Tower Equine

Veterinary Surgeons


Foaling. "Do you know what is normal?" - March 2009

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The prospect of foaling a mare makes even the hardened horse breeder nervous. The stakes are high. Eleven months of effort and expense all hinging on just half an hour of frantic heaving - and when things go wrong you can lose not just the foal but the mare as well. But since every foaling involves thrashing legs, groaning and violent straining, how do you tell when there is a problem? What is the difference between normal and ‘Call the vet NOW!’?    

The first rule of foaling is not to miss it. ‘You’ve got to be in it to win it,’ and you’re not much help if you’re asleep in bed. Finding two heads in the box the next morning instead of just one might seem a stress free solution to sitting up, but I don’t recommend it. Sooner or later you will lose a foal that could have been saved.

Invest instead in a foaling alarm and a cheap CCTV. If you’re on a tight budget you could opt for an alarm clock and a catering size tin of coffee, but you will probably need to add some matchsticks for your eyelids. Predicting the day of foaling is never easy. Three weeks either side of the due date is quite possible and mares who like to spin it out can go over a full twelve months. Milk test prediction kits are available, but in my opinion are no more accurate than an experienced observer. The visual signs include enlargement of the udder and teats, ‘waxing up’, relaxation of the pelvic ligaments and an increase in restlessness. These clues tell you that the mare is getting close, but some, particularly maidens, may have very little udder development until the last minute and some mares don’t develop a proper bag at all until after foaling.

The best guide is to watch a heavily pregnant mare closely, getting to know her normal behaviour – the way she moves about, the way she lies down, the way she eats - so you can spot the subtle changes that indicate tonight will be the night. Try to make your watching unobtrusive however or she may just wait until you’ve gone for breakfast in the morning.

For the sake of convenience foaling is described as occurring in three stages. The first stage consists of uterine contractions that steadily increase in strength, along with gradual relaxation of the mare’s cervix. The mare shows increased restlessness, getting up and down and maybe rolling. The textbooks will tell you that first stage labour lasts from half an hour to six or eight, however maiden or nervous mares can be in and out of first stage for a few days, while some old pros seem to skip it completely, getting straight to the main event.

A very important but unseen change during first stage labour is in the position of the foal. In late pregnancy the foal lies on its back, its front legs bent and its head pointing towards the mare’s tail. Basically it is snoozing nice and snugly, using the big swag of pregnant belly like a hammock. To come out through the pelvis however, it has to roll over onto its front and straighten into a diving position, forelimbs and neck outstretched. The rolling of the mare in late first stage helps the foal move into the right position. The increasing strength of the uterine contractions forces the foal into the birth canal and ruptures the outer membrane of the placenta, the chorio-allantois. The release of placental fluid signals that the foal is definitely on its way. 

Just occasionally the outer bag does not rupture. What you see then is a velvety-red membrane bulging out of the mare’s vulva – the so called ‘red bag’. It means that the placenta is starting to detach from the uterus, reducing the oxygen supply to the foal. Contrary to popular belief this does not mean certain disaster, but it does mean you need to ring the vet, cut the bag with a clean pair of scissors, and get the foal out fast.

When the bag ruptures naturally, the foal is usually delivered within half an hour. Any delay means a problem.  It is extremely rare for foals to be too large to pass through the birth canal, but with four long legs and an equally long neck they are quite capable of getting tangled up in the attempt.

What should emerge first are two front feet followed by a nose. Often one foot is a little behind the other, and the nose appears by the time the legs are out to mid cannon. If the nose is level with the fetlocks and the mare seems to be struggling to make progress, this can be because the foal’s elbows are flexed, jamming against the edge of the pelvis. A tactical tug at each front leg in turn is enough to straighten them and allow the foal to come out. If time is passing and you can see only one leg, or two legs but no nose, pluck up your courage and roll up your sleeve. Make sure that you are safe from getting kicked, use plenty of obstetrical lubricant on a clean hand, and have a feel. How willing you are to do this depends on your confidence and experience, but you will not do any harm, and if the problem is as simple as a front leg caught on the rim of the pelvis or a slightly twisted head you can correct it. Delivering your own foal is a very memorable experience.

If however you can’t feel both front legs and a nose it is time to call the vet. Give a mare twenty minutes from starting and if she is not making progress then you should reach for the phone. No vet objects to being called out to a foaling, even if most times the foal is out when they get there and their only job is to admire the new arrival and pretend they don’t mind that it is three o’clock in the morning.

If all is well and you can see the foal’s nose and feet, let the mare keep pushing. Once the head is out the rest should quickly follow, although it can sometimes be a pretty tight fit at the foal’s shoulders or hips, and a tired mare can welcome a helping hand. If you do pull make sure you do it evenly on each leg, pulling out and downwards in time to the mare’s contractions. One person on each leg is plenty, and if nothing is moving then stop. Too much force can damage the foal or tear the mare. Never pull on the legs if the head is not presented correctly, or just pull on a single leg. Both these risk making a malpresentation worse.

A quick word here about the inner sack or amnion. This is the greyish bag in which the foal is enclosed, and which it must break to get out. A major cause of foal loss in unattended foalings is suffocation, due to the amnion still being over the foal’s head after delivery. If the amnion does not split early in foaling you can easily tear it open with your fingers.


Once the foal is out everybody takes a breather, you included. The mare will usually stay down for a while, without initially taking much notice of the foal. If the umbilical cord is still attached, leave it to break when mare or foal moves. It has now been shown that early breaking of the cord does not deprive the foal of extra blood from the placenta, but a natural rupture of the cord is still best. Check the foal’s umbilical stump – if it is bleeding, a firm pinch with your fingers for a minute should be enough to stop it. Try to avoid tying off the end of the cord as this increases the infection risk.

Once the mare is ready, move the foal around to her head for her to lick it. Some peace and quiet is important to allow the mare to bond with her foal. Twenty people crowding into the box with their mobile phone cameras flashing is not ideal!

As a rough guide foals will stand within an hour and suck within two or three. The best advice I can give you is not to get too hung up on your timings – some people do literally get their stopwatches out and panic if the foal is five minutes behind schedule. Foals can be pretty dim when it comes to finding the teat and some need both time to experiment on their own and lots of help. Give it up to six hours but after that call the vet for help, as it is essential the foal gets its colostrum nice and early.

I use a similar sort of time scale for the placenta to come away from the mare. Most are passed quickly, but a few will be retained. If the mare foals at night a retained placenta can wait until the next morning, but no longer than that. I strongly advocate that all newborn foals are checked over the next morning anyway, and given tetanus antitoxin and antibiotic cover. This gives an opportunity to thoroughly examine the foal, mare and placenta.

It would take an entire book to cover all aspects of foaling, and there are some very good ones in print. These are just some personal tips that you may find helpful when the big moment arrives. Above all, trust your instincts, don’t be too nervous, and don’t hesitate to call the vet.

Roger Lee MA VetMB CertEM(Stud) MRCVS