You’re almost there. Your mare waddles when she walks, and you’re counting the days on the calendar. “Oh thank goodness!” you’re thinking. “Now I can finally read a happy piece about bouncing foals who eat rainbows and frolic with butterflies.”

You have been reading this series, haven’t you?

When I was about three years into practice, I mentored a newly graduated veterinarian. As spring, and his first foaling season approached, Dr. B. asked me nervously, “What can I expect if I get called out for a foaling?”

I was maybe a little overly blunt. “It’ll go one of two ways. Either the foal will be born and trying to stand by the time you get there, or it’ll be such a mess that you’ll wish for a lightning strike or sudden aneurysm.”

He turned a bit pale.

Before you grow white and reach for a chair, I’ll remind you of the most important rule for both veterinary emergencies and hitchhiking across the galaxy: “DON’T PANIC.”

Over 90% of deliveries in mares unfold normally. The problem is that the small percentage that refuses to follow the rule book can get spectacularly bad in a hurry.

Let’s look at preparations to minimize the bad and help you keep DON’T PANIC emblazoned in large, friendly letters on your mind.

1. Getting Ready –At least a month (ideally more) before your mare’s due date, start planning who, what, where, when and how for the big day.

a. Who – Make sure all involved know their jobs and can be available round the clock as the time nears. Don’t wind up having Uncle Phil with the bum knee and tendency to pass out at the sight of blood be the only person at home when your mare goes into labor.

b. What – Talk with your veterinarian about items to keep on hand, but here are some suggestions for a basic prep kit:
i. Well-fitting, functional halter and lead rope for the mare. I know this sounds basic, but it’s amazing how hard it can be to find the right halter when you really need it.
ii. Tail wrap supplies – wrapping the tail isn’t mandatory, but if time, mare, and circumstances permit, it can be nice to have that tail up and out of the way of business.
iii. Towels – Because you always need towels. (Also useful when hitchhiking across the galaxy.)
iv. Clean bucket and access to warm water. I can’t emphasize CLEAN enough. Access to water is essential. Warm is optional, but it’s kinder to the mare and to any personnel needing to wash.
v. Mild soap. Along with tail wrapping, washing the mare’s hind end can range from a nice preparation to intrusive and unnecessary. But it’s good to have a liquid soap on hand just in case.
vi. Chlorhexidine solution. This is used (talk to your vet about the proper dilution) to disinfect the foal’s umbilical cord. It also may be used to disinfect equipment if things go south and intervention is needed.
vii. A water-based sterile lube – Hopefully you won’t need it, but good to have. Talk with your veterinarian.
viii. Scissors – preferably with blunt tips. Useful for cutting open a “red bag” among other things. (See below.)

c. Where – This is the big one to have in place. Figure out well in advance WHERE you intend for the mare to foal.

If she will deliver in a pasture, it should be clean, free of obstacles or hazards, have good footing, easily accessible by truck/trailer, dry, fairly well protected from extreme weather, and free of other horses. Also, the fencing should be foal proof. Things do not go well if the foal is born during the night and manages to roll under the fence and wind up separated from mama.

A foaling stall is more practical for most people; it’s easier to control the environmental variables. The standard foaling stall area, assuming an average sized horse, is roughly twice a box stall or about 20’x20’. Obviously if you’re breeding miniature horses, smaller will work. If you have a draft mare, you’re going to need something bigger. Walls should be solid and able to take half-ton body blows. They also need to be free of gaps, sticky-out bits, sharp edges, and anything else that could gouge or trap part of a mare, foal, or human. The stall also needs to be thickly bedded with straw (not shavings as they tend to stick to the new foal’s nose and can impair breathing.) Have enough straw on hand to be able to completely change out the bedding once the foal is born and the placenta is passed. The wet gooey-ness makes a bacterial soup – not the best environment for a new baby. The Blood-Horse magazine website has some good tips for planning your mare barn.

d. When -- Remember how, as soon as your mare was bred, you counted out the days and circled the Foaling Date on your calendar? Forget that. Estimated foaling dates are based on the average pregnancy for a mare. That means they took a group of mares, added up the total of all of the days between conception and foaling, divided by the number of mares and took that number. Some mares deliver sooner, some later. Your mare may decide that she doesn’t want to be average.

Try not to be the person who calls the vet Every. Single. Day. after the estimated foaling date demanding to know why she hasn’t delivered yet.

However, you do want to know when your mare is likely to foal. There are a number of physical signs, such as enlargement of the udder and softening of the muscles around the tail that indicate foaling draws nigh. However, from years of experience, I can say only one definitive thing about signs of pending labor in the mare.

All of the signs will most likely occur at SOME point before the foal is born – maybe 3 weeks, maybe 3 minutes.

A more accurate way of telling when foaling is around the corner involves checking for changes in the secretions from the udder (pre-milk, if you will). Hard water detection strips (like you use to check swimming pool water) can be used to check calcium levels in the milk which will spike within 24 hours before foaling. A recent study has also demonstrated that the pH (measure of acid vs base) will drop, meaning that the pre-milk will become a little more acidic within a day of foaling.

You need a plan to keep consistent watch on your mare. Techniques for accomplishing this span the technology spectrum – though, somewhat surprisingly, I haven’t found an app for foal detection yet.

There are, however, sensors that can be sewn (by your vet!) to each side of the mare’s vulva; when the foal’s nose starts to push the sensors apart, an alarm sounds. There are a couple of potential drawbacks to this gizmo. Some mares get itchy “back there” and can rub the sutures loose, dislodging the sensors. Also, for the sensor to work as intended, some portion of the foal has to actually enter the birth canal and push against the lips of the vulva. If everything is going normally, this is great. However, in an emergency situation, such as if the foal’s head is twisted back, when prompt intervention is most needed, the sensor might not be triggered.

Another option is to install a closed-circuit camera. Check in advance to make sure there aren’t any blind spots for the camera. Otherwise, you can bet that will be the corner the mare picks to lie down to deliver.

And finally, there’s good, old-fashioned eyeball power. Frankly, even if you go with the gadgets and gizmos, you still need to supplement with frequent monitoring by a real human. Once that indicator strip spikes, plan to check your mare every 15 minutes until an extra horse appears. This is where a team approach is a very good idea. Take shifts and make sure everyone knows where to find the supplies and what normal and abnormal foaling look like. Post your veterinarian’s phone number (and the number of several other local vets for back-up) prominently throughout the barn and house.

e. How – Labor in horses is a bit different than in the human. You still have the same basic stages: Stage 1 -- Early (inactive labor) during which time the fetus (ideally) gets into position, the uterus begins contracting, and the cervix starts to soften and dilate; Stage 2 -- Active labor when the fetus is kicked out into the cold world and becomes an actual foal; and Stage 3 – when the placenta and fetal membranes are delivered.

However, in horses, things happen on a slightly different timeline. Unlike humans, horses are prey animals, and their offspring need to be born ready to scram when the coyote comes over the hill. The birthing process of horses reflects that.

Stage 1 can last a couple of days as it does in humans. However, much to the frustration of many a sleep-deprived foal watcher, the mare can interrupt Stage 1 labor if she feels threatened or insecure. Noise, lights, strange horses, an incoming storm, a barking dog, or really anything that the mare’s teeny brain deems “foreign” can cause that “I know she’s going to drop this foal tonight” certainty to get delayed until you really need to go to the grocery store or out of town.

Stage 1 labor involves a lot of repositioning – both of the foal (which you won’t see) and of the mare (which you will). As baby does somersaults getting into “diving position,” the mare will likewise do much lying down, getting up, and circling. She may not eat much during this period, and some mares have very loose stools at this time, as well.

From the human perspective, Stage 2 is by far the most interesting phase of this whole foaling endeavor. Here is the main thing to know about active labor in the mare:

IT’S FAST

From the moment the water breaks (the official starting gun of stage 2 labor), you’re looking at an average of 15-20 minutes before you have a foal on the ground. Much longer than that, and you may have a problem.

But before we dive into the abnormal, let’s take a look at a normal foaling. Once the mare’s water breaks, you should see a tiny hoof and/or nose present in the vulva within minutes. Normally the foal presents in a “diving position” with his nose between the front legs, usually one foot slightly in front of the other. The nose may well be covered by the amniotic sac. You don’t need to clear that away just yet. The foal is still getting oxygen from the mare through the umbilical cord.

There may be a slight delay as the shoulders pass, but after that, the rest of the foal slithers out pretty quickly (sometimes the hips can get a little hung up, too).

Once baby is out, either mare or foal stands or moves away, breaking the cord.

Stage 3, the passing of the placenta (afterbirth), usually happens within 30 minutes to two hours after the foal is born. The placenta will look like a heavy purple-ish-red piece of slimy velvet with tentacles hanging down from the mare’s vulva.

As her uterus continues to contract, more and more of the placenta will be exposed. DON’T cut it off. The weight adds gentle traction. If it’s getting wrapped around the mare’s legs or otherwise annoying her, you can tie it up in knots. Also, don’t get overly helpful and start pulling. If the placenta tears and pieces get left behind, your mare could be in for a nasty infection. Once the placenta passes, save it in a bucket (covered and away from the dogs and cats; don’t ask how I know this) for your veterinarian to examine when he or she does the post-foaling exam.

2. When things go wrong – If you’ve read this far, you’ve gotten the hints. Sometimes foaling isn’t all sunshine and roses. Let’s look at some of the warning flags in each stage of labor:

a. Stage 1—Calm, deliberate lying down or circling is normal in this stage, but if the mare looks dramatically painful (flinging herself to the ground, rolling, sweating, etc.) something may be wrong.

While mares may drip a little bit of milk from their teats before actually delivering the foal, if your mare is streaming milk (actually colostrum) before foaling, you need to talk to your vet right away. The first milk, called colostrum, contains all of the antibodies the foal needs to fight disease in the big, bad world. If mama dumps all of that onto the ground, you’ll need an alternate source for baby.

b. Stage 2 – This is the “have your vet on speed dial” stage. When things go wrong in stage 2 labor, they need to be corrected ASAP.

i. Delayed progress – if the mare’s water breaks and you don’t see nose/foot within minutes or if progression stalls for more than 15-20 minutes at any point, call your veterinarian right away. The foal could be presenting backward (breech) or have a head or leg bent back. Do NOT try to reach in to correct a poor presentation yourself. The mare’s contractions come hard and fast and are capable of breaking a human forearm or forcing a sharp foal hoof through the uterus. Do not try this one at home, folks!

ii. Red Bag –Normally, the first sign-of-foal is a bluish-grey membrane covering a nose or hoof. If, instead, you see a bulge that looks like red velvet, run, don’t walk, for a pair of blunt scissors. That red bag is the placenta; it should normally be attached to the lining of the uterus – that’s how the foal gets oxygen. If the placenta starts to separate before the foal comes out, oxygen-deprivation sets in. You don’t have time to wait for a vet on this one. The foal needs to get out into the world and breathe on his own right away. Talk with your veterinarian before-hand on how to handle a red-bag emergency.

iii. Shoulder-lock/Hip-lock – the shoulders and hips are the widest part of the foal and can sometimes gum up the works by sticking in the mare like Winnie-the-Pooh in Rabbit’s doorway. If the foal seems stuck at the shoulders (ie. both front legs and head/neck are out, but the momentum has stopped) you can try to help by gently applying traction down and out (follow the curve of the mare’s rump) to ONE leg then the other. If that doesn’t work, call your vet.

The same sort of wedged-foal-in-a-tight-position effect can happen as the foal’s hips pass through the mare’s pelvis. Through one of those weird anatomical quirks, the widest part of the foal’s hips is turned 90 degrees from the widest part of the mare’s pelvis. Sometimes just elevating the foal’s torso and rotating it slightly (so the foal looks like it’s lying on its side) can be enough to match up the wide parts and let the foal just slither out. Again, don’t over-try. If at first you don’t succeed, call your vet and wait for instructions.

c. Stage 3 – Once the foal is out, it’s easy to figure the job is done. Not so fast. The mare still needs to pass the placenta, the whole thing. If the placenta isn’t on the ground within about two hours, call your vet. After six hours, the situation is considered an emergency. The massive inflammation caused by a placenta remaining in the uterus beyond its expiration date can cause uterine infection and even severe laminitis in the mare.

Hopefully, in the time it took to read this, you have a foal and placenta on the ground. The foal should be trying to stand within minutes after birth. (If the placenta is trying to stand, you have a problem.) The average foal will stand and walk within one hour after birth and nurse within one hour after that. Remember the coyote; a long post-natal lie-in is not normal.

Next we will peer into the future from the newborn foal to weaning.

Part 1: The Decision
Part 2: Breeding and Gestation