Foaling isn’t always straightforward. Here’s what breeders watch for.
Most Thoroughbred foals are born without drama. But when things go wrong, they go wrong fast – and the risks can be fatal. That’s why commercial breeders, unlike in the wild, keep mares under constant surveillance as they approach their due dates.
Understanding what’s normal – and what’s not – can make the difference between a safe delivery and a problem.
The three stages of foaling
Thoroughbred foaling usually happens quietly in the middle of the night. Stage One can drag on for hours as the mare prepares. Stage Two, the actual birth, should be over in 20 to 30 minutes. And Stage Three involves expelling the placenta. All three stages are closely monitored.
Stage One: Early labour
In this phase, the mare’s uterus begins contracting and the cervix dilates. The foal shifts into the correct position, front legs and head pointing down the birth canal.
From the outside, it looks like restlessness. The mare might sweat, urinate frequently, lie down and get back up, or seem mildly colicky. That’s all normal. What’s not normal is visible distress or signs of severe pain. That usually signals a problem.
Stage Two: Delivery
This is the main event. The mare experiences strong contractions in clusters, typically three or four at a time with short breaks in between.
Once her water breaks, the amniotic sac should appear within five minutes. It looks like a white or clear balloon at the vulva. Inside, you should see the foal’s hooves – soles down -followed by its legs and head resting on or between the knees. One foreleg usually presents slightly ahead of the other.
Once the foal’s hips clear, many mares take a pause before finishing the job.
Stage Two should take no longer than 30 minutes. Delays, excessive bleeding, or abnormal positioning are red flags that require immediate veterinary help.
Stage Three: Expelling the placenta
The placenta should be passed within 30 minutes to three hours after birth. If it’s still inside after that, the mare is at serious risk of infection, laminitis, or worse. Close observation doesn’t stop when the foal hits the ground.
Seven complications that require urgent action
Even in the best-managed foaling operations, things can go wrong. These are the most common complications seen in Thoroughbreds, and how they’re managed.
1. Dystocia (difficult birth)
Roughly 10% of foalings involve dystocia, where the foal gets stuck or fails to present normally (Frazer, 2003). Causes include:
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malpositioning (breech, head turned back, leg retained)
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a foal that’s too large for the mare’s pelvis
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uterine inertia (ineffective contractions)
If 30 minutes pass without progress, intervention is critical. Vets may need to reposition the foal or perform a caesarean.
2. Retained Placenta
If the placenta isn’t passed within three hours, the mare is considered to have a retained placenta. This affects 2–10% of Thoroughbred mares (Miller & Kane, 2012).
Retained placenta can lead to severe complications: uterine infection, laminitis, and systemic illness.
Signs include visible placenta at the vulva, fever, discomfort, or foul discharge. Treatment involves oxytocin to encourage contractions, possible manual removal, and antibiotics.
3. Red Bag Delivery (Premature Placental Separation)
When the placenta separates from the uterus too early, the foal’s oxygen supply is cut off. That’s known as a red bag delivery.
Instead of the normal white sac, you’ll see a thick red membrane emerging at the vulva. It’s a medical emergency. The red bag must be ruptured immediately and the foal delivered fast to avoid asphyxiation.
4. Umbilical Cord Issues
Problems with the umbilical cord can include excessive length, twisting, or wrapping around the foal.
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Entrapment can restrict movement and blood flow
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Premature rupture can cause blood loss or oxygen deprivation
Often these issues aren’t spotted until after delivery. Signs include abnormal bleeding or foal distress. Management focuses on stabilising the foal and treating any trauma.
5. Uterine Rupture
Rare, but deadly. Uterine rupture is often caused by prolonged labour or rough internal manipulation.
Signs include shock, signs of colic, and visible haemorrhage. Emergency surgery is required, and survival depends on how quickly it’s caught.
6. Dummy Foal Syndrome (Neonatal Maladjustment Syndrome)
Dummy foal syndrome typically appears right after birth. It’s thought to be caused by oxygen deprivation in the womb, and it affects the foal’s brain function.
These foals may be disoriented, weak, or unable to nurse. Treatment ranges from IV fluids to a technique called the Madigan Squeeze, designed to “reboot” the foal’s nervous system (Madigan et al., 2012).
7. Uterine Prolapse
Another rare but critical emergency, uterine prolapse happens when the uterus is pushed out of the mare’s body post-delivery, usually after difficult or excessive straining.
The uterus will visibly protrude from the vulva. It needs to be cleaned, replaced, and treated with antibiotics and anti-inflammatories as soon as possible.
Final word
Foaling is a natural process, but when something goes wrong, there’s no time to lose. That’s why Thoroughbred breeding operations stay alert around the clock. Early detection and intervention save lives. And as equine medicine advances, survival odds for both mare and foal continue to improve.
