The Challenge of Ringwomb in Goats
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By Cheryl K. Smith In the late 1990s, my Nigerian Dwarf doe, Katharine, developed ringwomb during her first kidding. She had gone into labor, and when I went back to check on her, expecting hard labor, I found that she had simply stopped and was eating and drinking again. She seemed unsettled, though, so I realized something was wrong.
When I checked her, I felt a kid’s head stuck with a tight band around it. Her cervix had failed to dilate enough and was preventing him from progressing. With manual dilation of the cervix, I was able to get that large buckling out, but he had already died. A tiny doeling came after him, but she lived less than an hour.
The next kidding season, Katharine had very tiny twin doelings who delivered without a problem and survived. I decided not to breed her again. However, she and one of my bucks had a different idea, and the following spring, I found myself at a veterinarian’s office having a dead doeling removed from that doe — who had again developed ringwomb.
Katharine never had more kids, but she became the “auntie” goat who stayed with the young ones when their moms went out to pasture.
I have never seen another case of ringwomb in hundreds of kiddings.
What is Ringwomb?
Ringwomb is an incomplete dilation of the cervix (opening of the uterus) at parturition. The cervix is made of muscles that hold the kids in the uterus until it is time for birth. Usually, when a doe goes into labor, an interaction of hormones and contractions of the uterus causes the cervix to soften and dilate. With ringwomb, this process goes awry, and the kid gets stuck. Ringwomb can also lead to vaginal prolapse because of unproductive straining.
What Causes Ringwomb?
The cause of ringwomb is unknown, although there are different theories. It’s been associated with various other conditions, including toxemia, mummified fetus, inflammation of the placenta (placentitis), fetal death, or uterine torsion (twisted uterus). According to studies, it’s more common in Asia and the Middle East, causing up to 25% of dystocia cases. One theory on its cause is a failure of collagen to respond to birth hormones — but we don’t know why.
Different studies have found ringwomb more common in first or second fresheners, with bucklings and with multiple kids. It may be more likely in first or second fresheners partly because some animals are withdrawn from production after an initial bad outcome.
A graduate thesis on ringwomb in sheep, which looked at lambing records from two flocks over 12 years, concluded that the condition can have a genetic component as an autosomal recessive disorder. (One mutated gene from each parent; they are not affected, but offspring are.) Researchers reached this conclusion because the incidence of ringwomb increased when those sheep were inbred and, in twin ewes, one may have it, and the other never does. The author pointed out that researchers found the condition in both twins if nutrition issues, disease, or adverse weather caused it.
How is Ringwomb Treated?
The best treatment for ringwomb — to save both the dam and kid(s) — is cesarean section, with one study showing a success rate of 94%. But we know this is not always an option for goat keepers. Some may not have access to a veterinarian or be able to afford it, or their vet may not be available during the emergency. In these cases, another solution is needed.
Prostaglandins. A paper published in Saudi Arabia in 2011 looked at using prostaglandin injection to deliver kids that had already died due to ringwomb to save the dam. They did ultrasounds on does with ringwomb, and those with live kids got a cesarean section and treated those whose kids had already died with the prostaglandin. 69% of the does treated with this method had fully dilated cervixes within 42 hours, and kids were able to be delivered.
This study and others led me to wonder whether veterinarians in the U.S. use prostaglandins for ringwomb in goats. I talked to my veterinarian, Keelan Rogers, about this issue. He affirmed that a c-section is the best alternative for saving both doe and kids. If he could not do a c-section on a current client’s goat, he would encourage them to try another alternative, such as calcium, prostaglandin, or manual dilation, recognizing that the kid(s) may not survive. He also expressed that if a cesarean is performed, timeliness is essential — does are at higher risk of mortality the longer their kids have been dead.
Lutalyse (prostaglandin) in goats is off label in goats in the U.S. and must be used under a veterinarian’s advice and prescription. Handle with caution because it can absorb through the skin, lead to miscarriage in pregnant women, and may cause bronchospasms.
Manual Dilation. Goat keepers without access to a vet or confident enough to avoid a cesarean may attempt careful manual dilation. Be aware that the success rate for this method is quite low, and the risk of problems is high. First, ensure the doe is in second-stage labor (she has been pushing). Do not intervene before that. Wear gloves to avoid infection for both you and the doe, and use plenty of lubrication throughout the process. Gently put a finger or two inside the cervical opening. This will feel like either a donut hole or a ring around the presenting part of the kid. Stop during a contraction. Be patient and do not use force; move fingers gently inside the cervix in a circular, massage-like process. Do not break the membranes. Be very gentle to avoid cervical or uterine rupture or hemorrhage. Banamine may be given for pain. Do not give oxytocin.
If the cervix seems to be opening with manual stretching, add fingers. It is important to stop every five or six minutes to relubricate and minimize pain to the doe. Do not continue the procedure for more than an hour if there is no progress.
When considering the option of manual dilation, remember that the sooner the kids get out, the greater their chance of surviving. If the placenta is visible, time is of the essence. After you intervene, it is also essential to provide a course of antibiotics to avoid metritis (uterine infection).
Ringwomb is not common in goats in the U.S., but it happens often enough that identifying, understanding, and promptly treating it is essential to save both dam and kids. Cesarean section is the treatment of choice, but some goat keepers cannot afford it or may not have access to a veterinarian, so they need to rely on another alternative. The cause of ringwomb is unknown, and more study is needed on why the natural surge of prostaglandin that opens the cervix is not occurring.
- Ali, AMH. 2011. Causes and Management of Dystocia in Small Ruminants in Saudi Arabia. Qassim University 4(2): 95.1081.
- Harwood, David. 2006. Goat Health and Welfare: A Veterinary Guide. Wiltshire, England: Crowood Press.
- Kerr, Nancy Jean. 1999. Occurrence, etiology and management of ringwomb in ewes. (Graduate Thesis, West Virginia University.) https://researchrepository.wvu.edu/cgi/viewcontent.cgi?article=1984&context=etd
- Majeed, AF, and MB Taha. 1989. Preliminary study on treatment of ringwomb in Iraqi goats. Animal Reproduction Sci 18(1–3): 199–203.
- Smith, Cheryl. 2020. Goat Midwifery. Cheshire, Oregon: karmadillo Press.
- Smith, Mary C, and David M Sherman. 2009. Goat Medicine, 2nd ed. Ames, Iowa: Wiley-Blackwell. Pp. 603–04.
Cheryl K. Smith has been raising miniature dairy goats in the Coast Range of Oregon since 1998. She is the managing editor of Midwifery Today magazine, and the author of Goat Health Care, Raising Goats for Dummies, Goat Midwifery, and several e-books related to goats. She is currently working on a cozy mystery set on a dairy goat farm.
Originally published in the March/April 2023 issue of Goat Journal and regularly vetted for accuracy.