Horse Side Vet Guide ®

Equine Health Resource

Foaling, Red Sac Shown, Red Bag Delivery

Code Red - Call Your Vet Immediately, Even Outside Business Hours

Code Red - Call Your Vet Immediately, Even Outside Business Hours

  • Questions coming up around foaling should usually be discussed right away with your vet.

A well known foaling emergency is the presentation of a “red bag” at delivery. In a normal foaling, the amnionic sac, a translucent pale membrane, appears and is rapidly followed by the foal’s feet and head.

If instead you see a red, velvety-looking, opaque “red bag” before the foal is born, it means that the placenta has prematurely detached from the uterus, and the unborn foal is no longer properly sustained by the mare’s circulation. This is premature placental separation and it is a life-threatening emergency for the foal. The foal must begin breathing on its own immediately, or it will suffocate.


Call your vet immediately. Unless your vet can attend to the situation within minutes, ask them if you should cut the red bag and deliver the foal yourself. Your vet may guide you over the phone. See also the related Skill “Assist Foaling Mare, Pull Foal”

In the case of a red bag delivery, carefully but rapidly cut the thick red bag with a pair of scissors. To cut the bag, simply make a small snip in the bag with the scissors before making an aggressive cut or tearing the placenta with your hands. In this way, you are certain not to cut the foal inadvertently.

After the crisis, the foal is at risk for HIE (Hypoxic Ischemic Encephalopathy a/k/a Dummy Foal Syndrome). Watch the foal carefully. It should rise to its feet and nurse soon after birth.


Following a red bag delivery, your vet should perform a post-foaling exam on foal, placenta and mare. In some cases, the foal will require special care.

Author: Doug Thal DVM Dipl. ABVP


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