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					Originally Posted by RobinC  But isnt there a greater chance of them getting fluid in their lungs by ripping off the sac? | 
 
  I have not heard of this or been told there was a greater chance.  Sometimes, if a bitch has one puppy already good and nursing, they'll tend more to that pup than helping another out of the sac. 
We use to raise bassetts and we lost a pup once because Tabitha was too busy with the one she had and never tore the sac off the other.