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Hello, I'm Dr. Deb and will do my best to help you today.
I'm sorry for this concern for your girl. I do have a few additional questions to ask about her if you don't mind:
1. How long ago was the last puppy delivered?
2. Is she actively straining at all? If so, for how long?
3. I assume she's resting quietly and taking care of the 3 puppies she's already delivered?