<P> For otherwise healthy twin pregnancies where both twins are head down a trial of vaginal delivery is recommended at between 37 and 38 weeks . Vaginal delivery in this case does not worsen the outcome for either infant as compared with caesarean section . There is controversy on the best method of delivery where the first twin is head first and the second is not . When the first twin is not head down at the point of labour starting, a caesarean section should be recommended . Although the second twin typically has a higher frequency of problems, it is not known if a planned caesarean section affects this . It is estimated that 75% of twin pregnancies in the United States were delivered by caesarean section in 2008 . </P> <P> A breech birth is the birth of a baby from a breech presentation, in which the baby exits the pelvis with the buttocks or feet first as opposed to the normal head - first presentation . In breech presentation, fetal heart sounds are heard just above the umbilicus . </P> <P> The bottom - down position presents some hazards to the baby during the process of birth, and the mode of delivery (vaginal versus caesarean) is controversial in the fields of obstetrics and midwifery . </P> <P> Though vaginal birth is possible for the breech baby, certain fetal and maternal factors influence the safety of vaginal breech birth . The majority of breech babies born in the United States and the UK are delivered by caesarean section as studies have shown increased risks of morbidity and mortality for vaginal breech delivery, and most obstetricians counsel against planned vaginal breech birth for this reason . As a result of reduced numbers of actual vaginal breech deliveries, obstetricians and midwives are at risk of de-skilling in this important skill . All those involved in delivery of obstetric and midwifery care in the UK undergo mandatory training in conducting breech deliveries in the simulation environment (using dummy pelvises and mannequins to allow practice of this important skill) and this training is carried out regularly to keep skills up to date . </P>

Who was the first child born after operative procedure name