Equine Dystocia – When It All Goes Wrong

By Garrett Metcalf, DVM

The definition of equine dystocia is a very simple definition which means “difficult birth”. The simplicity of the definition does not disclose the serious and heart wrenching distress that these words create among the equine community and veterinarians. The word alone among breeders can make them quiver in their skin. This article will discuss how to recognize and address equine dystocia.

Dystocia is a very life threatening situation for the mare and the foal. There are important steps and information that need to be readily available to make quick calculated decisions about the situation. First, it is really important to have accurate breeding dates to know the gestational age of the foal. This helps determine the maturity of foal and the likely survivability of the foal. Another key piece of information is whether or not the mare received an ultrasound exam to confirm the presence of only one fetus. Although twins are rather rare to survive to term, it does pose a serious issue in a mare having a difficult birth.  Twin foals also have a very poor survival rate of less than two percent and need to be known for owners or breeders to fully understand the circumstances. Lastly which life is more important to save? Unfortunately in some situations the foal is more valuable than the mare and occasionally can be sacrificed to save the foal. This issue arises more with recipient mares.

The timing of foaling is very important. If you have ever witnessed a foal being born, you better not look away for long or you will miss the entire show. There are three stages of labor in a mare. First is usually the longest which ranges from one to four hours. The mare will be restless, pacing, flank watching, she may become colicky and sweating. Stage two is marked at the beginning by water breaking and the end of the stage with the foal being delivered. Uterine contractions will begin and parts of the placenta will be exposed from the vulva. The first part of the foal that should be exposed is the front feet and they should be facing the ground or downwardly. The next part of the foal is the head situated near the knees, then shoulders and torso.  The foal will be wrapped in a semitransparent thin membrane called the amnion. This doesn’t always rupture during foaling and needs to be removed from the foals head to allow them to breathe once the delivery is completed. This stage takes 15-20 minutes and should not last more than 30 minutes. If the foal is not out by then that is when panic sets in or it should. The third stage is passing of the placenta or afterbirth. The placenta should be passed within three hours after the foal is born.  A quick rule of thumb for foals is the one, two, three rule. One hour to stand, two hours to nurse and three hours the mare passes her placenta.

Foals can have multiple different presentations that are incorrect during foaling and various reasons for not presenting properly. Short lists of reasons include limb deformities or limb contracture, placentitis, in utero infections, prematurity/dysmaturity and maiden mares. Now back to the panicking part. Once the water breaks and the mare is in stage two labor the feet should be presented from the vulva within 10 minutes and if it takes more than 15 minutes a vaginal examination of the mare should be performed. The examination helps to identify the lack of progression of the delivery, potentially the position of the foal and the seriousness of the issue at hand. If a person without experience or the skills to help assist the delivery at this point needs to be calling their veterinarian for assistance because time is of the essence and the clock is winding down quickly.