Foaling Management Tips

It’s time! Nature’s symphony has created an 11-month crescendo that is about to reach its zenith. The mare that has been carefully bred, fed, dewormed, inoculated and monitored is about to foal. Watching this process is a wondrous and nerve-wracking experience for human midwives, one that is almost impossible for some people to observe without interfering.

“Nature has been doing this for a long time,” said Dr. John Steiner. “I think a form of benign neglect is best when everything is going as planned. About 30 days prior to foaling a veterinarian should be called out to inoculate the mare with the correct vaccines for the area of the country in which she is to foal. At the same time, if she has had a Caslick’s procedure (a suturing of the vulva to reduce the chance of the mare aspirating bacteria into the vagina), she should be opened up. After that, watch the mare. Make certain she is in a safe environment, and that everything is coming out in the correct fashion and then let nature take its course – without human assistance.”

The ideal environment for a mare that is about to foal is a clean grass paddock where the mare can be observed with as little disruption as possible, but inclement weather or insufficient lighting can make this impractical. A large, well-lit stall banked and bedded deeply with clean straw or hay will also provide a safe setting. A mare that is about to foal is experiencing what Dr. Steiner describes as a “violent process designed to expel the foal.” Some mares may become restless, look around often at their flanks, and lie down and rise repeatedly. The open environment of a grass paddock will allow her the opportunity to do this safely. Banking a stall with straw will protect the mare from getting cast.

Milk may drip or even stream from the mare’s teats and she may sweat profusely. Some mares may seem to experience confusion or discomfort for hours while others seem hardly bothered until just before they lie down to foal. At this early stage, contractions and fetal movement are placing pressure upon the cervix, encouraging it to dilate. A few mares may seem to go through this early stage more than once. Referred to as “heating up and then cooling back down,” it is still, even if a false alarm, the best time for the attendant to wash the mare’s vulva. Dr. Steiner recommends the use of a betadine or Nolvasan scrub for this purpose, and he suggests wrapping her tail with a bandage to help assure a clean environment.

As the pressure on the cervix increases, the allantoic fluids, about five gallons of brown or yellow-brown fluid comprised of waste material from the fetus, are pushed through the outer membrane or allantochorion. Known as “breaking water,” this signals the beginning of the second stage of labor.

This is when most mares will be lying on their sides with their uterine and abdominal muscles contracting to expel the foal. Some mares, particularly those that have been disturbed during the process, will continue to stand throughout the second stage of   delivery or they will repeatedly rise and lie back down. Dr. Dirk Vanderwall, an assistant professor at the Northwest Equine Reproduction Clinic at the University of Idaho, stated, “There is some thought that mares may do this to help reposition the foal. This can go on for a couple of up and down sessions but if it goes beyond that it would be wise to call for veterinary assistance.”

Dr. Michelle LeBlanc is the director of the Equine Research Program for the College of Veterinary Medicine at the Universityof Florida and also manages the Equine Reproduction Service at the veterinary medical teaching hospital there. She agreed that calling for veterinary assistance is wise if “the water breaks and nothing is seen coming out. Usually this is because the foal is not in the right position to be delivered. If the mare has been down and straining it may help to get her up and encourage her to walk. The sheer force of gravity might let the foal fall back into the uterus and allow it the room it needs to bring its body into the proper position.”

Dr. Steiner stated, “If the mare reaches the second stage of this process without any difficulty, it is best to continue to observe quietly. If possible, dim the lights and keep outside distractions from bothering the mare. Within five to ten minutes after the water has broken, the amnion, a white transparent membrane that surrounds the foal, as well as the foal’s front feet and nose should be visible. If they are not, it may be necessary to reach inside the mare to determine the foal’s position.” Dr. Vanderwall stressed the importance of contacting a veterinarian for advice before interfering with the process. The veterinarian can describe exactly what should be felt and can, from the attendant’s description, determine if it is necessary for the mare to have further veterinary assistance.

“Horse owners should call the veterinarian a few days prior to the mare’s due date as a reminder and to ask any last minute questions that might have come up. It is also wise to have the veterinarian’s contact numbers in a convenient place by the phone where they can be accessed quickly if a problem should arise,” he suggested.

The vast majority of foals will make their entry into the world front feet first with one foot slightly ahead of the other. The head will be positioned just on top of the forelegs with the neck and back lined up with the top of the mare’s pelvis. Occasionally a foal will have one front foot pushing its way in the wrong direction or the nose will miss the cervical opening and need redirection. According to Dr. Steiner, “a quick inspection can discover this and, with very little effort, the foot or nose can be redirected and the process can continue naturally. Once the head has been produced, I like to break and pull back the amniotic sac to allow the foal to get air just in case the placenta has become detached.”

Dr. Vanderwall added, “The general feeling is that you should let the mare do as much as she can by herself. If, however, the mare has produced the front feet, lily pads facing down, with the head just coming on top of the feet but nothing else seems to be happening, I think assistance is warranted. That assistance should come in the form of steady, general traction accompanying the mare’s own strong abdominal and uterine contractions. The traction should be applied in an arc downward and back towards the mare’s belly as opposed to straight out behind the mare.” While the speed of the delivery might need to be escalated in a few rare situations, it certainly is not necessary for the majority of normal deliveries.

Dr. Steiner mentions, “the average person is not going to hurt the mare by applying traction to the foal’s legs. It is important to pull along with the mare’s contractions.”

Both Dr. Steiner and Dr. Vanderwall recommend that attendants use a clean and lubricated sleeve that can be obtained from many veterinary clinics or supply stores to help protect the delicate tissues of the mare’s vulva. If a sleeve is not available, the attendant should be certain to remove any watches or jewelry and scrub and lubricate his or her arm prior to reaching inside the mare to check on the foal. They suggest scrubbing with the same solution used to clean the mare and using KY Jelly or a lubricant sold to equine veterinarians for the purpose of rectal examinations.

In situations where the foal might be presented with its back feet coming out first or with the umbilical cord compromised, it is crucial for the person helping the mare to get the foal out as quickly as possible. Dr. Steiner stated, “In a case like this, especially if the placenta may have detached, the foal will need oxygen if it is to survive. Of course, if it is impossible to tell what is being felt and nothing is happening regardless of how hard the mare’s contractions are, it is essential to get veterinary help for the mare as quickly as possible. The entire process should only take 15 to 20 minutes. It can go beyond that amount of time but not by much without there being a greater potential for problems.” Most mares will deliver a foal easily by themselves or with minimal assistance. In rare situations a mare may have a problem with the placenta detaching and being delivered first. The moment the placenta detaches from the uterine wall, the foal is left without the oxygen it needs to survive.

It is of paramount importance that the attendant gets the foal out of the mare as quickly as possible. Known as a “red bag” for its distinctive color, the placenta comes out first as a firm dark red surface instead of the white transparent amniotic sac that is expected. Dr. LeBlanc stated, “In situations like this the majority of foals, if they are still alive, are already in the correct position directly behind the placenta.

The attendant should break or cut the placenta, grab the foal’s legs and pull it out immediately. A veterinarian should be called to attend the foal and check on the mare once the foal is safely out of the mare.”

In the normal foaling process, once the foal’s shoulders have cleared the mare’s cervix, the remainder of the foal will follow fairly quickly. Some foals will lie quietly for a time with their back legs still inside of their mother. Dr. Steiner stated, “The thinking used to be that the longer the foal would stay in this position with the umbilical cord still attached, the better as it would allow the transfer of further blood supply from the mare to the foal. Recent studies have shown that this is not as necessary as was believed. It is certainly possible to assess the foal at this point. The attendant can watch to be certain the foal is breathing normally and appears bright and interested in its surroundings. I like to take a piece of straw and stick it up the foal’s nostrils to encourage its natural reflex to snort. This helps to clear out the sinuses.”

All three veterinarians agree that allowing the mare and foal time to get acquainted in a quiet, calm and uninterrupted fashion is wise. Dr. Steiner stated, “There is plenty of time to treat the umbilical stump and care for the foal. It does not need to be a race.”

Most mares will stand up shortly after the foal has been delivered. If they have not already delivered the placenta, the white amniotic sac that had encompassed the foal will trail behind them. Dr. Steiner recommends using baling twine or gauze to tie this up to keep the mare from stepping on it and tearing it. “Many people have been told to wrap things like brushes or heavier objects in this sac to add weight and assist the mare in delivering the placenta. I do not think this is necessary and, in fact, it can be detrimental. Just keep it from getting in her way.”

Either the mare standing or the attempts on the part of the foal to stand will usually cause the umbilical cord to break about one inch from the foal’s body. The mare then usually begins the third and final stage of delivery, passing the placenta. The mare may exhibit many of the same signs prior to delivering the placenta as she did when she began labor. She may sweat, rise and lie back down again, look at her flanks repeatedly and strain to push the placenta out. The placenta should be delivered within two to three hours of the birth of the foal, but it is usually delivered within the first hour. If the placenta has not been delivered within three hours or if what is delivered appears torn or unhealthy, a veterinarian should be called to attend the mare. Occasionally the placenta will be delivered directly following the birth of the foal.

When this happens, the attendant may need to break the umbilical cord if it is still attached to the foal. The best method for breaking the umbilical cord is to tie two pieces of baling twine tightly on either side of the natural indentation that appears about an inch from the foal’s body. The attendant can hold each side of the ties and apply abrupt pressure to break the cord. The stump can then be treated with an umbilical dip of Nolvasan or 2% iodine solution. A healthy foal will stand and attempt to nurse within an hour of its birth. Its struggles to rise can range from comical fumblings to impressive feats of instant coordination.

An experienced broodmare may help the foal get into the correct position to nurse but a first-time mom may need some assistance getting used to her foal and his nursing attempts. It is very important for the foal to receive the mare’s colostrum. If the foal appears weak or is unable to stand and nurse within two hours, a veterinarian should be called. It is also advisable for the attendant to arrange for the foal to have a blood test drawn 12 hours after his first meal to determine blood antibody levels system. To be in the right place at the right time to observe the orchestration of one of nature’s wondrous miracles is a blessing relatively few horse people get to enjoy. For those who do and even for those whose job it is to attend this regular rite of spring, the foaling process is a miracle that will always be a long treasured memory.