The big day has finally arrived. Your
pregnant mare, the one you've been watching now for two
long, nearly sleepless, weeks, is in labor. Unused
adrenaline is making your knees tremble as you peer over the
top of the stall door, watching her as she circles and paws
the bedding nervously. Any minute, you'll see the foal
you've been planning on for the past eleven months. Her
water breaks --- it won't be long now.
You've read all the books, you've picked
your veterinarian's brain. You even brought that video that
showed several foals being born. You're ready. You know what
to do. Your foaling kit is at your feet, your phone in your
hand in case the vet is needed. You take a deep breath to
calm your jangling nerves.
Your mare goes down and starts to push,
lying flat out on her side. What is taking so long?
Shouldn't the water bag have appeared by now? Your heart
starts to pound a bit faster. Then, you see a bag appearing.
But it's not the whitish membrane you've been expecting.
Instead, it's blood red and bumpy.
It's a red bag delivery!
You've read about these, but do you know
what to do? Frantically, you dial up the vet, praying that
he is not out on another emergency. Meanwhile, the mare is
still pushing . . .
* * * * *
Red bag deliveries, or premature
placental separations, are frightening, even after you've
seen several. The foal is in immediate threat of
suffocation. Unless someone is standing by, ready and
knowledgeable enough to assist, its young life will end in
the next few minutes.
The mare herself is in no particular
danger, unless the foal is improperly positioned. Usually,
the foal, placenta and all, will be delivered normally. The
foal, trapped within the thick sack that it is unable to
break, will perish. But if you know how to assist, its life
can usually be saved.
The most important thing to remember in a
red bag delivery is that there is not a minute to spare. The
placenta, which has been supplying the foal with oxygen
throughout its gestation, is no longer doing so. The foal
will soon start trying to breathe, but it will inhale only
fluids, not air. It must be delivered quickly if it is to
have a chance at survival.
One of the most difficult things about a
red bag delivery is breaking open the placenta. It is tough
and slippery, and almost impossible to tear with your bare
hands. A knife would do it, but could be dangerous to mare
or foal should it slip, or should it be dropped in the
bedding when you have your hands full of foal. I have found
that one of the best tools for cutting the placenta is
inexpensive and safe. I use a "craft stick" (also known as a
tongue depressor) cut off on one end at a sharp angle. You
can buy bags of these at any craft store or craft
department. A heavy pair of scissors will cut them. You want
a sharp point. Stick several of these in your foaling kit.
As soon as you see the red bag, even before it begins to
emerge, use one to slice the bag open. Immediately reach
into the mare and feel for the water bag. Cut it open, too.
Then, drop the stick and reach in for the foal.
Do you feel two hooves and a nose? If so,
grasp the front feet and pull in time with the mare's
contractions. You must get the foal out quickly if you're
going to save it, but don't injure your mare in the process.
Once you get the front feet out a few inches, stagger them
so that one is ahead of the other and continue to pull.
Remember to always pull the foal down towards the mare's
hocks, not straight out. Do not wait for the mare to push
the foal out by herself. Remember that the foal is not
As soon as you have gotten the body
delivered, and the foal's chest is no longer constricted by
the birth canal, make sure it starts to breathe. You will
likely hear gurgling sounds from the fluid it has inhaled.
Gently squeeze some of the moisture out by holding the
bridge of the nose between thumb and forefinger and sliding
your hand down towards its nostrils. If you have a towel
handy, this will help as well. Stimulate the baby by
vigorously rubbing it and by scratching the ticklish spot in
the middle of its back. It should begin to try to raise its
head. If the foal is still not breathing well, or still
gurgling, now is a good time to call the vet. If you have
someone with you, have him or her do it so you can continue
to assist the foal. You may have to pick it up by its back
feet and let some of the fluid drain from its lungs.
Don't give up! I've seen some foals that
looked nearly dead survive. Keep stimulating the foal until
its breathing improves and it starts trying to get up. Then,
pull it around to the mare so that she can stimulate it
herself. But keep a close eye on it until your vet arrives.
A friend's miniature mare recently had
her second red bag delivery in two years. Fortunately, we
were present both times and saved the foals. I consulted our
equine vet shortly after the last one. One cause of red bag
deliveries, he told me, was thought to be a premature
opening of the cervix. This allows bacteria to invade the
uterus and the placenta becomes infected. He said that in
the case of a mare who has red bagged more than once, he
would recommend starting her on oral antibiotics, such as
SMZ or Metronidazole, one month before due date. He said
that in some cases, he will go in vaginally and infuse an
antibiotic as well. Hopefully, if the infection can be
stopped, the premature separation of the placenta can be
avoided. I recommend you consult your own veterinarian and
follow his advice.
Red bag deliveries are, fortunately, not
common. But they can and do happen. By preparing yourself
--- and your foaling kit --- you can keep them from being a
ADDENDUM, July, 2002: The miniature mare
mentioned in the above article was put on oral Metronidazole
one month prior to her expected due date. I am pleased to
announce that she foaled normally this year. However, two of
my miniature mares, neither with a history of foaling
problems, red bagged. Fortunately, I was present at both
births and was able to successfully deliver their foals.