Large Puppies- Often it appears as though its natures way to make the first delivered puppy to be one of the biggest puppies. There may be the reason behind it, eg, to open up the birth canal, or it may just be bad luck. Either way, big puppies can cause some serious problems.
If your bitch has been straining for 30 mins, but not really getting anywhere, my first thoughts is that it is a large puppy. I would first weigh up my options: First; can I see the puppy? Is it creating a perineal bulge? If I cannot see the puppy, am I able to feel the puppy if I do an internal on the bitch? If I can see or feel the puppy, things are more promising than if the bitch has been straining for 30 minutes without pushing things further down the birth canal.
If the puppy can be seen or there is a perineal bulge, then you may have to help the bitch open the vulva. Firstly paste the labia with Obstetric Gel (KY Jelly). With your thumb and forefinger of your non-dominant hand, spread the labia of the vulva as she contracts, (she WILL likely squeal and possibly bite, but desperate times call for desperate measures) this is often enough to get either the head out (or the bum if breech), although it maybe necessary to try this several times. Then with a towel in your dominant hand, provide traction to the puppy (as demonstrated in the diagrams) and pull down and towards the bitches belly button (as though making a U-Turn) on each contraction.
If you cannot see the puppy but the bitch has been straining for a while, you should insert the obstetric gel into the bitch as far in as possible. Sometimes it is a case that the bitch may have dried out, making it difficult for the puppy to slide out, especially if the puppy is on the larger side of "normal". Using the feeding tube and a syringe is the easiest way. Try to make the insertion as sterile as possible.
It is important to remember: You cannot kill a dead puppy! If a puppy is left stuck in the birth canal it will die, and often causing the puppies behind it to die also. If a puppy is stuck, you have nothing left to lose by being aggressive in getting it out. But be warned, the bitch may bite you.
Image: the direction in which to pull a puppy
Presentation of 2 puppies: Every breeders worst nightmare, but luckily isn't that common. The bitch again has been straining for a while and you either see 2 sacs presenting, or perform an internal and feel 2 obstructions. Again, you need to try and paste the birth canal and vulva with obstetric gel. You need to decide which (if any) of the pups is the furthest one out, or the larger of the 2. This is the one you are going to allow out first. To do this, you need to try and push the other pup back up the canal, to allow easy passage for the other pup. Think of it like 2 people crashing in a doorway as they are both trying to get through at the same time. One person needs to hold back and allow the other to go through first.
Breech Births- Aren't actually that common. Mostly people mistake puppies that come out back legs first as a breech birth. These are not breech births. Breech births are BUM first, ie, their back legs are folded up by the puppy's abdomen and the tail and bum are the only things to protrude. A puppy stuck with its head inside the bitch must be got out very quickly before it tries to breathe and drowns. Apply most of the techniques you would do for a Large puppy, mentioned above.
One leg Presentations- In a way, this is similar to 2 puppy presentations, only much easier to cope with. Basically, you need to try and get it so that both legs are facing the same direction, making it easier for the puppy to slide out. Legs can get stuck and prevent the puppy from leaving the birth canal.
You need to push the one leg back inside the bitch and have a feel to see if you can get the other leg down. If not, continue with (obstetric gel covered) hands to feather the bitch, which will hopefully try to strengthen the contractions.
If all else fails use a towel to grab the puppy and pull (towards the dams belly button) on each contraction, but remain traction of the puppy in between.
Do NOT allow the bitch to strain for more than an
hour without producing a puppy!!! Ring the Vet!!!