Dystocia (Difficult Birth) in Horses

Dystocia (Difficult Birth) in Horses - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost
Dystocia (Difficult Birth) in Horses - Symptoms, Causes, Diagnosis, Treatment, Recovery, Management, Cost

What is Dystocia (Difficult Birth)?

If your mare has not delivered after 30 minutes since rupturing of the waters, or if second labor does not begin within three hours of the first stage, then an examination is vital for both mare and unborn foal. Having your veterinarian at the birth is advisable especially if this is your first experience with a pregnant mare, as complications do happen and having immediate help on hand is often vital.

Difficulty of your horse giving birth may be due to the unborn foal’s presentation, position or posture within the pelvic canal.

Symptoms of Dystocia (Difficult Birth) in Horses

Dystocia is one of those conditions that you can’t predict, it just happens during the process of birthing. Although your mare started giving birth, if it has halted, she is in distress, or the process is obviously very labored, then a difficulty must be considered.  

  • Stage one has gone on far too long (usually it takes between 1-4 hours) 
  • One foot or no feet are showing but nothing else is happening (stage 2)
  • Rolling by your mare is normal as she tries to position the foal


  • There are three stages of birth, with dystocia happening in either stage one or stage two
  • Stage one - Foal properly aligned in the birth canal, up to six hours 
  • Stage two -  10-30 minutes, the foal presents and is delivered
  • Stage three – 1 hour, the placenta and involution of the stretched uterus 
  • Dystocia occurs when your mare cannot birth the foal due to the positioning 
  • It may present upside down
  • One foot or both feet back is very common
  • Neck presentation is wrong, often the foal is dead 
  • Foal is backwards – A difficult presentation and caesarean must be considered
  • The birth of a foal in dog sitting position is very difficult


Causes of Dystocia (Difficult Birth) in Horses

  • Hard to predict and usually there are no warnings
  • A quick response time to assist your mare and knowledge of the birth stages helps
  • Having your veterinarian on call or present is the best practise if you are a novice with this all
  • Caused by the position that the unborn foal is in and whether it turns and presents itself or not
  • Often the contractions and the mare’s movements (getting up and lying down and even rolling) will reposition the foal 
  • A young small mare has been bred to a large stallion resulting in an overlarge foal that the mare cannot expel
  • Infection within the uterus and birth sac has occurred and the foal is dead or compromised 
  • The foal may be dead or deformed 


Diagnosis of Dystocia (Difficult Birth) in Horses

Diagnosing dystocia is straightforward. When your mare goes beyond stage 1 and 2 allotted time or there is obvious distress, then that is dystocia. Being prepared and knowing what to do to help is not easy but is vital, not only for your anticipated new foal, but for the mare herself. Doing the wrong thing like using three or four men to haul out a foal may cause irreparable damage to your mare. Remember that hygiene is important here, if you are assisting the birth and reaching inside your horse, your hands must be scrubbed and sterile so that you don’t introduce any bacteria at this vulnerable time for your horse. 

Having a veterinarian present can save precious moments and you can learn from him or her what the right way to assist is. Just having an expert present will give you peace of mind that your mare is getting all the right help. Often it is the lack of knowledge that causes complications when helping with the birth. Your mare deserves the most efficient and humane help possible in a case of dystocia.  In the worst-case scenario, a caesarean may be the only option and that requires veterinary help. Having a veterinarian on site during the birth allows accurate, timely decisions to be made.



Treatment of Dystocia (Difficult Birth) in Horses

Opinions vary as to whether It is better to have your mare give birth in her familiar home, or in a professional setting. Some feel the stress of moving her and the unfamiliar territory will only add to her distress and may interrupt the normal bonding process when the foal is born. A veterinary specialist can assist with most events in the birth process right there at the farm.  Usually your mare is quite capable of delivering herself, and if so can be left to her own devices (although keeping her under observation just in case there is a problem).

When there is a problem, the solution is to reposition the foal inside the birth canal to allow normal birthing. With sterile hands and lubrication to allow ease of entry, gently assisting a leg to come forward or whatever needs to be done that will allow nature to take its course is often the solution. However, in really difficult cases such as a breech or ‘dog sitting’ position, other alternatives need to be considered such as a caesarean which may be the reason that some prefer to have the horse give birth in a clinical setting.



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Recovery of Dystocia (Difficult Birth) in Horses

In the event that you managed to rearrange the foal’s position and it slid out to join its mother, then you have done well and both the mare and foal will recover from their ordeal. Sometimes, the foal may need resuscitation or oxygen as the longer it takes to be born the more risks of compromise are possible, while your mare may require antibiotics. Hopefully your mare passed the placenta and her uterus will return to near normal.

If a caesarean was performed, then healing will take some time but recovery to full health is usually assured. Knowledge is the most valuable tool to have here. Just keeping calm and assisting your mare through this traumatic time is a sign of great management. keeping mom and foal private, with good food and water, care and attention will enable the mare and foal to recover and regain their strength.



Dystocia (Difficult Birth) Questions and Advice from Veterinary Professionals

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