Victoria used the epi-no during both of her pregnancies.

There was a small Australian research study which indicated that women who used it had a lower incidence of tears.

I think in hindsight, for Victoria, the thing she found most useful was that the epi-no taught her what the feeling of her perineum stretching really felt like, so that when it happened in labour, she wasn't scared by the sensation.

It's rather awkward to use, and I'm not sure if it's testament to Victoria's pelvic floor muscles or not, but we had lots of difficulty getting it to stay in. We never made it to 10 cm with it, because it tended to slip out before we pumped it up that far.

We used the epi-no in conjunction with perineal massage, and Victoria has had a small tear both times.