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Everyone loves foals and foaling time can be very exciting for horse owners. However, not every foaling goes the way it should. Problems can quickly arise and lead to loss of the foal or mare. There are no seconds to lose when things really don’t go right, so make sure you’re prepared

Preparing for parturition

The most reliable indicator of impeding parturition is a significant increase in udder size and secretions. Mammary gland development become apparent in the last month, especially in the last two weeks before parturition. Milk production engorges the udder even further in the last few days before foaling. Drops of milk become visible at the teat ends 1-4 days before foaling, but sometimes as early as 2 weeks, or some mares won’t have any visible milk on their teats. If milk leaks from the teats this could result in significant colostrum loss. If you notice your mare leaking milk, strip the udder and store the colostrum in the freezer to feed to the foal during the first hour after birth.

Before foaling, the mare’s udder and abdomen (where the foal may attempt to nurse) should be cleaned. If a mare has had a caslick this should be opened.


First stage
During the first stage of parturition uterine contractions push the foal in the right birthing position and the cervix dilates. This phase usually takes 30 minutes to 4 hours and resembles colic. The mare is restless, may look at her flank, raise and swish her tail, urinate small quantities frequently, sweat, and lie down and get up restlessly. During this stage of parturition, the mare’s tail should be wrapped and the perineal area should be cleaned and dried. Take care not to distress the mare, as this may prolong this stage. If the mare doesn’t feel comfortable and safe, she may try to give birth standing, which means that the foal will drop to the ground and the umbillical cord will break instantly, which is not ideal (as we’ll explain further down). The first stage of labour ends with the water breaking. If instead of the ‘water’ breaking a red velvety bag becomes visible at the vulva, this means that the placenta has separated from the uterus prematurely and the foal can’t get oxygen. The red bag should be immediately ruptured and the foal should be delivered immediately. Call your vet immediately, the foal may need emergency care.

Fig.1: If a red velvety bag like this becomes visible at the vulva, this means that the placenta has separated from the uterus prematurely and the foal can’t get oxygen. Break open the bag at the centre of this light coloured “star” (visible in this image), find the foal’s legs and help deliver the foal immediately. If this takes too long, the foal will suffocate. To be able to breathe, it’s ribs and abdomen need to be out of the birth canal. Uncover its nose/airways and check if it’s breathing.

Second stage
During the second stage of parturition the foal is pushed through the birth canal. This phase usually takes about 15-30 minutes. The mare usually lies on her side and periodically strains forcefully to push the foal out. Within 5 minutes of the water breaking, a white glistening membrane called the amnion is pushed between the vulvar lips. Then first one, and then two feet should become visible, with their soles facing downward. The nose should then follow (at the fetlock and carpal level of the foal’s legs). The mare sometimes stands up when the foal starts to pass through the birth canal, may circle around and will lie down again. The white glistening amnion membrane normally ruptures as the foal passes its head and shoulders through the birth canal. At this stage assistance may be provided by gently pulling the foal’s legs in synchrony with the mare’s abdominal effort. The amnion should come off the foal’s nose so that the foal can breathe. Once the foal’s hips pass through the birth canal, the mare usually rests for 15-20 minutes. During this time the foal receives extra blood from the placenta through the umbilical cord. This process increases the foal’s strength and should therefore not be disrupted. If the mare stands up the umbilical cord will break and blood can no longer run through. The mare should therefore be allowed to rest and bond with her foal undisturbed. When the mare is ready she will start to sniff and lick the foal. The umbilical cord normally ruptures naturally in the correct spot. The umbilical stump should be checked for bleeding, and disinfected with 0.5% chlorhexidine (or 1-2% iodine or 7% tincture of iodine). The navel should be disinfected twice daily during the first few days of life.

NB: If the water has broken, but there’s still no sign of the foal at the vulva after 10 minutes, call your vet immediately! The foal’s position should be examined with clean hands/arms.

Normal positioning: hoof soles facing down, two legs forward, one just in front of the other, the muzzle 10-20cm behind the feet at the fetlock and carpal level of the foal’s legs. If the foal’s position is normal, allow another 10 minutes. If the foal still hasn’t advanced, call the vet immediately.

Third stage
During the third stage of parturition, the mare expells the placenta. Once the mare stands up, the placenta can be tied in a knot. Just make sure it’s still hanging out because the weight of the placenta provides traction to help with expulsion. Don’t pull the placenta because this can cause inverted uterine horns or retained placenta pieces. Uterine contractions and involution will assist the placenta out. The placenta should have been delivered within 3 hours. If this is not the case, the mare is said to have a “retained placenta”, in which case your vet can give the mare an injection to stimulate placenta expulsion. If the placenta has not seperated within 6 hours, the risk of complications such as toxins in the blood, laminitis and systemic illness increases. Once the placenta has been expelled, it needs to be checked to see if any is missing by laying it out on the ground. If any areas have stayed behind in the uterus, these can cause an infection and lead to toxic shock syndrome which can be fatal if left untreated.

After birth, the foal should…

  • sit in sternal recumbency within 2 minutes
  • stand within 1 hour
  • nurse within 2 hours, and then about every 30 minutes
  • pass meconium and urinate in 12 hours

If any of these things don’t happen in appropriate time, call your vet.

A foal should be bright, alert and responsive. Call the vet if in the first week after parturition the foal seems uninterested in the mare, the mare doesn’t allow the foal to nurse, the foal seems disoriented, can’t find the udder, suckles on other objects, has its tongue hanging out, dribbling milk from the nostrils or mouth, is making abnormal sounds (barking, grunting), is lethargic or disoriented, is seizuring, is colicking.


Good colostrum is thick, viscous, yellow to orange milk that is only produced at the end of pregnancy. After that, normal milk production starts. Colostrum contains antibodies that the foal depends on for immunity, milk doesn’t contain any. If a foal doesn’t receive enough antibodies in the first 6-12 hours after birth, the foal becomes immuno-compromised. These foals need immediate veterinary attention to prevent illness (joint infections, pneumonia, diarrhoeia, sepsis) and death.

Colostrum quality (antibody concentration) varies between mares. If quality is low, a foal should receive additional good quality colostrum. Colostrum quality can be measured with a sugar refractometer (BRIX score should be >23%). Your vet can do this for you, so hold a couple mL aside before the foal gets to it. If the quality is adequate, but the foal doesn’t drink 1-2L in time, the foal is at risk of failure of passive transfer. Always check whether the foal is actually drinking, not just sucking on the side of the udder. If you’re not sure, or you just want to check, have your vet do an antibody-blood test at 12 hours old to decide whether the foal needs extra support.

Antibodies are specialised large proteins. In adult horses large particles have to be broken down to be absorbed, as the gut has a natural barrier so that bacteria can’t get through. In a newborn foal this barrier is still in its “fetal stage”, which allows the antibodies to be absorbed in the gut. However, from birth, the gut barrier gradually starts to close. It would normally take a foal approximately 2 hours from birth to nurse. If this takes longer than 3-4 hours this is considered abnormal. At this stage a vet should be contacted so that the foal can be helped before the gut barrier has closed completely. Once it has, therapy becomes more intensive for the foal, owner and vet and often comes at a higher cost.

Tip: Let your vet check the foal’s antibody level at 18 hours, check the foal for congenital problems and give the foal tetanus antitoxin if required. The latter is especially important if the mare has not had her tetanus booster within 4-6 weeks before parturition.

Tip: Colostrum may be stored in the freezer at -20°C for up to one year. If you want to heat up frozen colostrum for the foal to have after birth, do not microwave it! This would destroy the antibodies inside it. Colostrum should be thawed and warmed to body temperature by placing it in a warm (35°C to 37°C) water bath or au bain marie.

If you have a pregnant mare or planning to breed your mare, please make sure you plan vital vaccinations and worming on time. Prevent issues by good pregnant mare management.

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