A Sequential Pictorial Essay of a Foaling

Most commonly, mares are best foaled inside where observation is easy. The disadvantage with foaling in the pasture is the loss of that ability to monitor the mares at night - it is no fun trying to deal with a dystocia by the lights of your pick-up truck! In this instance however, the mare was turned out through the day, and was observed to be entering the first stages of parturition in the late afternoon. The advantage of foaling in a good clean dry pasture (presuming suitable weather of course!) is that it will typically be cleaner than the cleanest barn - research has shown that pressure-washing faced concrete with a bleach solution will still not necessarily get rid of all pathogens! Sunlight however is a great anti-bacterial agent. We would reinforce the necessity of good fencing, good weather, and a clean pasture though. In this case, the mare chose to lie down in the hay round bale!
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Wrapping the tail (note that ground tying the mare to do so may not be recommended with all mares!)

The wrapped tail will prevent stray hairs interfering with the foaling process, and also keep the tail cleaner

During the early stages of labor, it is not unusual for the mare to get up and down several times. She is typically repositioning the foal, or may just be plain uncomfortable!

There can be a lot of "hurry up and wait" during stage 1 of labor! Mares have even been known to remain in this stage for a day or more! Monitoring is recommended, and if in doubt, consult your vet!

Sometimes the mare will appear to stop being uncomfortable and wander off and eat for a while, or possibly eat and scratch her butt in this case...

...only to resume signs of discomfort a little later - biting at the flanks, or signs suggestive of colic are typically indicating uterine contractions.

Don't confuse urination with the "waters breaking" - there's a lot of pressure on that bladder, so frequent urination with low volume is common!

Finally the mare does lay down, and...

...very shortly afterwards, the "waters break" - meaning that allantochorion ruptures, and the allantoic fluid is released.
The allantoic fluid will look a lot like urine - and it is in fact comprised primarily of fetal urine.
Within 20 minutes of the passage of the allantoic fluid, the white amniotic membrane should become visible. If the membrane that appears is red, do not hesitate to intervene and rupture that membrane manually, seeking the white membrane within, and manually encouraging passage of the foal. A red membrane is indicative of a "red bag delivery", meaning that the allantoic membrane failed to rupture, but rather is separating from the lining of the uterus, and the foal is in danger of suffocation.
Within the white membrane, you should now see the appearance of a foot, followed shortly by another foot, and then the nose. If you have seen the appearance of the white membrane, and no foot within 20 minutes, or a foot and no second foot or the nose within 15 minutes, you should - if experienced in foaling - determine the position of the foal, or if not experienced, get your veterinarian out - you may be looking at a dystocia (malpresentation) situation, and time is of the essence to achieve a healthy outcome (and even then, you may not).
Hopefully now the foaling will move ahead with the minimum of difficulty. Many people feel the uncontrollable need to step in and "help" the mare, but unless there is an obvious inability on the mares part to be able to pass the foal herself, leave them alone! Unnecessary interference at this stage can give rise to all kinds of future complications ranging from cervical damage (due to pulling before the cervix is adequately relaxed) through to a mare developing uterine inertia - a lack of desire to push - in future foalings, as she is waiting for someone else to do the work (and this may be a major issue if that someone else is not there to assist!)
Notice the natural passage of the foal toward the hocks. If assistance is required, in most situations pulling toward the mares hocks in conjunction with the contractions is recommended. There may be some emergency situations where this is not recommended, and rapid extraction is desirable, but in most cases the "toward the hocks in conjunction with contractions" rule will apply. Once the chest is out of the mare, manual rupture of the amniotic membrane should be performed if it has not naturally occurred. Note that the foal cannot breath until its chest has passed out of the mare and is able to expand (and draw in air). Remember too that there will still be oxygen transfer achieved through the placenta and umbilicus until the shut-down of placental-umbilical blood movement and separation of the umbilicus.
As long as the mare is quiet and prepared to remain laying down, we like to gently manipulate the foal toward the mare where she can see it easily, and possibly touch it. We try avoid disruption at this stage to keep the mare down as long as possible, as we want the umbilicus to separate naturally rather than prematurely by the mare getting up or moving. The natural separation indicates the close-down of placental blood transfer, and although if there is a premature separation, the amount of blood loss is minimal (although it looks a lot!), and not a major cause for concern, the natural shut-down process has been associated with increased uterine contractions and a lower incidence of retained placenta, so awaiting the natural rupture of the umbilicus is usually preferable.
At the time of umbilical separation - natural or not - placing the hand on the foal's abdomen while gently pinching the umbilicus is desirable to provide abdominal support. This reduces the stress placed on the umbilical/abdominal junction, and reduces the likelihood of an umbilical hernia. Once separated, the umbilicus should be dipped in a solution of ½% chlorhexidine. Iodine has been used by many for years, but has been found to be caustic enough to actually cause tissue damage and increase the risk of umbilical damage, leading to a potentially higher incidence of patent urachus or even umbilical hernia. There is however a need to dip the umbilical stump more frequently with the chlorhexidine - 3 or 4 times a day is recommenced for the first 3 or 4 days, or until the stump is dry and sealed. Take a piece of string, tie up the placenta to itself to avoid the possibility of the mare stepping on it while rising or waking after foaling - either of which could result in breakage of the membrane, and a loss of hanging weight that encourages complete passage of the placenta. This would result in a higher risk of retained placenta. We then like to move the foal within easy reach of the mare, and withdraw ourselves while monitoring the situation from a little distance away, allowing the mare and foal to bond.
The foal will usually try to get up before too long - often with some ungainly results! Again, don't feel a need to rush right in there and become involved - the foal is learning, and if the foaling area is safe will be unlikely to come to any harm even though the crashes can look quite bad! Remember how many times you skinned your knees as a kid?
Before too long, the foal will most likely start to look seriously organized about getting up, or the mare herself may show signs of wanting to rise. It is desirable to wash off the mares udder at this point, using just warm water, and prior to the foal nursing. Research has shown that washing the udder prior to nursing significantly reduces the incidence of neonatal septicaemia - which makes a lot of sense when one thinks about it, as the udder is not really very clean, and the foals gut can absorb any large molecules it encounters within about the first 12 hours after birth. Preferably those large molecules will be immunoglobulins in the colostrum, imparting antibody protection, but they could be bacteria as well, so the fewer bacteria encountered, the better!
The foal will probably get up soon, and be more organized about how it tries, so now a little assistance may be beneficial - just a balancing hand is best, a bit like you're teaching your child to ride a bicycle... be ready to prevent a serious crash, but just assist with balance if you can! Eventually those long legs will get set at each corner, and the foal will be standing alone - albeit a little wobbly!
It is worth noting that even though this appeared to be a textbook foaling of this maiden mare, with no complications, she did retain her placenta for about 4 hours. Upon dropping it (after oxytocin treatment), evaluation showed that there was a piece missing, and we were obliged to retrieve it manually from the uterus. This clearly demonstrates that it is important to maintain careful monitoring not only prior to and through the foaling period, but also afterward! If this mare had been left to foal unattended without monitoring, although the foaling itself would have passed "without a hitch", the mare would have become severely sick and quite possibly have died as a result of the piece of placenta that broke off and was retained within the uterus. Had the mare been left to foal outside unattended, it is most likely that some sort of scavenger would have retrieved the placenta before a human, and evaluation - showing a piece missing - would have been impossible. The sequela would almost certainly have been a severely sick mare 24-48 hours later. It therefore goes to show that one can never be too watchful at foaling time!

Foal details:

Dam: Morticia (Mannhattan x Fabergé by Frohwind)
Sire: Escudo II
Born: May 23rd, 2008

"Edward" is now almost grown up and is standing at stud!
Current details about him and pictures of him can be seen on his page on Avalon Equine's website.

© 2008
Photographs by permission of and © Reg Corkum
Used by Equine-Reproduction.com with permission.