“Doc – Woud you give me some pointers on delivering foals?”
© A.J. Neumann, D.V.M.
published in The Draft Horse Journal, Spring 2003

Yes, I sure will. The foaling season is upon us and in the next four or five months thousands upon thousands of mares will deliver their young. Most of them will not have any trouble at all but a few will need some assistance during the process.

Normal parturition or birth in the mare can be divided into three phases. The first or preparatory phase lasts from three to five hours and its onset can be controlled by the mare. We know from experience that the time of day, degree of seclusion and the amount of activity or noise in the environment are factors which will depress or stimulate the actual process of parturition. Apparently the mare can control, to a point, the release of hormones in her system which eventually sensitize and stimulate the musculature of the uterus. When this happens the muscles in the uterine walls begin to contract and by their action pressure is put directly on the allantoic and amnionic fluids which in turn causes the allantochorion membranes to dilate the cervix and eventually bulge through into the birth canal with dilation of these tissues.

In the following sequence of events the allantochorion membrane ruptures and allows what we call the “true water bag” or amnionic sack to pass through the cervix further dilating it and the birth canal.

The feet, legs and head of the fetus may then be presented through the pelvic inlet, cervix and into the birth canal.

As I have already said, this process can be controlled somewhat by the mare. We have all heard of the individual who wished to watch the mare foal. He watched and watched but finally had to leave only to return in a few minutes and find that the foaling had taken place while he was gone. Many individuals have had that experience.

For many years we foaled 10 to 15 mares a season. Our foaling season ran from the last week in March through April and into May. I rarely had a foal born in June. I never had a mare under lights for the January or February birth dates. My foals were always as big and fit by late August and September show time as those December, January and February foals from lighted mares. But that’s another story which has no bearing here.

My pregnant mares were always barned overnight from at least Thanksgiving on through the winter.

Two weeks before their due date they were placed out into a fairly large yard with hay and water available for the night. They were watched all night. Two men were bunked on the premises where one man could observe the mares at all times. I would be one of these people and I spent most every night out there for about three months observing my mares and being present when each and every foal was born.

I foaled a mare in a box stall early on in my mare foaling days. I couldn’t watch her all of the time since this was before the day of the closed circuit TV camera with the screen in the house. She got down with her rear in a corner and after finding her there the foal was seen to be half out and dead. We could not get her up to deliver the foal and by noon the paralyzed mare was dead. I vowed then and there I would never ever foal a mare in a box stall, I didn’t care how large it could be. I can say that I never lost another mare or foal, foaling them outside even though I delivered one once on a snow bank in front of the barn door.

But back to the mare who seems to control the onset of labor.

Noise and activity will affect many mares and prevent them from preparing to foal. There was always someone at my barns doing chores, hauling manure and performing other jobs. We only had one mare foal in the daytime and she performed the feat over the noon hour while the surroundings were quiet.

I foaled mares from 1963 to 2001 and that was the only case of a foal being born in the daylight hours.

By watching our penned mares who were approaching their due date, early in the evening we could spot the individual or individuals which were going to foal that night.

We noticed they would take time out and pick a spot in the yard. It was usually the most dark and secluded area on the premise. The mare would check it out much as a dog will do when it is ready to bed down, then she would return to the hay bunk and resume eating.

Sometime, usually between the hours of 11 p.m. to 4 a.m., the mare would return to her previously chosen area and the show would begin. I kept track of all foalings which occurred on my farm. Over 75% of them happened between the hours of midnight and 4 a.m. Most of these could be narrowed down to the time span between 2 a.m. and 4 a.m.

Why would this be? Between the hours of 2 a.m. and 4 a.m. the environment on my farm is almost devoid of any sounds. Even highway 60 which is 3/4 of a mile away is shut down. I also noted after watching my mares over these long periods of time, that most all horses at my place would sleep lying down in the yard or lying down in their tie stalls from 2 a.m. to 4 a.m. By the way, they will snore with great gusto and volume and we used to get quite a kick out of a yard full of Belgians all stretched out and snoring for all they were worth.

I believe in this instance you are observing this draft mare reverting to the wild in that she picks the most secluded and dark area which is away from the herd to give birth, when all her environment is at its lowest activity. I know this is true because I have watched it occur over hundreds of foalings and have recorded the results.

During the latter part of phase one the mare will be at her appointed place of delivery and may circle around, go down, get back up and repeat the activity.

When phase two or the actual expulsion of the fetus takes place, generally the mare will lie down, roll on her side, and you will see the abdominal muscles contracting very forcibly. The mare’s legs are usually fully extended and these very powerful contractions will occur every minute or two.

In a normal delivery this phase of “labor” will last about 15 minutes. Prolonged labor at this point will result in the separation of the fetal membranes or so-called “afterbirth” and the foal will die of asphyxiation unless it is far enough out of the birth canal that it can breathe on its own. Therefore phase two is the most important time in the birth of the fetus.

I cannot understand why some people will breed a mare or mares, get them in foal, and not one soul will be around when the mares deliver. If you are going to treat your mares in this fashion there is absolutely no excuse for such conduct. Why would anyone get a mare in foal and at the critical moment of birthing be off doing something other than paying attention to the mare? If you cannot be there in person make arrangements for someone with some knowledge of the process to be present. At my barn when the time came for delivery there were always two men present. A clean bucket of warm water was available plus our small plastic carrying case loaded with necessities which could be used during the birth of the foal. (I have a picture of the plastic case and have listed its contents in Figure 1 of this article.)

As the mare went into labor, warm water was placed in the bucket with some disinfectant added. The O.B. chains or ropes and the handles were placed into the bucket and the mare was quietly approached from the rear. The bucket and plastic carrying case were brought along. Generally at this time the amnion is visible, protruding from the mare. Feet and legs often can be seen or felt within the sack.

At this point, rupture the amnion sack and let the fluid come out. The membrane may be thick enough that you cannot rupture it with your fingers. Use the scissors in your carry-all to do the job. With the membrane torn open you can probably see the feet and legs protruding, coming further out with every labor of the mare. If the foal is being presented in the normal fashion, both feet will come with the sole of the foot down toward the direction of the mare’s hocks. Probably by this time you can observe the end of the nose of the foal.

If you cannot see the nose, put your arm in the bucket of disinfectant, wash it, and run your arm up into the mare. If you can feel the nose you are okay to place your OB chains or ropes on the foal’s pasterns and aid the mare each time she labors.

As traction in the form of both of you exerting pressure or pull on the OB chains is applied, you first want to pull straight back until the poll or top of the foal’s head is in sight. At this point pull slightly down until the head, neck and shoulders of the foal are through the vulva. At this stage the direction of pull should be straight down or parallel to the rear legs of the mare. To “pull” the foal in this direction will prevent the fetus from becoming “hip locked.”

Let’s go back just a little to when you first observed the front legs. You will note that one is always extended a little further than the other. This is normal in that it allows one elbow to pass through the pelvis before the other. This is important when applying traction to aid in delivery of the foal. When the one leg is pulled through the pelvis you must pull the other one through and even them up. This is Old Mother Nature’s way of preventing an elbow or shoulder lock in the mare’s pelvis.

As soon as the foal’s head is in the clear, clean out his nostrils and mouth, especially the nostrils. At this point it is very nice to have an assistant. As the assistant exerts pressure on the foal you can clean its airways of material, slap it on the side of the head and stimulate it to breathe. The foal will take its first breath when the navel cord reaches the pelvis and becomes pinched off. Slap its face, shake its head and if the foal slips out rub it vigorously with an old towel or better yet, a burlap or “gunny” sack.

If the foal is out and not breathing, get your syringe and needle out of your carryall which you have previously loaded with 1-1/2 to 2 cc of Dopram-V. Inject it directly into the bottom of the tongue. If needed, the dose can be repeated in one or two minutes.

In my opinion Dopram-V by A.H. Robbins, distributed by Fort Dodge Labs, is the finest respiratory stimulant we have for use in horses, dogs, cats, calves, swine, sheep and goats. It is a wonderful drug to use to stimulate breathing in the newborn of these species. I have used it for years with excellent results.

Okay, now the foal is out. He’s lying there shaking his head and breathing good. Hopefully the mare is quiet and you have not pulled the foal so far as to prematurely rupture the navel cord. Leave him lie there for 10 minutes. You will see the navel cord begin to shrink about 3 or 4 inches below the belly line. This is where it will break normally and not bleed when you remove the foal from behind the mare.

If you have pulled the foal too far the cord will prematurely rupture and will bleed. Grab the stump with thumb and forefinger and clamp your hemostat from your carryall over the stump to stop the hemorrhage. You may then take your two inch half circle cutting edge needle and suture from the carryall and simply tie off the cord above the hemostat.

This procedure is done by going above the hemostat and running the needle through the tissue on the side of the cord. Take needle and suture around the back of the cord and come through the tissue on the opposite side. The suture will not slip up or down and can be pulled tight and tied.

Next take cotton from your carry-all and wipe off the end of the cord. Pour some seven percent or so-called “strong tincture of iodine” into a throw-a-way plastic cup and soak the end of the navel by immersing it into the iodine. After soaking for one minute or so throw the iodine and cup away. Do not save it or use it on another navel.

By this time the mare has been down for 10 or 15 minutes. Remove the foal to a safe distance and if the mare does not get up you must force her to her feet. You must get her up because if you leave some of these mares down too long they will become paralyzed in their “downside” rear leg and will be unable to rise.

Now what do you do if she cannot get up and is in a box stall? You will have to drag her out by her front legs, head and neck, and get her where there is good traction for her feet with plenty of room. Roll her over so she lies on her good rear leg. Then get her up even if it means using a good deal of persuasion. If you do not do this you probably will have a paralyzed mare, at least in one rear leg. This is not much of a problem in the pony or light horse but get a ton mare flopping around in a box stall and you have a big problem.

I’ve foaled a few mares which I have gotten up in 10 or 15 minutes and their down rear leg was very weak when they came up. They slung around in quite a circle and one man had to be on their halter to steady them. You would risk your life getting one of these up in a box stall.

A good many people worry about a foal being presented rear legs first or “backwards.” This is known as a posterior presentation.

If this presentation should occur you will see that both rear legs of the fetus are coming through the birth canal. If the foal is in a perfect position, the soles of both feet will be up or pointing to the mare’s tail.

If you cannot see the hocks, disinfect your arm and check up into the mare. Follow the legs up and you will feel the hocks.

To deliver one such foal you must have help in the form of one or two assistants. If you must wait for their arrival, keep the mare on her feet until help has arrived.

Attach the OB chains or ropes to the legs at the pastern area. Exert traction straight back until the foal’s hip area contacts the mare’s pelvis. At that time exert your pressure straight down or parallel to the mare’s hind legs.

As the assistants maintain their traction you can rotate the foal by placing a fork handle, crowbar, or handle, even a hammer, between the legs and by using this as a lever the legs can be twisted one way or the other. This in turn will rotate the foal’s pelvic area and one side will pop right out through the mare’s pelvis whereby the foal can be delivered very quickly.

You must get the foal out very fast because when the umbilical cord comes in contact with the pelvic floor the foal will attempt to breathe.

When you get the foal out, work immediately on its breathing as I have described previously. It is a good idea to have your assistants elevate the rear quarters of the foal to facilitate the removal of fluids from the mouth and nostrils.

The third phase of parturition involves the expulsion of the “afterbirth” or fetal membrane. This should be accomplished within three hours of the foal’s birth. When the tissues are expelled, one should spread them out and by close examination of them determine if the afterbirth is all present and accounted for. It should be a large bag, having one opening through which the foal passed. The rest of the bag should be complete.

Here is a partial list of some of the most important do’s and don’ts regarding the delivery of foals.

1. Make every effort to have help available to aid in the delivery and care of the foal after it is born.
2. Do not use a “calf-jack,” “come-along” or fetal extractor of any type in the delivery of a foal. It’s too easy when using them to exert excessive traction and cause obturator or gluteal paralysis, hemorrhage or tears in the birth canal and pelvic area, as well as damage to the mare’s urethra and bladder. Also excessive force will cause the bones to fracture where you have placed the OB chains or ropes around the foal’s legs. In my practice the use of any mechanical fetal extractor on a foal has been a no-no!
3. Before applying any traction to the foal be sure both front legs and the head are into the pelvis and birth canal. In the case of a posterior presentation you need both rear legs in the same area.
4. Never apply any traction to the front legs if the head or nose is not in the pelvis or birth canal.
5. If you need help – call a veterinarian and get him or her out there immediately. In the meantime keep the mare on her feet and walk her as much as possible. This will delay labor until help is at hand.
6. Never enter a box stall or paddock where a mare has just foaled without first determining how she will react to your presence. Some good old faithful mares after foaling will mentally revert to the wild and look upon you as a predator bound on doing in her newly born foal. She will attack you and fully intend to kill you. Do not make that mistake!

I could keep on writing about foaling, the care of the newborn and the care of the mare after parturition, however I have given you some “pointers” on the subject and if you follow them you will do okay in over 99% of your mare deliveries.

Lower left corner - Cotton kept in a red plastic bag. Above the cotton - A plastic dispenser for the disinfectant, I use Roccal-D or Nolvasan Solution. If you do not have a commercial disinfectant, one can be made by adding 3/4 cup of Clorox per gallon of water in your bucket when you prepare to aid in the delivery. Right of Disinfectant Dispenser - A bottle of 7% Tincture of Iodine and 3 disposable plastic cups. Upper left corner - Plastic carryall. Upper right - Two 30 inch O.B. chains, two 60 inch O.B. chains, three O.B. chain handles. Lower row on black area, from left to right - Straight hemostat with jaw size 1-1/2 inch. Surgical scissors. A small roll (36 inches) size number 3 of non-absorbable suture. (Braided nylon fish line will do in a pinch.) Middle row from left to right. 2 sterile 3cc plastic syringes, 2 sterile 20 gauge 1-1/2 inch needles, 1 - 3 cc syringe with needle attached, loaded with 2 cc of Dopram-V, 4 stainless steel cutting edge curved surgical needles. Size 1 and 2. Upper row left to right: 50 cc. vial of Dopram-V from Fort Dodge Labs, a plastic container for the surgical needles, suture, sterile needles and syringes.

All of this material fits easily into the plastic carryall and it will be handy when you need it. Nylon 3/8 inch rope can be substituted for the O.B. chains. The hemostat, scissors, surgical needles, suture, syringes and needles can be picked up from your vet or a farm and ranch store.

The Dopram-V can be purchased from your veterinarian.

In addition you will need a clean bucket, warm water and a large towel.

An Update on the History of Smallpox

I wrote an article for The Draft Horse Journal about smallpox which was published in the Summer 2002 issue. In the paper I stated the first known vaccination against the disease occurred in England in 1774. I also reported that a Doctor Jenner published a paper in 1799, stating it was possible to vaccinate people against the disease by using fluids taken from cowpox lesions.

In February of 1999, my wife, Mary, and I went to Roxboro, North Carolina where I taught a Percheron Draft Horse Association sponsored school for adults. After the classes were over we visited several friends and their families in North Carolina and my wife and I entered upon a mutual agreement whereupon we would stay in the area for a few more days.

It was agreed we would visit Biltmore Estate at Asheville, North Carolina, which she really wanted to see, and I could tour the two Revolutionary War battlefields known as King’s Mountain and the Cowpens. They are located just across the border in South Carolina. I had a most interesting visit and tour of both battlefields and we both fully enjoyed the Biltmore Estate.

I had two reasons for visiting the battlefields. The first is, I love history, especially that pertaining to the French and Indian War and the Revolutionary War. Second, we believe some of my wife’s ancestors fought against Ferguson and his Tories and destroyed them at King’s Mountain on October 2, 1780. We also believe that some were in the militia units which fought and destroyed the British and Tory forces on January 17, 1781, in the battle of Cowpens.

After visiting the battlefields I have acquired a number of books regarding these actions which took place at their respective sites. One of the best is a book by Lawrence E. Babits, The Battle of Cowpens. The author has included in his work many pages of notes listing the various sources of his information.

I was struck by the author’s reference to the incidence of smallpox among the soldiers under General Morgan, the American overall commander.

He states, “There was a low, but steady incidence of smallpox among the soldiers. A person with smallpox passed on the infection from the first rash until the last scabs drop off, a period of about forty days.”

There were two types of troops present under General Morgan. One was the militia soldiers from South and North Carolina, Georgia, and Virginia. The other group of soldiers were of the regular army known as Continentals. The Continentals were regular army while the militia was made up of citizens who were called into action for a limited time during an emergency situation.

The author states that according to records “Four men had smallpox immediately before Cowpens. At least five men apparently contracted the disease with the army, and two others are related cases.”

He goes on to state, “Whoever the carrier, a steady incidence of smallpox was associated with the South Carolina militia. Unlike Continentals who were immunized, even early in the war, militia were usually unprotected.”

And so from these pieces of historic information I learned two things. First, a person with smallpox will spread the disease from the time the first rash appears until the last scabs are gone which is a period of 40 days.

Secondly, Continental soldiers, or the members of the regular army, were vaccinated against the disease early on in the war which started in 1775, and for all practical purposes was over in 1781.

According to this last piece of information, vaccination against smallpox must have been going on long before Dr. Jenner’s paper was published in 1799.

I just thought this is a little bit of interesting history concerning a disease much talked about today.