I asked a pelvic floor physio about EPI-NO. She said it can stretch more than the perineum and affect your pelvic floor strength, so not to use it. For perineal massage, she suggested just trying to massage the perineum from the positions of 4 o'clock to 8 o'clock (if the bottom of it is 6 o'clock) with some olive oil from 38 weeks on.