immigrant services.

In 2023, the number of veterans experiencing homelessness increased 7.4% from 2022, according to data from the Department of Housing and Urban Development. But homelessness among veterans has been declining in recent years, with a 4% overall reduction within the last three years alone.

Terrorist Attacks Under Trump

While talking about Iran and terrorism, Trump falsely claimed that “you had no terror, at all, during my administration.” As we’ve written , there were several acts of terrorism carried out by foreign-born individuals when Trump was in office.

For example, in October 2017, Sayfullo Saipov used a truck to run down people in New York City. He killed eight people, including Americans and tourists, in an attack carried out on behalf of the Islamic State.

Then in December 2017, Akayed Ullah detonated a homemade pipe bomb he was wearing inside a New York City subway station. Ullah told authorities he did it in response to U.S. airstrikes against the Islamic State in Syria and other places.

Then in December 2019 , Second Lt. Mohammed Saeed Alshamrani, a member of the Royal Saudi Air Force, shot 11 people at Florida’s Naval Air Station Pensacola, killing three U.S. sailors. Trump’s own attorney general, William Barr, called it an act of terrorism in January 2020. “The evidence shows that the shooter was motivated by jihadist ideology,” Barr said in a statement.

China Trade Deficit

When discussing U.S. trade relations with China, Trump said “we have the largest deficit with China.” That’s false, as we’ve written .

In 2023, the U.S. had a trade deficit with China in goods and services of roughly $252 billion, according to revised figures the Bureau of Economic Analysis released in early June. The deficit in goods trading was about $279 billion which was partially offset by a roughly $27 billion surplus in the trading of services — which can include travel, transportation, finance and intellectual property.

The trade gap with China last year was the lowest it had been since 2009, when it was $220 billion.

In fact, according to BEA data going back to 1999, the highest total U.S.-China trade deficit in goods and services was about $378 billion in 2018 — when Trump was president. Under Biden, the highest trade deficit with China was $366 billion in 2022.

Not ‘Greatest Economy’ Under Trump

Trump falsely said that prior to the pandemic, the U.S. had “the greatest economy in the history of our country. … Everything was locked in good.”

Trump’s boast about creating the “greatest economy in history” is ubiquitous in his campaign speeches. And it’s not true, at least not by the objective measure typically used to gauge the health of the economy.

As we have written , economists generally measure a nation’s health by the growth of its inflation-adjusted gross domestic product . Under Trump, growth was modest. Real GDP in Trump’s four years grew annually by 2.5% in 2017, 3% in 2018 and 2.5% in 2019 — before the economy went into a tailspin during the pandemic in 2020, when real GDP declined by 2.2%, according to the Bureau of Economic Analysis.

So, in the best year under Trump, U.S. real GDP grew annually by 3%. By contrast, the nation’s economy grew at a faster annual rate 48 times and under every president before and after Trump dating to 1930, except Barack Obama and Herbert Hoover. The economy grew at more than 3% six of Ronald Reagan’s eight years, including 7.2% in 1984, and it grew 5% or more 10 times under Franklin D. Roosevelt, including 18.9% in 1942. Under Biden , the GDP grew by 5.8% in 2021 — a post COVID-19 bounce-back — by 1.9% in 2022 and 2.5% in 2023.

Trump’s Was Not Largest Tax Cut in History

As he has many times before, Trump wrongly claimed, “I gave you the largest tax cut in history.” But saying this over and over, as Trump has for years, doesn’t make it any more true.

As we have been writing even before the 2017 Tax Cuts and Jobs Act was enacted into law, while the law provided tax relief to nearly all Americans, it was not the largest tax cut in U.S. history either as a percentage of gross domestic product (the measure preferred by economists) or in inflation-adjusted dollars.

According to a Tax Policy Center analysis , the law reduced the individual income taxes owed by Americans by about $1,260 on average in 2018. It also reduced the top corporate tax rate from 35% to 21% , beginning in January 2018.

The law signed by Trump was initially projected to cost $1.49 trillion over 10 years, according to the nonpartisan Joint Committee on Taxation . It could end up costing substantially more if individual tax provisions are extended past 2025. Over the first four years, the average annual cost was estimated to be $185 billion. That was about 0.9% of gross domestic product in 2018.

That’s nowhere close to President Ronald Reagan’s 1981 tax cut, which was 2.89% of GDP over a four-year average. That’s according to a 2013 Treasury Department analysis on the revenue effects of major tax legislation. Five more tax measures since 1940 had an impact larger than 1% of GDP, and the Committee for a Responsible Federal Budget includes a 1921 measure as also being larger than the 2017 plan. That’s eighth place for Trump’s “biggest tax cut in our history.”

In inflation-adjusted dollars, the Trump-era tax cut is also less than the American Taxpayer Relief Act of 2012, which comes in at No. 1 with a $320.6 billion cost over a four-year average. And it’s less than tax reductions in 2010 ($210 billion) and 1981 ($208 billion).

Energy Independence

Trump boasted, as he often does , that “on Jan. 6 [2021], we were energy independent,” implying that’s no longer the case under Biden. But by Trump’s definition, the country remains energy independent.

To be clear, under Trump, the U.S. never stopped importing sources of energy, including crude oil , from other countries. What he likely means is that the country either produced more energy than it consumed, or exported more energy than it imported. During Trump’s presidency, after years trending in that direction, the U.S. did hit a tipping point where exports of primary energy exceeded energy imports from foreign sources in 2019 and 2020 — the first times that had happened since 1952, according to the U.S. Energy Information Administration.

But contrary to Trump’s suggestion, that has continued in the Biden presidency. The U.S., during Biden’s presidency, has exported more energy, including petroleum , than it imported, and it has produced more energy than it consumed. Also, the U.S. is producing record amounts of oil and natural gas under Biden.

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Column: Yes, Biden looked and sounded awful. But the debate didn’t change the stark choice we face

First Lady Jill Biden joins President Biden onstage after Thursday's presidential debate.

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Here’s a terrible thought I could not shake as I watched Thursday’s debate: President Biden looked like a corpse.

Sure, anyone might look pale while standing next to the floridly orange former President Trump, but Biden’s pallor was alarming.

When he was not speaking, Biden’s eyes had a faraway look, and, more distressingly, his mouth was slack. Compared with the overanimated Trump — who scowled, sneered and screwed up his mouth in a pout — Biden’s face looked as if it had been dipped in Botox and frozen.

And his voice! What has happened to our loquacious president’s voice? It was so whispery and phlegmy that I wanted to yell, “Just clear your throat, for God’s sake!”

Biden’s performance Thursday was revelatory, for all the wrong reasons.

FILE - Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases, holds his face mask in his hands as he attends a House Committee on Appropriations subcommittee hearing on about the budget request for the National Institutes of Health, May 11, 2022, on Capitol Hill in Washington. Fauci, the government’s top infectious disease expert, says he plans to retire by the end of President Joe Biden’s term in January 2025. Fauci, 81, became director of the National Institute of Allergy and Infectious Diseases in 1984 and has advised seven presidents. (AP Photo/Jacquelyn Martin, File)

Column: Anthony Fauci has a right to savage Trump. His memoir takes a different and telling approach

The physician and researcher who weathered the COVID pandemic, the HIV/AIDS crisis and countless Republican conspiracy theories has a new book.

June 23, 2024

For years, Republicans have tried to make us believe Biden is feeble. They’ve deceptively edited videos to make him look clueless, magnified his every small bumble and exploited his lifelong stutter , which old age seems to have exacerbated.

On Thursday, tragically, he did their work for them .

Trump was, of course, Trump: He spewed a volcano of lies , misstatements, exaggerations and fear-mongering. It seemed as if virtually nothing that came out of his mouth was true, especially his insistence that the United States under Biden has become a worldwide laughingstock, that Putin would never have invaded Ukraine on his watch, that Hamas would never have attacked Israel.

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I recorded the debate and did not watch it until after it was finished. I refused to look at my phone — which was dinging like crazy — because I did not want to be influenced by anyone else’s opinion of what had gone down. I wanted my impressions to be mine alone, free of whatever conventional wisdom was rapidly congealing in the cybersphere. And on Friday morning, I tried not to look at headlines, though it was obvious that Biden had a terrible, terrible night.

I conducted a thought experiment: If I read the transcript , would I be as alarmed by Biden’s performance as I was while watching it on TV? Would his sepulchral presentation be apparent? Would he seem like a man in command of facts and history? Would he, to put it bluntly,make sense?

The answer is a resounding but bittersweet yes, because his substance will ultimately be less important than his geriatric demeanor.

Take the exchange on abortion, which will be a key issue in November, as it has in every election since the Supreme Court overturned Roe vs. Wade two years ago.

Here is Biden: “The idea that the politicians, that the founders wanted the politicians to be the ones making decisions about women’s health, is ridiculous. That’s the last — no politician should be making that decision. A doctor should be making those decisions. That’s how it should be run. That’s what you’re going to do. And if I’m elected, I’m going to restore Roe v. Wade.”

Trump came back with his crazy spigot on blast: “So that means he can take the life of the baby in the ninth month and even after birth, because some states — Democrat-run — take it after birth. Again, the governor — former governor of Virginia: ‘Put the baby down, then we decide what to do with it.’ So he’s in — he’s willing to, as we say, rip the baby out of the womb in the ninth month and kill the baby. Nobody wants that to happen.”

(For years, Trump has been misrepresenting a 2019 statement by then-Virginia Gov. Ralph Northam, a Democrat and pediatric neurologist, about what happens when a nonviable fetus with severe deformities is delivered.)

Trump’s statements are often ludicrous to the point of being nonsensical, but he speaks with the conviction of a pathological liar. During a back-and-forth on immigration, for instance, he spoke forcefully, but I have no idea what he was talking about:

“He decided to open up our border, open up our country to people that are from prisons, people that are from mental institutions, insane asylum, terrorists,” Trump said. “We have the largest number of terrorists coming into our country right now. ... We had the safest border in history. In that final couple of months of my presidency, we had, according to Border Patrol, who is great — and, by the way, who endorsed me for president. But I won’t say that. But they endorsed me for president. Brandon , just speak to him.”

I’m sorry, what?

“I’m not saying no terrorist ever got through,” Biden said of the border. “But the idea they’re emptying their prisons, we’re welcoming these people, that’s simply not true. There’s no data to support what he said. Once again, he’s exaggerating. He’s lying.”

Tell me again, who is confused?

Regarding the economy, the No. 1 issue for most voters, CNN’s Jake Tapper asked Biden, “What do you say to voters who feel they are worse off under your presidency than they were under President Trump?”

“We’ve got to take a look at what I was left when I became president, what Mr. Trump left me,” Biden replied. “We had an economy that was in free fall. The pandemic was so badly handled. Many people were dying. All he said was,’It’s not that serious, just inject a little bleach in your arm. You’ll be all right.’ The economy collapsed. There were no jobs. The unemployment rate rose to 15%. It was terrible.

“And so, what we had to do is try to put things back together again. ... We created 15,000 new jobs. We brought out in a position where we have 800,000 new manufacturing jobs .” (Biden meant to say a total of 15 million new jobs , which his campaign often boasts about.)

Trump’s response to the question was, again, lies and nonsense:

“We had the greatest economy in the history of our country,” he boasted, wrongly . “We have never done so well. Every — everybody was amazed by it. Other countries were copying us. We got hit with COVID. And when we did, we spent the money necessary so we wouldn’t end up in a Great Depression, the likes of which we had in 1929. By the time we finished — so we did a great job. We got a lot of credit for the economy, a lot of credit for the military, and no wars and so many other things. Everything was rocking good.”

Yes, Thursday’s debate was painful to watch. Biden, who has maintained that his age, 81, is irrelevant, can no longer make that claim. His decline is distressing.

And yet whether he bows out of the race or not, the choice facing voters in November is stark: Do we want democracy, or do we want dictatorship? The answer should be obvious.

@robinkabcarian

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Robin Abcarian is an opinion columnist at the Los Angeles Times. She writes about news, politics and culture. Her columns appear on Wednesday and Sunday. Twitter: @AbcarianLAT

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COMMENTS

Delivery, Face and Brow Presentation
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]
Fetal Presentation, Position, and Lie (Including Breech Presentation
In face presentation, the baby's neck arches back so that the face presents first rather than the top of the head.. In brow presentation, the neck is moderately arched so that the brow presents first.. Usually, fetuses do not stay in a face or brow presentation. These presentations often change to a vertex (top of the head) presentation before or during labor.
Face and brow presentations in labor
The vast majority of fetuses at term are in cephalic presentation. Approximately 5 percent of these fetuses are in a cephalic malpresentation, such as occiput posterior or transverse, face ( figure 1A-B ), or brow ( figure 2) [ 1 ]. Diagnosis and management of face and brow presentations will be reviewed here.
Delivery, Face Presentation, and Brow Presentation ...
Causes: Face presentation can occur due to factors such as abnormal fetal positioning, multiple pregnancies, uterine abnormalities, or maternal pelvic anatomy. Complications: Face presentation is associated with an increased risk of prolonged labor, difficulties in delivery, increased fetal malposition, birth injuries, and the need for ...
Face and Brow Presentation: Overview, Background, Mechanism ...
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 ...
Management of face presentation, face and lip edema in a primary
Introduction. Face presentation is a rare unanticipated obstetric event characterized by a longitudinal lie and full extension of the foetal head on the neck with the occiput against the upper back [1-3].Face presentation occurs in 0.1-0.2% of deliveries [3-5] but is more common in black women and in multiparous women [].Studies have shown that 60 per cent of face presentations have one or ...
Management of Brow, Face, and Compound Malpresentations
In face presentation, the mentum (chin) and mouth are palpable. Management considerations for face, brow, and compounds presentations are unique with compound presentations having higher rates of vaginal delivery and lower complications as compared to either brow or face presentations. For brow presentations, approximately 30-40% of brow ...
Managing Face Presentation In Delivery
The incidence of face presentation is reported to be between 1 in 500 deliveries to 1 in 1400 deliveries. It happens when the baby's head is very extended backwards. Fortunately, it was a mento-anterior face presentation as a mento-posterior face presentation usually needs a Caesarean section. Also, that it was her third vaginal delivery and ...
Face presentation: Predictors and delivery route
A total of 61 women who met the study criteria were diagnosed with face presentation in labor; for 55 of the women, follow-up data were available for analysis. Cases of face presentation were abstracted from a cohort of 40,598 cases, which gave an incidence rate of 1 in 666. Preterm delivery, birth weight <2500 g, and maternal obesity were more ...
Delivery, Face and Brow Presentation
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.
7.9 Face presentation
Flex the head to obtain a vertex presentation: with one hand in the vagina, grasp the top of the skull and flex the neck, using the other hand, on the abdomen, to apply pressure to the foetal chest and buttocks. Obviously, the presenting part must not be engaged, and it is often hard—or impossible—to keep the head flexed (Figures 7.6).
How to Use Gestures and Facial Expressions Effectively in Presentations
Keep this in mind when giving a presentation. Presenting with a blank face is like talking in a monotone voice. Things like raising your eyebrows, widening your eyes, and giving a smile can make a huge difference and set the tone for your presentation. If your facial expressions fall in line with your words, the information you are presenting ...
Face Presentation
A type of cephalic presentation in which the presenting part is the face, the area between chin and glabella. The incidence varies from 1 in 500 to 1 in 1000 deliveries. Primary face presentation is rare. Secondary face presentation caused by extension of head during labor is common. Thus, the diagnosis is usually made during active phase of ...
Perfect presentations: Face-to-face and virtual
We're taking bookings now for future meetings and will put in place the necessary measures to enhance COVID-19 safety procedures. Give us a call now on 0800 073 0499 to book an affordable venue for your future events. You can create the perfect presentations for both face-to-face and virtual settings with some careful planning and ...
15 Essential Presentation Techniques for Winning Over Any Audience
Keep it simple: One idea per slide keeps confusion at bay and attention locked in. Use bullet points: Break down your points so your audience can track. Pick a font size: Generally speaking, bigger is better. Use color: Harness colors that pop without blinding anyone; contrast is key.
Facial expressions matter when presenting, here's why
Whether on camera, on stage presenting, or communicating in a meeting, your facial expressions send messages that are just as important as the content itself. They give you the chance to enhance your point, distract from it, or confuse the heck out of your audience. Here are some key concepts to keep in mind when it comes to facial expressions. 1.
The 6 reasons why face-to-face presenting is more persuasive
5. Liking - we're more easily persuaded by people we like. Deciding whether we like someone we've seen or met online, takes time. Meeting people face-to-face, we can make millisecond judgments about whether we like them. 6. Scarcity - believing something is scarce makes us want it. A live presentation is by definition scarce - being ...
How to Record a Presentation with Your Face (Audio and Video)
In the coming prompt, click Allow and toggle on Also allow tab audio to enable the camera and microphone. Now, you can record your face and voice. Step 5. To end the recording, press the red button again. Here, you can click Re-record to start over or click Save to Drive to save the presentation as a video.
What Are Effective Presentation Skills (and How to Improve Them)
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 ...
Diagnosis and management of face presentation
Face presentation is an unusual complication of pregnancy; it occurs once in every 500 to 600 deliveries. Prematurity, fetal macrosomia, anencephaly, and cephalopelvic disproportion (CPD) are the major obstetric factors that predispose the fetus to face presentation. Although the mechanisms of labor in face presentation are different from those ...
148 FACE English ESL powerpoints
Cool ppt, for face r. 513 uses. veroa1401. Face pictionary. The children create . 312 uses. dotranggts. Face Parts + Game. This powerpoint less. 164 uses. brilaoshi. Parts of the face. We try to make kids . 2621 uses. tacata28. Make a face GAME. ... Red in the face. Based on unit 2 of c.
How To Make Your Presentation Sound More Like A Conversation
1. Avoid using the word, "presentation." Every time you say, "I'm here to give you a presentation on X," or, "In this presentation, you'll see…," you are emphasizing the formal ...
Face Presentation Attack Detection
Face presentation attacks usually mislead the real-world automatic face recognition (AFR) systems via presenting face upon physical mediums (e.g., a photograph, a video, or a 3D mask) of a targeted or obfuscated person in front of the imaging sensors. Some representative PA types are illustrated in Fig. 7.1.
Hear what Joe and Jill Biden said about his debate performance
Joe Biden and Jill Biden both praised Biden's performance at the CNN Presidential Debate against former President Donald Trump. Some Democrats criticized Biden's performance and are ...
FactChecking the Biden-Trump Debate
Summary. The much-anticipated first debate of 2024 between President Joe Biden and former President Donald Trump featured a relentless barrage of false and misleading statements from the two ...
Biden's awful debate doesn't change the choice voters face
The president's appearance was far worse than the substance of what he said, while Donald Trump offered a forceful presentation of lies and nonsense. Biden's awful debate doesn't change the choice ...

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

Position and Presentation of the Fetus

Variations in Fetal Position and Presentation

Occiput posterior position

Breech presentation

Other presentations

Medical Information

Delivery, Face Presentation, and Brow Presentation: Understanding Fetal Positions and Birth Scenarios

Delivery Process:

Face Presentation:

Brow Presentation:

Delivery Techniques and Intervention:

Conclusion:

On the Article

Krish Tangella MD, MBA

Alexander Enabnit

Alexandra Warren

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Management of face presentation, face and lip edema in a primary healthcare facility case report, Mbengwi, Cameroon

Ngouagna Edwin

Yunga Patience Ijang

Joyce Shirinde

Samuel Nambile Cumber

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Patient and observation

Competing interests

Acknowledgements

Authors’ contributions

Management of Brow, Face, and Compound Malpresentations

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Delivery, Face and Brow Presentation

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7.9 Face presentation

7.9.2 Management

The chin is anterior

The chin is posterior

Presentation Training Institute

Why Gestures and Facial Expressions Matter

1. Find a Neutral Place for Your Hands

2. Use Gestures to Create Visual Imagery

3. Let Your Face Tell the Story

4. Make Eye Contact

Perfect presentations: Face-to-face and virtual

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15 Essential Presentation Techniques for Winning Over Any Audience

Table of Contents

Mastering Presentation Techniques for Impactful Delivery

Elements of an Effective Presentation

Strategies for Delivering a Successful Presentation

Engaging Your Audience with Nonverbal Communication

The Power of Eye Contact, Body Language, and Facial Expressions

Designing Compelling Presentation Materials

Tips for Creating Effective Slides

Handling Questions and Interactions Professionally

Preparing for Audience Questions and How to Address Them Effectively

Techniques for a Memorable and Effective Presentation

Incorporating Storytelling into Your Presentation

Using Humor to Connect with the Audience

Overcoming Public Speaking Anxiety

Techniques to Manage Stage Fright and Boost Confidence