There has actually been a recent evaluation of perineal massage by hand and by using things like the Epi-No. They found no difference between hands and the machine - so for those who don't want to spend $160, and can reach, your own thumbs are just as effective. The Epi-No may be a really good option for those who can't reach.

The study found that PM was beneficial for first time vaginal births but couldn't find any evidence to suggest it made any difference to subsequent births. (read my post here--->https://www.bellybelly.com.au/forums...032#post582032)

If you google Epi-No you will find the the retail website fairly easily.