Editing Caesarean section (section)

====Breech birth====
{{main|Breech birth}}
A breech birth is the birth of a baby from a breech [[presentation (obstetrics)|presentation]], in which the baby exits the pelvis with the [[buttocks]] or [[foot|feet]] first as opposed to the normal [[cephalic presentation|head-first presentation]]. In breech presentation, fetal heart sounds are heard just above the umbilicus.

Babies are usually born head first. If the baby is in another position the birth may be complicated. In a 'breech presentation', the unborn baby is bottom-down instead of head-down. Babies born bottom-first are more likely to be harmed during a normal (vaginal) birth than those born head-first. For instance, the baby might not get enough oxygen during the birth. Having a planned caesarean may reduce these problems. A review looking at planned caesarean section for singleton breech presentation with planned vaginal birth, concludes that in the short term, births with a planned caesarean were safer for babies than vaginal births. Fewer babies died or were seriously hurt when they were born by caesarean. There was tentative evidence that children who were born by caesarean had more health problems at age two. Caesareans caused some short-term problems for mothers such as more abdominal pain. They also had some benefits, such as less urinary incontinence and less perineal pain.<ref>{{cite journal | vauthors = Hofmeyr GJ, Hannah M, Lawrie TA | title = Planned caesarean section for term breech delivery | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 7 | pages = CD000166 | date = July 2015 | pmid = 26196961 | pmc = 6505736 | doi = 10.1002/14651858.CD000166.pub2 }}</ref>

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]].

Though vaginal [[childbirth|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 the practice of this important skill) and this training is carried out regularly to keep skills up to date.