First Foal
Ready for the miracle?
by Ken Marcella, D.V.M. http://www.manepoints.com

When you first found out your mare was pregnant, 300 days seemed so long to wait. You were sure that you'd have plenty of time to read "Blessed are the Broodmares," to watch the foaling videos, and to get all of your questions answered.

It still seemed like a long way away when you gave your mare her fifth-month rhinopneumonitis vaccination and made plans for improving her nutrition during the second and third trimesters.

The seventh- and ninth-month vaccinations passed by in a blur. Sure, you still had the foaling stall to finish and all those articles about methods of predicting foaling to read, but there was still time.

Now that the weather has turned colder, what had seemed so far away is just around the corner. You are bound to be nervous, a little apprehensive and anxious. Don't panic -- that's normal, and it's probably also how your mare feels. Learning about abnormal foaling should help lessen those worries and let you enjoy the event.

It is important to remember that mares are individuals and will approach foaling in their own way. They tend to be consistent from year to year, so knowing how long your mare's previous gestation was may help you determine when she will foal this year.

Maiden or first-time mares can foal a bit early or a bit late. Nervous mares can "resist" the normal sequence of delivery and prolong gestation. Use your breeding dates, whatever history you have about the mare and input from your veterinarian. Your mare's udder should begin to swell or "bag up" within the last 30 to 45 days of gestation.

Many mares do not like having their nipples or udders touched, and thus can resist the foal's nursing attempts. Get your mare accustomed to having her teats cleaned with a warm cloth. You may need a helper and some patience, a twitch perhaps, and, occasionally, some tranquilization.

Once the mare allows you to handle her teats, you can then regularly check for filling of the udder -- first up near the belly and then into the mammary gland and nipples themselves.

As foaling approaches, the nipples will get thicker, hang down lower and "wax," or develop a thick wax-like material on the ends of the nipples. This is a good indicator that foaling should occur within a day or so.

But remember the individuality factor; some mares do not produce much of a bag before foaling. Some mares will bag up and even leak milk for days before foaling. Some mares wax, and some do not. It is wise not to depend on any single indicator of foaling, but instead to monitor all the signs of impending birth.

Other signs include a softening of the muscles over the rump and along the tailhead as the pelvic area prepares for the stretching necessary for delivery.

The vulva itself often becomes swollen and elongated. Many mares will show changes in behavior leading up to foaling. They may become more, or less, affectionate; they may try to separate themselves from others; they may become nervous, and many mares do not eat well immediately prior to foaling.

Most mares foal between 10 p.m. and 4 a.m., so a normally good eater who skips her dinner may be close to delivery.

Mares prefer a quiet, low-lit area for foaling, one that is free from excessive noise and activity. If you are planning on videotaping the event or want some light present, it is wise allow the mare to become accustomed to the lighting by leaving the stall lit at night for a week prior to foaling.

It is also recommended that mares foal on straw rather than shavings. Shavings tend to stick to the mare's vulva and can be drawn back in as the mare and foal struggle during the birthing. Shavings also tend to stick to the foal and allow bacteria to more easily enter the umbilicus. Fresh, dry straw is preferred; the mare and foal can be switched back to shavings after a few days.

Foaling is a natural process, and many foals are born without human assistance. If possible, allow your mare to foal naturally. Let her deliver the foal, clean it and bond with it while you quietly watch -- there to help if needed, but not interfering.

Those interested in imprinting will still have plenty of time to work with the foal after mother and offspring have had their special time.

But how can you tell if assistance is needed and what to do when it is? The best foaling plan involves communication between you and your veterinarian. The actual foaling process lasts about an hour, and there is often little time to waste if problems develop.

Make sure you have talked to your vet before the expected foaling starts. You may have to help the mare via phone instruction until help arrives. Does your vet have good directions to your farm? Directions with landmarks he can see at night, in a hurry?

Do you have your veterinarian's phone numbers ready? Does the vet have your phone number? If you plan to use a portable phone in the barn, make sure it works.

Make sure that your foaling kit is stocked, ready, and close at hand (see sidebar). The mare's tail should be wrapped, the stall cleaned and the lights dimmed. Go over the normal foaling process and make sure that you understand the danger points in that process and understand when you should call for help.

The process begins when the placental sac breaks and releases a large amount of water. (What's called "breaking water.")

A smooth sac may begin to protrude from the mare's vulva, and she will usually lie down. The pressure on this placental sac caused by the mare lying down usually ruptures it. The rush of escaping fluids is easily heard if you are sitting near the stall waiting. These fluids lubricate the birth canal and the foal. The mare should slowly lie on her side and begin to push.

Contractions in the horse are vigorous (the mare is often pushing 70 to 90 pounds of foal through a small birth canal), and many mares will groan or vocalize. As the mare pushes, another smooth, thin, white-to-clear sac will appear. This is the sac around the foal, and parts of the foal can be seen through it.

In a normal delivery, the front feet of the foal are seen first. Usually one is slightly ahead of the other, and the hooves are covered by a rubbery protective material. Once the front feet are out to the level of the knees, the foal's nose and head should start to appear.

This is the first danger point. If more than 20 minutes of the mare's straining have passed and no feet are visible, seek help. If only one foot is visible, or if two feet and no head are present, also seek help.

When either of these conditions occur, and if help is not far away, the mare should be made to stand up and walk. This helps the foal slide back into the uterus and will help in later attempts to reposition it.

If your veterinarian cannot get to your mare right away, listen carefully to instructions. You may need to clean and lubricate your arm and gently slide it up inside the mare. You should follow the protruding leg to the chest and then find the other leg or the nose and head.

It will be unusual if you need to actually reposition a foal. Most times you will only have to help gently pull the foal out if you have to help at all.

In a normal delivery, the passing of the head and shoulders is the most difficult part, and the mare may rest briefly after the shoulders clear her vulva. If the mare seems to have trouble pushing the head, shoulders or chest out, you may need to help pull.

Use a dry towel to grasp the foal's front feet. The sac over the foal should be broken at this time, if it hasn't torn already. Pull the feet down toward the mare's hind feet; this angle helps rotate the foal's head through the canal. Once the head and shoulders are through, pull straight along the line of the mare's backbone.

If the mare struggles when the foal's hips are in the canal, you should again pull the foal's feet down. This angle will rotate the hips through the canal and out.

Whether you help pull or the mare delivers on her own, the rear feet can often remain in the mare as both the tired mother and the newborn rest. If you remove the feet from the mare, it is important to leave the mare and foal close to each other. This rest period is crucial to the foal because the umbilical cord is still attached and a large, necessary volume of blood is passed from the mare to the foal during the five to 15 minutes that the two remain attached.

After a short while, the mare, the foal, or both will stand. When the mare stands, she will break the umbilical cord at a predetermined point. Very little bleeding will occur.

If either jumps up or pulls away too early, the cord snaps prematurely, and bleeding occurs from both sides. Suture material, or even sterilized fishing line, boiled shoelaces, or clamps can be used to tie off these bleeding vessels.

The foal should have its navel dipped in an iodine solution to coat the umbilicus and seal the tissue, keeping out infection. (Note: Recent research has shown that seven percent iodine may be too harsh and that its use may damage the umbilical tissue and increase infections.) The currently recommended solution is a diluted Nolvasan mixture, which can be provided by your veterinarian.

A small amount is poured into a small glass or a syringe case, placed over the umbilicus and held up against the foal's belly. The glass or case is then shaken so that the entire stump is coated. This should be done two or three times daily for the first two days of life.

Mares can also foal in the breech position, or with the hind feet coming first. This is not normal but can occur without problems. Breech births are more difficult and help is more likely to be needed.

If you determine that the foal is coming breech, you should call for assistance immediately. In all likelihood, you will not need to help your mare, but it is far better to have an idea as to what to do.

In such a delivery, the first joint you will see after the cannon bone will be the hock. You can also tell a breech from a normal delivery by the way the foal's feet flex. In a normal delivery, the (front) feet will flex toward the mare's hind feet. In a breech delivery, the rear feet will flex toward the mare's tail.

The hips and tail will follow the hocks in a breech birth. This is usually the most difficult point because it is the widest part of the foal when delivered this way.

Again, you may need to grab the feet and help pull towards the mare's feet to rotate the pelvis through the canal.

Once the foal has been delivered, the next two important steps are the passing of the placenta by the mare and nursing by the foal.

The placenta will appear as a large mass of red and white tissue hanging from the mare's vulva. She should pass this tissue within two to four hours after foaling. Retaining this tissue much longer can lead to infection. Even if the delivery has been normal, a retained placenta will require veterinary assistance.

The newborn foal should stand and begin nursing within four to six hours of birth, and most will nurse within one hour. They can be somewhat weak and have trouble standing and/or attaching to the teats. You can provide gentle assistance and help guide your foal to the nipples. There are some simple tricks that your veterinarian can demonstrate to make working with the newborn foal easier.

The complete foaling kit
A first-class foaling kit should contain:

A flashlight with fresh batteries. This can be a small light.
A few large towels and a few small hand towels. These are used to grasp the foal's feet and legs if you need to help pull and to dry and clean the foal after birth.
Tail wraps, to wrap the mare's tail prior to foaling.
A few pairs of rubber gloves (preferably sterile) to be used if you need to enter the mare and assist in delivery.
Betadine to wash the mare prior to foaling and to paint the navel after birth. Nolvasan can also be used.
At least two commercial enemas, to be used if the foal seems to have trouble defecating after it is born. Contact your veterinarian prior to using them, but having them on hand will shorten the time to treatment.
Sharp, clean scissors to open a thick placental sac, cut the umbilical cord, or cut suture material to tie off the cord.
Hemostats or clamps to stop bleeding from an umbilical cord or torn blood vessel.
A large, heavyweight trash bag to remove the placenta from the stall. (Your veterinarians may ask you to save the placenta so that it can be examined to see that all the pieces are present, ensuring that infections and problems will not crop up later.)
A clean bucket for cleaning your hands and arms or the foal and mare.
Sterile lubricant such as Vaseline.
Suture material, to tie off bleeding vessels or the umbilical cord if needed.
Roll cotton to be used along with a bucket of warm water and the betadine to clean the mare's vulva prior to foaling and to clean the mare's udders. Make sure to rinse off these areas well, as soap can be irritating and the taste can discourage the foal from nursing.
A watch, to keep track of time during foaling.
Your foaling kit should be handy and completely stocked well before the actual foaling date.

A large, secure plastic box and tight lid make the best foaling kit container. It can be left in the barn and will stay dry and clean until needed