Epi-No or just no?

The Epi-No is a fairly polarising little piece of equipment. But the biggest question, ultimately, is: does it work?
The Epi-No is a fairly polarising little piece of equipment. But the biggest question, ultimately, is: does it work? Photo: Getty Images

I will never forget the day when I made myself a cup of tea, kicked off my underwear and made myself comfortable on the couch while alone in my house. I was 38 weeks pregnant and I was training my vagina for the marathon it was about to undergo – labour – by using the Epi-No.

The Epi-No is a German-made innovation that claims to "reduce the risks of tearing and episiotomy (stitches) during a natural birth". It's a device that looks like a balloon attached to a small air pump; the balloon is inserted into the vagina and inflated to bigger and bigger sizes over the weeks leading up to the baby's birth. 

"Used early in pregnancy to strengthen the pelvic floor muscles, Epi-No exercises change after week 36 to prepare the perineum," the website states. "Epi-No is clinically proven to significantly increase the chances of an intact perineum, increases control during delivery, and is more effective than perineal massage."

The Epi-No kit, which sells for $179 in Australia.
The Epi-No kit, which sells for $179 in Australia.  Photo: Epi-No

The idea of having stitches was unbearable to me, so I would have tried anything to avoid it – including inserting an inflatable contraption to give my bits a heads-up of what was about to go down.

There I sat, pants off, legs akimbo, breathing deeply and rhythmically whilst slowly inflating the balloon I'd carefully inserted, when I heard a key turn in the door. In waltzed my husband, and I was mortified. (Little did I know what the labour ward would bring a few weeks later.)

The Epi-No is a fairly polarising little piece of equipment; some women love it and some women hate it. But the biggest question, ultimately, is: does it work?

The professional world is divided on the device's effectiveness, according to midwife Krissy Abraham*. "There are two schools of thought: the first believes it gives women something to help control something that would otherwise be uncontrollable," she says. "The other school of thought is that it disempowers women, as it is a piece of machinery artificially doing something that has been done naturally for thousands of years."

Krissy's own midwife suggested that she give it a shot while pregnant, but she would not necessarily pass that recommendation on to her clients. "I would mention it exists, as does perineal massage, in a conversation about tearing, but wouldn't recommend it as such. Personally, and I used it myself, I didn't like it."

While episiotomies were almost routinely – and often unnecessarily – given in the 70s and 80s, these days only about 15 per cent of women require one. According to a 2011 study in NSW, 56 per cent of women suffer from perineal tearing.

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Dr Vijay Roach of the Gidget Foundation believes that perineal massage can be affective to prevent stitches – and even plenty of intercourse during the final stages of pregnancy appears to create more distension in the perineum.

He also thinks the Epi-No has its place.

"If we say here is an exercise regimen, and here's a personal trainer to do it with and a machine to do it on, it will be far more effective – so the Epi-No just ritualises the training process in the same way," he says.

While Dr Roach believes that perineal massage has merit, it only deals with one area of the vagina; the Epi-No potentially trains the entire vaginal entrance to stretch, which is logical the baby's head passes the entire vaginal entrance.

Nevertheless, it's not something Dr Roach recommends to his patients.

"Women bring it up, and they're either motivated to do it or they're not motivated to do it. Motivated women will use it, but the thing is, is it justifiable in terms of it being an expensive device? And is the outcome so good that you can justify the intervention?"

For me personally? Yes. It forewarned me of what it felt like for a baby's head to pass through my birth canal. Some people may rather not know ahead of time, but I'm a control freak, so when that moment of searing stretching hit I knew what to expect, and to stay relaxed.

That said, with my second child, she came out with her arm next to her head. No amount of Epi-No could have helped me avoid my date with a doughnut cushion.

*Surname has been changed.

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