If your mare has made it through 11 months of pregnancy, you’re almost home free. Labor and delivery, while momentous, are generally uncomplicated. Every effort should be made to be present during foaling. In most cases, you will simply need to be a quiet observer. Mares seem to prefer to foal at night in privacy, and apparently have some control over their delivery, and can delay foaling if interrupted. Hiring a foaling attendant, installing a video monitor or using a birth alarm system can save the life of the foal if a problem should arise. It is advisable to have your supplies in a readily accessible location prior to foaling. If there are ANY questions at all during or after foaling, please call us immediately on the emergency line!

Your mare will need a clean, safe, quiet place to foal. Horses have been giving birth on the open range for eons, and this is still an acceptable choice. Allowing the mare to foal in the pasture even has some advantages. An open grassy area is likely to be cleaner than a stall and provides a healthy environment with adequate room to foal. If you are going to have her foal outside, I always suggest keeping your mare alone in her own pasture, especially if she is a maiden (first time mom), since we don’t want to complicate things with your other horses crowding her or the foal. Many owners prefer to confine the mare to observe her progress. Should you choose to foal your mare in a stall, provide one that is a minimum of 14′ x 14′. Straw is preferable to shavings, as it won’t cling to the wet newborn or mare the way small wood particles can. Remove manure and soiled bedding promptly and disinfect the stall between deliveries.

Mares provide clues that they will soon give birth. However, the timetable is far from absolute. Some mares may show all of the signs like clockwork, others show practically none. The following is a general guideline, but be prepared for surprises:
· The mare’s udder begins filling with milk two to four weeks prior to foaling.
· The muscles of the vulva and croup relax. The tailhead may become more prominent a few days prior to foaling.
· The teats become engorged four to six days prior to foaling.
· “Waxing” of the teats occurs (a yellowish, honey-like secretion [colostrum] appears one to four days prior to foaling).
· The mare becomes anxious and restless. She may appear to be colicky. She may kick at her belly, pace, lie down and get up, look or bite at her flanks and sweat. She may frequently raise her tail and urinate. Generally, this is the first stage of labor (however, be aware that colic remains a possibility; if such behavior is prolonged for more than an hour or two without progress towards foaling, contact your veterinarian).

Most mares foal without difficulty and it usually is best to allow the mare to foal undisturbed and unassisted.

What you can do:
· Keep a watch or clock on hand so you can time each stage of labor. When you’re worried or anxious, your perception of time becomes distorted. The watch will help you keep accurate track of the mare’s progress during labor. Take written notes so that you won’t have to rely on memory alone.
· Wrap the mare’s tail with a clean wrap or vet wrap when you observe the first stage of labor. Be sure that the wrap is not applied too tightly or left on too long as it can cut off circulation and permanently damage the tail.
· Clean and disinfect the stall as thoroughly as possible. Provide adequate bedding.

I also suggest preparing a Foaling Kit at least 30 days before her due date.
Make sure that the kit is well labeled, and in a location where you can easily access it in the dark (most likely will be at night time). Make sure that the kit is fully stocked, don’t “borrow” supplies from it, because inevitably those supplies are what you will need. I like to use a clear rubbermaid with a sealable lid for my foaling kits.

Supplies to include in your foaling kit:
· Pen, Paper, and stopwatch (if you don’t have a watch)
· Towels (3 bath sized towels, and 2 hand towels)
· Sterile Lube (KY brand)
· Gloves (disposable latex gloves, store in ziplock to keep clean)
· Vet wrap or other suitable tail wrap (2 rolls)
· Flashlight
· Scissors
· Stethoscope
· Digital Thermometer
· Hemostat for umbilicus
· Diluted (1:4) chlorhexadine solution and dixie cups
· Fleet enema (2)
· Banamine paste
· Large Plastic Measuring Cup

Labor is divided into three stages:

Stage one begins with the onset of contractions and generally lasts one to two hours. Even in a normal delivery, the mare may stand up, lie down and roll several times in an effort to properly position the foal for delivery. During this phase, contractions move the foal through the cervix and into position in the birth canal. The fetal membranes (allantois) may become visible at the mare’s vulva. When the sac breaks, signaled by a rush of fluid, stage one ends.The rupture of the allantoic membrane and rush of placental fluids may be confused with urination.

Stage two is the actual expulsion of the foal. Most mares lay down to actively deliver the foal, however some mares alternate between standing and laying down, while others foal standing up. This phase moves relatively quickly. If there is not significant progress within 10 to 15 minutes after the membranes rupture, call our emergency line immediately. If labor seems to be progressing, wait and watch. Normal presentation of the foal resembles a diving position, with front feet first, one slightly ahead of the other, hooves down, followed closely by the nose, head, neck, shoulders and hindquarters. If you suspect any deviation from the normal delivery position, call us immediately.

Normal membranes that cover the foal are white or yellow and translucent. This membrane should naturally tear over the foal’s head and nose, but if it does not, you can rip it open over the foal’s nose so he can breathe. The most deadly of foaling emergencies is a premature rupture of the chorioallantois, known as “Red Bag Delivery.” If at any time during stage two you see red/maroon membranes covering the foal as it emerges from the vagina, the placenta must be rapidly torn open, because in this condition, the foal is detached from its blood and oxygen supply.

Stage three labor begins after delivery of the foal and is the phase during which the afterbirth (placenta) is expelled. Some mares will lay down again and actively deliver the placenta, whereas other times it seems to passively fall out of them while standing. The placenta is sometimes passed immediately but more commonly will hang from the mare’s vulva for a short time. I typically tie the placenta to itself so it is not hanging on the floor for her to step on and rip. If the placenta has not passed within 3 hours, call us. A retained placenta can cause serious problems, including massive infection and laminitis.

In the excitement of birth, it is important to remember some tried and true guidelines. Once the foal is delivered, be sure it is breathing normally. Generally, it is not recommended to cut or break the umbilical cord. If it has not broken during delivery, it will usually break when the mare or foal gets up. The cord should break at a site approximately one inch from the foal’s abdomen, where the cord’s diameter is slightly narrower than the remainder of the cord.

Encourage the mare and foal to rest as long as possible. Give them an opportunity to bond undisturbed. Especially if your foal is born during the cold season (which can be long in New England), I like to dry the baby off with towels. This also stimulates foals, and many times we’ll see them make attempts to stand after being rubbed dry. Treat the umbilical cord with an antiseptic solution, soon after the cord breaks and two to three times daily for several days thereafter to prevent bacterial infection. Diluted (1:4) chlorhexadine solutions are preferred over strong iodine for naval dipping. Tincture of iodine can burn the skin surrounding the umbilical stump and should be avoided. Observe the mare and foal closely for the next 24 hours.

Following birth of the foal, the mare and foal should be monitored for the following:
· Foal is breathing normally.
· Foal is bright and alert to its new surroundings. The foal should make attempts to rise within 30 minutes following its birth.
· Mare is non-aggressive, curious and accepting of her newborn. Occasionally a mare will reject her foal. In such a case, the foal should be removed and reintroduced with the mare under restraint. Foal rejection is more common in maiden mares.
· Foal should stand and nurse within two hours of birth. If the foal has not nursed within 3 hours, call us. The foal may be weak and in need of assistance or medical attention.
· Foal should pass meconium (the first sticky, dark stool) within 12 hours after birth. Please call right away if the foal appears to be in discomfort or has not passed meconium. Female foals do not urinate until about 11 hours after birth; male foals may take six hours to urinate after foaling.
· Mare should be bright and alert. Allow her to eat as soon as she is ready and supply plenty of clean, fresh water.
· The placenta is sometimes passed immediately but more commonly will hang from the mare’s vulva for a short time. I typically tie the placenta to itself so it is not hanging on the floor for her to step on and rip. Once the placenta has been expelled, please take it out of the stall, and keep it in a safe location until we can examine it to make sure it is intact and has been passed completely. A retained placenta can cause serious medical issues for your mare, including metritis (a serious infection of the uterus) and laminitis (founder).
· You may wish to check the mare’s temperature and other vital signs periodically within the first 24 hours to make sure they are normal. An elevated temperature may indicate infection (normal range is 99.5 to 101.5 F).

My general rule of thumb is 1-2-3: The foal should stand within one hour and nurse within two hours, and the mare should pass her placenta within three hours.

It is essential that the foal receive an adequate supply of colostrum. Colostrum, the mare’s first milk, is extremely rich in antibodies. It provides the foal with passive immunity to help prevent disease until its own immune system kicks in. A foal must receive colostrum within the first 8 to 12 hours of life in order to absorb the antibodies. Maiden mares often have a more difficult time adjusting to a nursing foal. The mare may require you to offer reassurance that the foal is OK and restrain her to allow the foal to nurse. If a mare appears to be leaking an excessive amount of milk prior to birth, please call us. This pre-foaling milk is not typically colostrum-rich. However, depending on how far along your mare is, it may indicate a problem with the pregnancy.

We always recommend testing the foal’s blood at 8 to 12 hours of age to evaluate IgG antibody levels, and ensure that they have consumed adequate colostrum. The majority of absorption (85 percent) takes place within the first six to eight hours. The foal can be tested when it is eight hours old and if IgG is deficient, it can be supplemented with oral colostrum. If you wait until the foal is 24 hours old to evaluate IgG absorption and it proves to be inadequate, your only option will be an intravenous plasma transfusion. If IgG is inadequate, the foal will be treated for Failure of Passive.

· If you suspect a problem during the foaling process (such as a foal which is not in the normal birth position), call our Emergency Line immediately. If caught early enough in labor, we may be able to reposition the foal for a normal delivery. Remember, a prompt delivery is crucial to the health of the newborn foal.
· Unless it is a dire emergency, do not try to pull a foal. An exception to this rule might include a backwards presentation or “Red Bag Delivery”, because the foal can suffocate unless delivered promptly. Under no circumstances should you ever pull with anything more than your own muscle power, and pull only during a contraction (when the mare is straining). Improper pulling risks damage to the mare’s reproductive tract, injury to the foal and premature separation of the umbilical cord, which will deprive the foal of oxygen.
· Many foals begin life with weak legs. Don’t be overly concerned if the baby is down in the pasterns and fetlocks for the first day or two of life. They will generally straighten up. However, if you see extreme deviations of limbs or note other physical problems, or the condition persists, call us.

The Next Day
We always suggest a visit by one of our veterinarians the day following the birth of your foal (within 8-12 hours of birth). The mare will be examined for foaling complications, vulvar or reproductive tract injuries, udder health, and post-foaling comfort. We will lay out the placenta to ensure that it has been passed completely, and that there are no tears or evidence of retained placenta. The foal will have a full physical exam and will have a blood sample taken for an IgG (antibody level) test, which will be performed stall side, so we have immediate results. Depending on the result of the IgG test, we may suggest treatment of the foal including tubing with colostrum or administration of intravenous plasma.