It’s the part of natural childbirth that many women are the most squeamish about: just how much ‘stretch’ will be required to deliver this baby… and how much is it going to hurt?
During childbirth the opening of the vagina must expand to 10cm to allow the passage of the baby’s head. This sudden expansion can cause tearing.
In fact, the incidence of some form of perineal trauma in first pregnancies is approximately 80 per cent. Half of those are episiotomies, and half are due to spontaneous tears, not all of which will need repairing.
Perineal massage can prevent tearing but it can be difficult to do in the third trimester; this is where EPI-NO comes in.
A portable device developed in Germany, which has a good record in supporting and encouraging natural birth, the EPI-NO accustoms the vagina to the stretching required in childbirth and facilitates its return to normal afterwards. Perineal injuries are generally the result of spontaneous tearing or of an episiotomy, often both. Clinical evidence shows EPI-NO training reduces this risk.
So how does it work?
The EPI-NO has two uses, first in the early stages of pregnancy to strengthen the pelvic floor muscles and support the added weight of pregnancy and later after Week 36 to stretch the vagina between 8cm and 10cm. After childbirth it can be used to strengthen the pelvic floor again. Made out of non-allergenic medical silicone, the EPI-NO is used with water-based lubricant. It’s inserted 2/3 of the way into the vagina, then the balloon bit is inflated. It does not come into contact with the cervix.
Is it possible to, er… over-stretch?
If you’re worried about over-stretching, fear not: EPI-NO perineal training is facilitated by the natural hormone Relaxin produced by the expectant mother in the late third trimester. Relaxin enables a elasticity of the perineum essential for a vaginal birth. EPI-NO gradually and gently stretches the tissue increasing the elasticity at the perineum.
What do doctors think?
Dr. Rachel Mackey, specialist in Obstetrics & Gynaecology at The Women’s Health Clinic believes the Epi-No is worth a shot if you’re worried about tearing, she told us: “I have no experience of it in relation to my own patients, but properly conducted research trials have shown that perineal stretching in women on their first pregnancy reduces the rate of perineal trauma. However the studies did not show any advantage for women on their subsequent pregnancies. I can see no downsides to using it other than cost.”
The HerFamily.ie verdict
At around €115, the EPI-NO is not cheap and experts are divided about whether it’s worth the outlay. However if using it helps you to feel like you have some control over a part of the birthing process that worries you, it’s a good investment and available to buy online here.
