A247
Foaling - Care for the Mare and Foal During/After Foaling

what a normal birth looks like | when to give assistance | premature placental separation | foal is in an abnormal position | foal does not start breathing | umbilical cord does not separate from the foal | when to call a veterinarian | problems with the mare after foaling | foal care after birth

The foaling process: Mares typically go through three different stages of labor. Stage one is defined as the first stage or preparatory stage of labor. Mares in this stage of labor often look as though they are having a colic problem. They act uncomfortable, sweat, move away from other animals, and may even lie down and roll. This stage lasts from 1-4 hours. If the mare is in this stage for longer than 4 hours, or if the mare acts like she is in severe pain, a veterinarian should be called.

Stage two is active labor when the mare is pushing and straining. It begins when the mare’s water breaks and ends with the birth of a foal. It usually lasts no longer than 45 minutes. Stage three is defined as the time when the mare expels the placenta.

What to do when the mare is going into labor:
  1. Move the mare to the predetermined foaling area.
  2. Clean the anus and vulva area with clean, soapy water. Rinse the area thoroughly to remove any soap.
  3. Wrap the mare’s tail with vet wrap.
  4. Make sure the caslick (if present) has been removed.
  5. Leave the mare alone and remove all distractions (dogs, other horses etc.). Many mares will stop the birthing process when disturbed.

What a normal birth looks like: Second stage labor begins with the water breaking. During this time the mare may spend much of the time laying down and on her side. It is normal for her to get up and down a few times. After the water breaks, the amnion (the transparent, bluish colored sac that surrounds the foal) will appear. The feet can often be seen through the sac. The soles of the feet should be turned down. After the feet appear, the nose should soon follow. With some intense contractions and some breaks in-between, the foal’s shoulders are often delivered. At this point the foal may begin to breathe.

Before the shoulders are delivered it is not uncommon for membranes to still be covering the foal’s nose. This is not a problem because the foal is still receiving oxygen through the umbilical cord. After the shoulders are delivered, the hips and hind limbs are often delivered quickly without any problems. The time from when the water breaks to the complete delivery of the foal should take no longer than 45 minutes.

When to give assistance: One of the most common mistakes that a horse owner can do is try to give assistance when it is not necessary. The vast majority of mares will foal without any problems. There are really four major situations when a mare may require an owner’s help. The rest of the time help is either not needed or the problem is serious enough that professional veterinary help is required. The following information outlines these four situations:

  1. Premature placental separation: This is where, at the beginning of the foaling process, a thick "red bag" or "red ball" is showing out of the mare instead of the typical white to clear membrane. This situation is an emergency and IMMEDIATE attention should be given by the person(s) attending the mare. The "red bag" should be broken/torn and the foal should be immediately removed. This situation is called premature placental separation and will result in suffocation of the foal if it is not treated immediately. Once the foal is removed, a veterinarian should be contacted.

     
  2. The foal is in an abnormal position (dystocia): A foal that is being born in a normal position will come front feet first with the soles of the feet pointing down. The head will soon follow. During the beginning of the birthing process, the foal must rotate from laying on its back to where the foal’s spine is next to the mother’s spine. If the foal is not in this position, the mare will have trouble giving birth and correction of the foal’s position is necessary. The problems that can be encountered may include a foal with its head back or with a foot retained. The foal may not have completely rotated and may be upside down. Some foals may be coming backward; this is a serous problem that must be corrected fast. No matter what position or problem the foal may be in, it is important to get veterinary help on the way. If the owner feels comfortable in giving some assistance, follow these basic guidlines:
    • Wash hands and arms with soap and disinfectant. Have the finger-nails trimmed short. Being as clean as possible is essential to preventing infection.
    • Be very gentle in any physical efforts to help. The mare and foal are subject to injury if the manipulations are not done correctly and gently. Never use more pulling force than can be delivered by one person; jacks, mechanical tools, and vehicles should never be used to pull.
    • Use plenty of lubrication (J-lube) on hands, arms, and in the uterus.
    • Only perform those procedures that you feel comfortable with. If things are not going well, quit and let a veterinarian or someone with more experience get involved.
    • To delay the birthing process, try and get the mare to stand up. This will often interrupt foaling until a veterinarian can arrive.
    • Determine the position of the foal. First, find the most exposed leg and determine if it is a front or a hind leg. To do this, find out if the next joint above the fetlock (ankle) is the knee (carpus) or the hock. If it is the knee, the joint should bend the same way as the fetlock and it is a front limb. If it is a hock, it will bend the opposite way of the fetlock and the leg is a hind limb.
    • Always pull when the mare is having a contraction. Before doing any pulling, make sure the foal is in the proper position and that both legs are accessible. Be careful not to pull on one hind leg and one front leg.

       
    1. Correcting a foal that is coming backwards with the legs extended into the pelvis: This is a foal that is coming backwards, but has the hind legs coming first. Because of the chance that the foal may drown in its own fluids, it needs immediate help! Start by making sure that the foal is right side up. If it is not, correct it by crossing the legs and placing pressure on the upper leg while rotating. Next, pull the foal out quickly. This is the one time that it is not necessary to wait for the mare to strain. The whole idea is to get the foal out as fast as possible without injuring foal or mare.

       
    2. Handling a foal that is coming backwards without the legs extending out of the mare (breech): This is probably the most difficult birthing problem to handle. In almost all cases, a Caesarean is required to correct this problem. The best thing to do in this situation is to get a veterinarian there immediately.


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    3. Correcting a foal that is coming head first, but is still upside down: First, try and get the mare to stand up; this will often correct the problem by the time the mare lays back down. If this does not work, attempt to use the foal’s legs and gently rotate the foal so that its back is towards the mare’s back. If this procedure is not done easily, seek professional help.

       
    4. Correcting a foal that has a leg retained: If the mare is not in active labor, the limb can often be found and gently moved towards the outside. This can sometimes be difficult and has the chance of damaging the mare’s uterus; therefore, use plenty of lubrication on hands, arms and in the mare’s uterus. With one hand, try to cup the end of the hoof on the leg(s) that is retained. This will protect the uterus and allow the limb to be pulled towards the pelvis. If more space is required, one hand can be placed on the chest or head of the foal. Then while pushing the foal back into the uterus, the other hand can be used to cup and pull the retained limb into the pelvis.


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    5. Handling a foal that is coming frontwards, but has the head tucked between the legs or to the side: These situations can sometimes be corrected if the mare is not very far along in the labor process. For foals with their head turned to the side, one hand can be placed on the chest of the foal. Then, while pushing the foal back into the uterus, the other hand can be used to grasp the head (sometimes using the eye area) and pull it into a normal position. A foal that has the head between the legs is even more challenging. These foals are identified by feeling mane or maybe the poll of the foal between the legs. If after a few attempts to correct this problem no progress has been made, call a veterinarian. In many of these cases, a Caesarean is required.

       
  3. The foal does not start breathing or membranes are obstructing the breathing: In a normal birth, the foal does not take its first breath until its shoulders are delivered. At this point, the sac or amnion that covers the foal’s nose and head is almost always broken. If the membranes remain on the foal’s head after it has been completely delivered, remove the membranes. If necessary, wipe or suction out any mucus or fluid from the nostrils. It may also help to elevate the foal’s head, with the nose pointed towards the ground. This can help the fluids drain out the nose. A foal that is not breathing can be stimulated by placing a finger or piece of straw up its nose. The ear can also be twisted. Both of these will help the foal take a breath. Additional details about artificial respirations and CPR can be found on page E195.

     
  4. The umbilical cord does not separate from the foal: On only rare occasions should the umbilical cord be separated from the foal by the owner. These situations may include when the foal must be moved for safety reasons or when the mare will not get up. In almost all cases, a section of the cord about 1-2 inches from the foal’s abdomen will begin to constrict. This is the location where the cord will naturally separate and where, when necessary, an owner may tear the cord. To separate the cord, grasp on either side of the constriction and tear the cord. To prevent pulling out the abdominal contents of the foal, do not pull against the foal’s abdomen. Disinfect the umbilical stump with diluted chlorhexidine once the cord is separated.

Selected references:
Bennett, Dwight G. "From Breeding to Weaning," Western Horseman Inc. 1999
Beeman, Marvin. "Foaling," Western Horseman March 1992: 22-28.

When to call a veterinarian:
  1. If the mare’s milk leaks for more than 3-4 days and she has not given birth.
  2. The mare is in hard labor for more than 20 minutes without any progress.
  3. The soles of the foal’s feet are facing up and the foal cannot be rotated.
  4. The foal is coming backwards (breach) or the foal is in an abnormal position that has not been corrected.
  5. The placenta has not passed in 3-6 hours. If the placenta is still hanging from the mare, do not pull it and do not cut it. Let the natural weight of the placenta help in its removal from the uterus. If it is dragging on the ground or causing the mare to hit it as she walks, tie it in a knot or wrap a plastic bag around it to keep it contained and clean.
  6. If the foal has not passed the meconium (first stool or manure, that is dark in color) within one hour of standing or after an enema has been given.
  7. The foal (especially a male) has not urinated and the abdomen seems to be distended.
  8. It is determined that the foal has not received sufficient passive transfer.

Problems with the mare after foaling:
  1. Uterine rupture: The uterus of a mare may be torn or ruptured as a result of a uterine torsion, a difficult birth, or when a foal’s feet punch through during the birthing process. A uterine rupture is a serious health threat to the mare and should not be treated lightly. In some minor cases, the tear may not be noticed until the mare begins to act sick. Typically, infection enters the abdomen through the rupture and the mare develops peritonitis. These mares act colicky, may have a fever, and then go into shock. Severe ruptures can often lead to the mare’s death. Any time a mare has had a difficult birth or a uterine torsion, the uterus should be examined by a veterinarian for evidence of a tear. When possible, the veterinarian will try to repair the rupture. The horse is usually placed on high doses of antibiotics and watched carefully for signs of problems.

     
  2. Postpartum hemorrhage/hematomas: Blood is associated with almost every birth due to minor damage and rupture of small vessels; however, in older mares that have had previous foals, rupture of larger vessels can occur. These larger vessels, such as the uterine artery, carry a significant amount of blood; when ruptured, they can cause the mare to bleed to death in a very short time. Most mares that have significant amounts of bleeding will be weak, want to lay down, and have pale gums. If the bleeding causes a hematoma (large, blood filled mass) to form in the uterus, she may act colicky. Mares that develop this problem should be completely confined and not allowed or made to get up or walk. The mare should be confined to a stall for 3-4 weeks after foaling. These mares are also prone to hemorrhage again during another foaling.

     
  3. Uterine prolapse: A uterine prolapse occurs when the uterus is turned inside out and pushed out of the mare’s vagina. This problem occurs during or immediately following foaling and is common after a difficult birth. This problem is easily identified by observing a reddish colored mass being pushed out the vagina of the mare. The prolapsed uterus should be kept clean and free of contamination until a veterinarian arrives. The prolapse can then be corrected by the veterinarian. The mare should also receive intense treatment with antibiotics, fluids, and pain medications as needed.

Foal care after birth:
  1. Perform a physical examination immediately after birth:
    • Make sure the foal is breathing. Any membranes should be removed from the nose and if fluid is thought to be in the nostrils, a large turkey baster can be used to suction the fluid out. Respirations can be stimulated by placing a finger or piece of straw in the foal’s nostrils.
    • The heart should be beating strong and faster than 60 beats per minute.
    • If the umbilical cord is not broken, tear (do not cut) the cord about
      2 inches from the foal’s abdomen. Tearing will help prevent serious bleeding. Refer to page E195 for additional emergency treatment ideas.
    • Most mares will want some time to mother the foal and allow it to nurse. During this time the mare will lick and dry the foal. If the mare is not interested and the foal is exposed to adverse weather conditions, the foal should be dried with a clean towel. At this point if things seem to be going well, the mother and foal should be left alone.

       
  2. Navel care and additional examination:
    • Dip the cord in dilute chlorhexidine (Nolvasan) and again 6-8 hours later. The chlorhexidine should be diluted with one part chlorhexidine to four parts water. Because it can be too irritating, iodine should be avoided.
    • Watch the cord and abdomen for redness or swelling. If these occur, contact a veterinarian.
    • Check the foal for congenital (present at birth) defects. These include a cleft palate, hernia, limb abnormalities, or heart defects.
    • The foal should be up, able to nurse, and act alert and responsive.

       
  3. Enemas: A squeeze type enema can be given if the meconium (dark brown manure) is not passed in the first few hours after standing. These foals may strain to pass some stool but not produce anything. Because the rectum and colon can easily be torn, the enema should be given slowly and gently. Only ONE enema should be given to a foal. A veterinarian should be contacted if the foal continues to act uncomfortable.

     
  4. Colostrum management and checking for passive transfer:
    1. General information: Colostrum is the first milk produced by the mare after foaling. A mare will typically begin producing this colostrum 1-2 weeks prior to giving birth. Colostrum contains the maternal antibodies essential for disease prevention in the newborn. The mother, if properly vaccinated prior to foaling, should naturally produce these antibodies and will pass them to the foal in the colostrum. Antibodies are the immune system components that identify a viral or bacterial invader and fight off the infection. Protection passed from the mother to foal through colostrum is called passive transfer. Failure of passive transfer will lead to sickness, poor weight gain, and possible death. With time, a foal that has a failure of passive transfer can have a fever, injected membranes (red and inflamed), and diarrhea. With this as a background, heeding the following suggestions is a must to ensure healthy animals:
      • Each foal should consume at least 1-2 liters (2-4 pints) of colostrum in the first 6-8 hours after birth. As time progresses, the foal absorbs less and less antibodies from the colostrum. By the time the foal is 24 hours old, little if any antibody absorption will occur.
      • Each foal should be checked for passive transfer at 16-24 hours of age. This is done by taking a small sample of the foal’s blood and performing a test that measures the amount of antibodies in the blood. An example of one of these types of tests can be found on page D243.
      • It is recommended that each foal has at least 600-800 mg/dl of IgG (an antibody) when tested. Any foal measuring less than 400 mg/dl should be considered to have a failure of passive transfer (FPT) and additional steps need to be taken. These FPT foals will require supplemental colostrum or plasma administration.

         
    2. Feeding colostrum: (If a foal does not nurse normally after delivery, feeding colostrum will be necessary.)
      • Once the foal has been identified to have a failure of passive transfer, feed approximately 250 mLs of colostrum every hour during the first 24 hours of the foal’s life. A total of 1.5 - 2 liters is required. If the failure of passive transfer has been identified after the foal is 24 hours old, plasma and additional treatments will be required. At this point a veterinarian should be involved.
      • Feeding additional colostrum can be accomplished using a stomach tube feeder, allowing the foal to suckle, or letting it drink from a pan.


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    3. Obtaining, storing, and using the colostrum:
      • The best colostrum comes from the mother and can be milked from the mare each hour it is needed. The average mare will produce around 300 mLs of colostrum every hour.
      • Colostrum that tests high in antibodies can be frozen for up to one year. Thaw this milk in a hot water bath or in the refrigerator.


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    4. Measuring antibodies in colostrum:
      • A simple and effective method of ensuring adequate antibody levels in a colostrum sample involves using a colostrometer. This instrument measures the amount of antibodies present in a milk sample.

         
  5. Tetanus: Some farms give each foal a shot of tetanus antitoxin (1500 IU) at birth. Because of potential side effects, this should be done only with direct veterinary advice.
    6.   See page E805.

     
  6. Placenta: After the placenta has been passed, it should be filled with water from a hose. All areas of the placenta should be expanded, looking for any areas where part of the placenta may be missing. These areas could still be in the mare and may result in a uterus infection. A mare that has retained part or all of the placenta will often act sick, have a fever, and experience colic-like symptoms.