Epi-NO for Perineum training - Anyone used it?

[nellnell]

I've just had a chat to my GP who delivered my first baby. The birth was easy but I sustained 2nd degree tears ( bub was only 2.98kg and HC 33cm - which is small) to my perineum which have been giving me a little grief while DTD and still hurt occasionally now. GP thinks it will be good to tear a little and get rid of the old scar tissue and start again, and also recommended Epi-no. I jumped in the web site to have a look and it looks good, but at $179 it's a lot to spend.

GP also mentioned that women tend to tear less second time round anyway.

Anyone used it and thought it was great?

Anyone used it and thought it was a waste of money?

I'm open to anything. Oh, also tried perineal massage before 1st birth but didn't seem to do anything!

[nellnell]

Anyone?

[Muffy]

no im sorry i havnt used it but i hope you get the advice you are looking for!!
also congrats and wishing you a H&H pregnancy

[paradise lost]

I have a vague feeling that someone around here used one and tore using the Epi-no, NOT while giving birth...can't recall who or when, but perhaps someone will be along to help with details in a bit. Kelly? Do you know?

In general i'd think that not pushing during crowning and making sure the crowning is s-l-o-w would be more use than any preparation one could do before. What was your pushing phase like? What pain-relief if any did you use? WHat position were you in? How fast was it? Did anyone "guard" your perineal area with a hand (you or a medical person)?

Bx

[Muffy]

i found this thread https://www.bellybelly.com.au/forums...37-epi-no.html

[fifi33]

Hi,
I used it with my first baby, he was big, 9 pound 1! I needed a few stitches but not many, surprised i didnt tear more , looking at the size of him when he came out! Dont know if it helped at all, as my pushing stage was 2.5 hours, so naturally I was stretching anyway! Think i will use it again this time though, although hopefully my son well and truely paved the way!
Fi

[nellnell]

Thanks for the feedback fifi, what was your DS head cir?

laura - thanks for the link, interesting chatter

hoobley - pushing phase lasted about 1.5 hours. I was basically hanging over a fitball, so kind of in a hands and knees position the whole of the pushing phase, with a little squatting but not at the end. I didn't have any pain relief at all but was on a syto drip which was turned down really low (my body kicked in really well). As for guarding the perineal area - well the midwife was great and telling me to go slowly, talking me through the crowning stage but maybe I didn't go slow enough?

I've also read since then that applying a hot washer to the perineum during crowning can help things out as well.

Love to hear from more people who have used it and it worked or didn't.

[Muffy]

no problem.
my midwife put a hot cloth there when i was crowning.. i think that helped.. well she said thats what it was for anyway

[pollyanna]

My physiotherapist forbade me from using/buying the epi no. She said there is no founded medical advice that says they work or are a good idea. She had heard many horror stories of women tearing and becoming incontinent. She said one of the major problems with using the epi no;is that it isnt during labour. Because during labour you have the increased hormones and blood flow through the system that encourage the body to soften and become more supple. She also said gentle massage(gentle)and stretching of the perineum with olive oil or similar is likely to make the perineum a little more elastic,and she concurred with the idea of a hot washer on the area during crowning is most beneficial.
HTH
Pauline

[nellnell]

Thanks Pauline - that's interesting

[chocolatecatty]

My freind used an Epi-No and still tore. Was her first baby. Not sure how badly she tore though.

For what it's worth, I didn't push at all for my second birth (waterbirth and on my knees) and I didn't tear and I felt quite normal down there very quickly (DTD five days later lol). I believe all of the above happened due to my not pushing during birth and hence no damage being sustained. My body pushed on its own accord, and I had one hand down feeling bubs head crown which is supposed to help too.

[Tobily]

My physiotherapist forbade me from using/buying the epi no. She said there is no founded medical advice that says they work or are a good idea. She had heard many horror stories of women tearing and becoming incontinent. She said one of the major problems with using the epi no;is that it isnt during labour. Because during labour you have the increased hormones and blood flow through the system that encourage the body to soften and become more supple. She also said gentle massage(gentle)and stretching of the perineum with olive oil or similar is likely to make the perineum a little more elastic,and she concurred with the idea of a hot washer on the area during crowning is most beneficial.
HTH
Pauline

I think that Pauline makes an excellent point - stretching your perineum out to 8 or 9cm like that without the benefit of labour hormones and blood flow would be something I'd be pretty wary of.

Upright positions, a slooooow crowning of the head and avoiding directed pushing are the best ways to avoid a tear. Warm compresses on the perineum are also worthwhile.

I haven't used an epino but I'm just so...I dunno...suspect of them I guess.

The irony of an expensive device to avoid tearing being pushed by obstetricians - whose birth practices cause tearing - isn't lost on me lol.

I know you said you have a GP but I've seen leaflets for these things in OB's offices and known a number of women who've been recommended them by OB's....often the same OB's who tell women there is not enough evidence for the benefits of perineal massage to make it worth doing. There's no evidence the Epi no works either! But it's a helluva lot more expensive than two hands and olive oil

[aimeesmum]

I used one and I would recommend it. The thing with Epi-NO is you never know if you didn't tear because of the Epi-No of you didn't tear because you were not going to anyway.
I have a chronic painful condition called vulvodynia ( won't go into but it causes extreme pain to the vulval area realted to pelvic floor muscles being over contracted). I was PARANOID about tearing and was willing to try ANYTHING to avoid it. For me to do perineal massage was not possible but I was able to use the Epi-No taking it very slowly. I could only get to 7cm in the end and I had to start it earlier then most women would and take it slower but I really think it helped. I ended up with two small grazes but I also had a waterbirth and I am sure this would have also helped to prevent any tearing. DD was 8.1lbs so not on the small side.
My midwives supported my use of it and the reason I decided to splash out was I was in contact with another women with vulvodynia and she raved about it and I also posted on a forum asking for opinions from women who had actually used it and what they thought and they were all positive - although I have read of women tearing who have used it).
I think it is often the cost that makes people question it's use however in my case it was money well spent and I will use it again for any other children I have.
You can get them on Ebay sometimes for a lot cheaper if that kind of thing doesn't gross you out - they are all sterilised etc, etc.