Red Bag Birth or Placenta Previa Birth

Initially I was going to list this under our "Dystocia" Page, but this is a unique problem that doesn't fit in that category.

This series of articles is based on our experience as horse breeders and foaling many hundreds of horses over the years.  We are NOT veterinarians and we are just sharing our experience with you.  You should discuss with your veterinarian the possibility of problems during your foal's birth and follow the subsequent advice given and be sure to do this before your mare foals.  Always be sure to have a way of contacting your vet when your mare is ready to foal.  Problems can and do occur and your vet is your SECOND line of defense after your own knowledge.

This situation is called " a Red Bag Birth" because that's what it looks like. It's not exactly a dystocia because the foal is almost always presented in a proper birthing position.  There are apparently many possible causes for it, which we don't need to go into here.  We haven't had this happen often but a friend of ours has had three of these in as many years.  Your vet is a good source for those answers. Instead, this is how to deal with the problem!

In a normal birthing process, the foal breaks out of the the placenta inside of the mare with a white birthing sac around it.  The mare's water gushes, and soon after one will see a "white bubble" emerging from the mare's vulva. The white bubble is the birthing sac.

For a Red Bag birth, the mare is down and contracting.   Usually, no water gushes out;  instead, the first thing we've seen was a mass of BRIGHT RED poking out.  This means grabbing the scissors or a knife from the foaling kit IMMEDIATELY (A person's sharp nails and shear strength also work. We've read that some people use tongue depressors cut to a point.) .  You literally have only minutes when presented with a foaling of this sort.  The placenta is no longer attached to the uterus.  The foal, who will try to breathe, will breathe in fluid. 

As soon as we have enough of the Red "Stuff"  to grab hold of, we  tear and cut, being careful not to touch the foal with whatever we're using to get through the placenta.  Then, we reach in, break the white bag (amniotic sac)  and begin pulling the foal out in time with the mare's contractions. We pull downwards towards the mares hind legs.

Interestingly the water that you'd expect to come out FIRST, comes out AFTER the placenta.   So, be prepared to be "doused".

The reason for urgency is that when the placenta detaches WITH the foal, as described, it means the foal is no longer receiving vital blood flow and oxygen through its umbilical cord.  It is only a matter of a few minutes before it either suffocates or is brain dead.

Once the foal is born, another interesting situation arises.  The foal is still directly connected to the Placenta with its ubilicus, and bacteria from the air and barn is hitting the Placenta.  It's extremely important to break the cord as quickly as possible.

There is a "weak spot" or narrow area in the umbilical cord which we have taken advantage of by pulling or stepping on one side and moving the foal away, allowing for a natural break.   This spot is close to  the foal and is usually pretty obvious.  However, this isn't always possible.  The other method is to tie off the cord an inch or so away from the foal's umbilicus with a disinfected string, and then cut it on the outside, AWAY from the foal.  It's vital to douse the foal's navel and stump area immediately after the break occurs and repeat the dousing a few times over the foal's first few hours of life.

A major concern with a foal that was a result of a "Red Bag" birth is Septicemia.  This is when bacteria managed to enter the foal through the umbilicus prior to either disinfecting it and/or prior to the foal receiving its colostrum (first milk).  So keeping a watchful eye on the foal over its first 24 to 48 hours is extremely important.

See the article about a "Septic Foal" for more information and what to look for.