Dystocia in Beef Cattle – Managing Malpresentations Tips for Manipulating the Calf.

 By Heather Smith Thomas.

 One of the major causes of dystocia is simply a calf that’s a little too large to fit easily through the birth canal—a problem that can be reduced by using bulls that sire smaller calves.  Sometimes, however, a calf can’t be born because he’s not positioned correctly to come through the birth canal.  The cow may seem to be in early labor too long, or may break her water (which often signals the end of early labor and beginning of active labor as the bag of fluid is pushed ahead of the calf into the birth canal) and then she does nothing.  She may or may not start straining.  Strong abdominal straining is only stimulated when some part of the calf starts through the cow’s pelvis.

Before labor begins, the full-term calf is in a position that takes up the least space in the uterus.  His neck is bent, with head tucked close to the body, and his legs are flexed; knees and hocks bent, with feet drawn up close to the body.  When the cow goes into labor and uterine contractions put pressure on the calf, his head and neck extend and his forelegs straighten.  This head and front-feet-first position is the most streamlined, and the only way the average calf can fit through the limited space of the cow’s pelvis without assistance.

At the beginning of labor the first part of the calf to press against the dilating cervix is usually his knees, but 30 minutes later the legs have straightened and his feet are entering the cervix.  Problems arise, however, if the calf does not or cannot extend his head, neck and legs to start through the birth canal.  Malpresentations are common if the calf is too big to fully extend his legs in the limited uterine space, or if the calf is already dead.  A live calf wiggles and moves in response to uterine contractions and straightens its legs, whereas a dead calf is limp and unresponsive and more apt to be jammed into the birth canal in abnormal position.

Some part of the calf may enter the birth canal but then he progresses no farther because one leg or the head is turned back, for instance.  The cow continues to strain, however, putting pressure on the calf.  If she’s been straining awhile and nothing appears, you need to check her by reaching into the birth canal to see what the problem is.  
If the cow does not begin hard labor after a reasonable time in early labor, it may be because the calf is positioned in such a way that it cannot start through the birth canal.  If you suspect that a cow has been in early labor more than a few hours (and a heifer may take longer) but has not yet begun straining, she should be checked.  It helps to know your cows, orkeep records on their calving history.  Then if a cow who normally is a “fast calver” takes too long in early labor, you know there is a problem.  

Some malpresentations are fairly simple things that hinder forward progress, like a fetlock joint turned back, or both front legs on the same side of the head (total mass wider and tighter in the birth canal than if the head is resting above and between the legs), or the calf’s elbow hung up on the brim of the cow’s pelvis.  Other positions are more difficult to correct, such as the head turned back (not entering the birth canal), or breech presentation in which the rump (instead of legs) is aimed toward the birth canal.

Knowing what can go wrong and how to correct it can make the difference between life and death for the calf.  In some instances the malpresentation is too difficult to correct (unless you have a lot of experience), and you need to call your veterinarian.  If the problem is something simple like a leg turned back at the knee or fetlock, you can probably correct it yourself.

Since time is crucial, it pays to check the cow--to see if it’s something you can correct.  If it’s a breech calf whose legs you can’t reach, or a torsion of the uterus (in which there is a twist in the cervix and the calf can’t come through), don’t spend a lot of time trying in vain before you call the vet.  He or she will probably be able to correct it, but in certain cases may decide to perform a C-section and remove the calf surgically.  If you can recognize a problem early, and get help before the cow is in serious trouble or the calf is dead, you can save the odd cases that you’d otherwise lose.

Toe or Elbow Hung Up
Sometimes one foot is bent, knuckled under.  Once you straighten that out, the calf should come easily.  
Occasionally one or both elbows may catch on the cow’s pelvis.  In this instance, one or both feet will only advance as far as the calf’s nose, rather than extending farther out.  This means the front leg(s) is back at the elbow and the shoulder blade is thrust forward.  Sometimes all you need to do is pull on that leg and the calf will be unstuck.  If the leg(s) won’t advance easily, however, it becomes more difficult to correct because you need to push the calf back a little ways to get the elbow(s) unstuck.  The calf’s head will be in the birth canal, and your best bet is to push on the head to get him backed up.

Try to push when the cow is not straining.  This isn’t easy, because your hand in the birth canal (trying to manipulate the calf) stimulates the cow to strain and push against you.  If you can push the calf back a bit, however, this gives room to reposition the leg that was hindered by the elbow catching on the cow’s pelvis.  Then you can pull the stuck leg(s) upward in a rotating manner, to lift the elbow joint over the pelvic brim.  Once you get the leg(s) coming, the calf should come easily, but you can go ahead and pull him on out.  One reason the elbow(s) got caught might be that the calf is a little large, and might need assistance.

Pushing the Calf Back
In most instances when you need to correct the position of a leg or the calf itself, you must push the calf back into the uterus where there’s more room to manipulate limbs or head.  Push on the portion of the calf that is already in the birth canal.  If you push hardest during moments when the cow is not straining (and try to hold ground as she strains), this will be easier.

 The simplest way is to merely lean your weight against the calf continually (rather than pushing with brute strength and wearing yourself out), and each time the cow quits straining for a moment, your leaning will push the calf back.  Put your hand on his head, breastbone, rump (whatever is presented) and lean steadily, and you’ll gain a few inches between the cow’s contractions.  If the cow is standing up, it’s easier to manipulate the calf--without the pressure of her abdomen against the uterus.  

After you have pushed/leaned on the calf enough to get him back into the uterus with room to reposition him, grab and move his leg (or head) in one quick motion just after one of the cow’s contractions, bringing it around before the cow can strain again.  

Calf Sideways or Upside Down
Often a calf will be aimed a little crooked when entering the birth canal, sometimes due to slight torsion of the uterus.  Most of these calves will straighten as the birth progresses, and the situation corrects itself, but sometimes you must help.  A rotated calf can’t come through readily; he’s not streamlined in this position.

If the calf is sideways or upside down, you can usually correct his position enough to deliver him normally if you can push him back into the uterus where there is room to rotate him into correct position.  He is floating more freely in the uterus/abdomen and not as constricted by the walls of the birth canal and rigid structure of the cow’s pelvis.  It is also easier to rotate him if the cow is standing up rather than lying down.  When she’s down there is always more pressure on the uterus (and calf) from her abdominal contents; the uterus is not hanging so freely in the abdominal cavity.

Don’t start pulling on a calf until you have rotated him into proper position or you may hurt him and the cow, especially if he is completely upside down.  It’s rare to find a calf completely upside down (much more common to be a little sideways), but this can usually be corrected by twisting the legs to rotate him--if you can get him far enough back into the uterus to do so.  One way to accomplish the rotation is to have the calf help you in providing part of the necessary movement--by using one hand to provoke him into moving while putting a rotational twist on his leg with your other hand.  To stimulate him to move, press on his eyeballs (which are protected by his eyelids) with your thumb and middle finger.  This triggers a convulsive reflex movement which can greatly aid your effort to turn him.

Another thing that helps when rotating him is to cross his legs before applying traction via leg chains, which tends to turn the calf as you pull.  Push him as far back into the uterus as you can, apply the chains, and cross the legs in appropriate direction to turn him as you pull.  The crossed legs and chains should become parallel as the calf twists into proper position.  If this doesn’t turn him enough, push him back into the uterus again and repeat the process until he is in proper position to be pulled out.

If the calf is completely upside down and you can’t rotate him, it may help to have the cow lying down so you can roll her onto her back temporarily while you attempt the rotation.  It helps if her hindquarters are higher than her front end.  If this doesn’t work, or you don’t have enough helpers to roll the cow, call your veterinarian.  Then if he/she cannot rotate the calf either, there’s the option of surgical delivery.  This is especially important if the calf is backward.  An upside down backward calf may be impossible to rotate and must be delivered by C-section.

Foot or Leg Turned Back
Sometimes one or both front legs are turned back.  In these instances one front foot may appear and not the other (or just the nose appears, and no feet), and the cow makes no more progress.  If she continues to strain, she may start to push the head out through the vulva even though one or both legs are turned back.  Most calves cannot be born in this position, unless they are very small and the cow has a large pelvis; the calf won’t fit through the birth canal with a leg turned back, and definitely won’t fit with both legs turned back.  The cow will just keep jamming his shoulder(s) against the pelvis and he is stuck.

It’s best if you can discover this problem before the head is completely out, so you can push the calf back into the uterus where there is more room to maneuver the leg(s).  If the head has come completely through the vulva, this becomes much more difficult or impossible.  Get the cow up, if she will get up--since it makes it easier to push the calf back in, if she’s standing.  Not only will she not strain quite as hard, but this gives you more room to work and you’re not in such an awkward position as when lying on the ground behind her, struggling to manipulate a leg.

Push the calf back in (by pushing against his head or the point of his shoulder), and reach farther to find that leg.  A leg turned back at knee or fetlock joint is fairly easy.  You just need to straighten it and bring it into the birth canal (if it’s turned back at the fetlock joint) or push the knee up (if it’s turned back at the knee), moving the foot outward in an arc over the pelvic brim, being careful that the hoof does not scrape the sides of the uterus or birth canal.  Cover it with your hand as you raise it up, so it won’t scrape the uterine wall.  

A leg turned back at the shoulder is more difficult to reach and bring it forward.  You may need both arms in the cow, holding the calf back as far as you can (in the uterus) with one hand while you use the other hand to lift the leg up and straighten it so it can come into the birth canal.  Occasionally you’ll encounter a situation in which both front legs are turned back; all that’s coming into the birth canal is the head.  The calf usually gets stuck as the shoulders try to come through. In this situation you must push the calf back farther and get the legs straightened out one at a time.

Once you get the leg straightened (or any other abnormality corrected, so the calf is aimed properly into the birth canal), it’s easier to deliver the calf if the cow is lying down.  She can strain more effectively, and you can also get more leverage by sitting behind her, bracing your feet on her hindquarters.  If she wants to lie down after you’ve corrected the malpresentation, give her a chance to do so, then continue with the delivery.

Always be careful when correcting any malpresentation, and use lots of lubricant.    Water-soluble soaps will work in a pinch (to provide a slippery liquid) but choose a mild soap that contains no artificial scents or coloring agents that might be irritating.

When trying to straighten a leg or turn the head around, keep your hand between the calf and the uterine wall.  If you tear a hole in the wall by pushing or scraping some part of the calf against it, this will be a life-threatening situation for the cow.  Sometimes the cow’s own contractions may push a hoof or nose through the wall, especially if the calf is in the wrong position.  Tears in the uterus occur much more readily, however, with human manipulations.  A torn uterus is serious.  More than half the cows with this type of injury will die, even if a veterinarian surgically repairs the tear immediately after the birth.  So handle the calf with care when trying to reposition him.

Head Turned Back
If the calf’s head fails to enter the birth canal, this may be due to lack of space in the uterus during late gestation. If the head is bent around to one side it may be unable to extend during early labor.  One or both front feet may show, but no more progress is made.  Sometimes nothing will show.  If the front feet have appeared and the legs protrude through the vulva as far as mid cannon and there is no sign of the calf’s nose, the head is probably turned back.

The sooner this problem is corrected, the better--before the cow continues to strain.  Reach inside the birth canal to feel if the head is there.  It should be coming, 6 to 12 inches behind the feet, depending on size of the calf and length of his legs.  The head should be positioned above the legs, calf’s eyes at about the position of his knees.  If the head has not entered the birth canal and is turned back, get the cow up, if you can.  There’s always more room inside the uterus to manipulate the calf, and it’s also easier for you to get both arms into the birth canal if she’s standing.  

Put a halter on her before you make her get up, so you can tie her to the fence or stall to restrain her while you try to correct the position of the calf.  If she won’t get up, hopefully she is lying on the side that will help you the most and not hinder you (not lying directly on the part of the calf you need to work with).  You may have to roll her over onto her other side.  If the calf’s head is turned back toward her left flank, you want the cow on her right side so its head is uppermost rather than down under everything.

A head turned back can be a difficult challenge.  Some stockmen try to use a head snare (a loop of stiff cable to put over the calf’s head) to help guide it into the birth canal, but this is risky, because it may damage the uterus if the calf’s head rubs/pushes against the uterine lining as you try to pull the head around.  A chain loop around the head (and through the mouth) is also risky.  It’s better to just use both hands.  Hold the calf as far back as you can with one hand, while grasping his head with the other (taking hold of the lower jaw) to bring it up into the birth canal.  If you can get a good grip on the jaw with one hand you can usually get the head repositioned.  If you can’t reach his jaw, get hold of the corner of his mouth to pull the head around to where you can reach the jaw.

A head snare (or chain) is helpful in instances when the head is already aimed the right direction but won’t enter the birth canal--and should only be used in cows that have adequate room for the calf’s head to come through.  Even then, there is risk for damaging or cutting the birth canal with the calf’s teeth, as his mouth tends to gape open as his head is pulled with the snare or chain.

If you have trouble getting both arms into the cow, try pushing the calf as far as you can with one hand, then quickly transfer your hand to the calf’s jaw and pull it around in an arc until the nose is pointed into the birth canal.  It is much easier, however, if you can get both arms into the cow, so you can keep pushing on the calf as you reach for the jaw, and you won’t lose ground if the cow is straining.

Once you get the head started into the birth canal, put chains on the calf’s legs and begin to pull.  Keep checking, however, to make sure the head is still coming before you pull very much.  Sometimes it will flop off to the side again, until you get it well started through the birth canal.

Forehead Up, Nose Down
This presentation can be easy or difficult to remedy, depending on how quickly you discover it.  If the head is starting to approach the pelvis, you can grab the calf’s mouth or nostrils and pull the head up into position above the front legs, guiding it into the birth canal.  But if the cow has been shoving him hard against the pelvis already (or you have been pulling on the calf’s legs without first checking to make sure the head was coming through, too), and his nose is down and his face rammed against the brim of the pelvis, he can’t come through.  His head may drop down between his front legs and his neck is being jammed against the cow’s pelvis.  

You must push the calf back far enough to have adequate room for bringing the head up into proper position--and then make sure it continues to come into the pelvis when you pull on the legs.  To bring the head into the birth canal when it’s hitting the face, push on the forehead (to get the head back away from the pelvic brim) while lifting the jaw up over the brim with your other hand.

If the head is clear down between the front legs (just the top of the neck hitting the cow’s pelvis), it may be harder to get.  This problem may be caused by pulling on the calf too soon--before the head has extended into proper position for birth.  The calf must be pushed back to where there is room to bring the head up.  This may mean pushing him back enough to get one of the front legs clear back into the uterus and out of the way, to give you room to pull the head to that side and then up over the pelvic brim.  Then you can bring that leg back into the birth canal, attach chains to the legs, and pull the calf.  

In a difficult case, it may be necessary to push both legs back into the uterus in order to get the head up into proper position.  Another alternative is to rotate the calf by twisting his legs, putting him temporarily upside down--making it easier to extend his head.  Some vets recommend rolling the cow over onto her back, which may also help you more easily maneuver the calf’s head into the pelvis.  

A Few More Tips
Don’t wait too long to call for help.  Sometimes people become so focused on trying to correct a malpresentation that they don’t realize how much time has elapsed.  If you can’t get the calf’s position corrected within 20 minutes, call your veterinarian, while you still have a live calf, especially if it will take the veterinarian a while to drive to your place.

If you do manage to get the calf coming properly, the next step is to pull him out.  The best position for a calving cow is lying down rather than standing up.  When she is lying down, she can strain effectively—and gravity is working in her favor as the calf comes up over the pelvic brim into the birth canal.  The cow can help you, with her straining, when she is flat on her side.  If she’s standing up, or if she has gone down in an awkward position in a squeeze chute, you have lost that advantage.

If she’s restrained with just a halter she can get into a better position.  Some people think a cow must be completely restrained in a chute, but once you start pulling on that calf she’ll start straining harder and won’t try to run off.  Work with the cow and don’t get in a hurry.  When she strains, you pull, and when she rests, you rest.

When the calf’s body gets out past the ribs, stop for a moment.  As the ribcage is squeezed through the birth canal, if you relax your pull on the legs, the fluid in that calf’s airways will be squeezed out.  It will be easier for him to start breathing without all that fluid in his airways.  Don’t get in a hurry.  A calf born naturally, without assistance, has this fluid squeezed from his air passages as the ribcage comes through.

Once the ribcage has cleared the birth canal, it can expand, and the calf will be able to take a breath even if he hiplocks; this can buy you time to get him on out safely, because he can start to breathe if he needs to.
    
[information in this article comes from many years of personal experience and discussions with many bovine veterinarians]