My friend sustained a 3rd degree tear due to the Epi-No before her baby was even born. She had to have stiches, lucky it healed before the birth and she only needed a few replaced. I say steer well clear of them. Everytime you use it is equivilent to one birth and your pelvic floor muscles get stretched needlessly. I was the first intact perineum in 10 years at my local hospital that was ethier a dancer or avid horse rider. I swear an adequate amount of zinc saved me from tearing, as I have quite a tight perineum and was told to expect and episiotomy, I declined and birthed with only front labial grazes from my sons cord.