Epi-no. Would you? Did you?

[the why bird]

My biggest birth fear is a bad tear. I can cope with labour pains, long labour, c section if it comes to that... but I'm really scared I'll be one of the unfortunate people who are left injured or incontinent.

So I've been reading about the epi-no. It's basically a balloon that you use for pelvic floor exercises and stretching. The idea is you train your perineum to be able to stretch enough to pass baby's head, learn which muscles you will be using to push and after the birth, use it to get your pelvic floor back in shape.

There's a video about its use here (warning if you click through to youtube: though the video is not at all graphic, some of the images that come up as related videos for me do show graphic birth images) https://www.youtube.com/watch?v=biAkJboybKE

From what I read it's popular in some European countries and there have been studies saying it dramatically reduces the need for episiotomy. But on the other hand, if it's that good, why isn't it better known? And it's flipping expensive too.

So would you use it? Any experiences with it? I know perineal massage is supposed to really help but honestly I don't know how anyone can reach while heavily pregnant! Tried it with hubby last time and abandoned it because it was totally awkward. At least I could use this alone.

Edit: sorry no idea why it's coming up underlined in purple, no link there.

 

[the why bird]

BUMP - someone please tell me if I'm mad for considering this.

 

[Tigerlilyb]

I wouldn't say you're mad, I think it's just that nobody has any experience with it. It's probably not better known because it's relatively new and there's lack of medical research on it.
Personally I'd just stick with perineal massage, as awkward as it is. It's free and apparently works wonders.

 

[tryfor2]

I actually have one of these from my prepregnancy days of pelvic floor physiotherapy. I asked my dr. about using it my last pregnancy and she said not to. I asked her again this time (considering I have a stiff perineum that wouldn't stretch enough last time, necessitating an episiotomy) but she said not to. Something about how the body secretes hormones to allow the perineum to stretch enough for a baby to pass through, plus the fact that it isn't a great idea to "place foreign objects in the vagina during pregnancy." So I can't really advise other than to pass on what my OB said. She is very science- and research-oriented though and tends not to recommend anything unless it's backed by a large-scale study. The epi-no probably just doesn't have that kind of thing to support it. Personally, I can't see how it would be a BAD thing, unless you shelled out all that money and used it only to end up having a CS!

 

[moter98]

I don't think it will be necessary. My experience with tearing has not been negative at all. I had an episiotomy with my first and needed 3 stitches I think. My DS#1 had a HUGE head and still does. We have to custom order any helmets for him for riding bikes lol. It caused me zero problems and healed just fine. With DS#2 I did tear just a bit, needing 2 stitches. Again, zero problems and it really wasn't a big deal. Healed up just fine. Thankfully DS#2 had a normal sized head!

If incontinence worries you, do exercises now that strengthen your pelvic floor and continue them after the birth. I myself do Mutu system, the Core exercises to keep my TVA and pelvic floor muscles strong.

 

[StephtheHiker]

I actually have one of these from my prepregnancy days of pelvic floor physiotherapy. I asked my dr. about using it my last pregnancy and she said not to. I asked her again this time (considering I have a stiff perineum that wouldn't stretch enough last time, necessitating an episiotomy) but she said not to. Something about how the body secretes hormones to allow the perineum to stretch enough for a baby to pass through, plus the fact that it isn't a great idea to "place foreign objects in the vagina during pregnancy." So I can't really advise other than to pass on what my OB said. She is very science- and research-oriented though and tends not to recommend anything unless it's backed by a large-scale study. The epi-no probably just doesn't have that kind of thing to support it. Personally, I can't see how it would be a BAD thing, unless you shelled out all that money and used it only to end up having a CS!

Do you have pelvic floor dysfunction? I do and I haven't heard much on how it affects labour. I've been doing perineal massage as well to get things to not tense up so much, but I'm afraid that I'm going to tear a lot because of this. Would much rather have a c section than a 4th degree tear.

To the op: I totally get the fear...really I do. That's my worst fear during birth. My midwife who is really knowledgeable on current studies says it's not so much the stretching the causes tearing, its the tensing. That's what massage during labor shows no improvement in rates of tearing. To get your oh to do the massage is better because it's someone else and you have to learn to relax those muscles, which will make them more flexible. Also the last two pushes during stage two should be done mostly by your uterus instead of you forcing the baby out.

I know it's a scary thought. Drinking raspberry leaf tea is also found to reduce the length of 2nd stage and to reduce the need of forceps/vacuum delivery (which increases the likelihood of 3rd and 4th degree tears)

That being said, I would not put foreign objects up there unless need be. Good luck!

 

[ljo1984]

Someone posted about this I'm my fb home birth group last year and apparently it's ment to be really good.

 

[AmysU4ea]

My daughter ended up coming out so fast that I tore a bit... Couple stitches and everything healed up just fine. I had the same worries you're having though, but it turned out to not be such a big deal...

 

[ljo1984]

My first I was cut for forceps. My second was 9lb and out in 3 pushes. I could even feel the tearing but to be honest although it makes me cringe now (lol) at the time it was a sort of relief feeling a different type of pain. So I don't think tearing actually scares me as much as the local after does or the pain after wee'ing!! There the reasons I'm hoping to not suffer as bad this time. Also planning hb and if I tear bad I'd have to go in for stitches which I'd rather not.

 

[Eleanor ace]

I had a bad tear with my 1st and asked my consultant about using the epi no to reduce the risk of tearing with my second and got a "definitely not" response. I can't remember what he said exactly but basically it doesn't replicate the stretching your perineum does in labour so it is a bit pointless and it can increase your risk of infection/trauma to the area.

 

[Popples1]

I had a second degree tear and 2 labial tears with my LO. They really weren't a big deal - after 2 weeks they felt loads better and I certainly didn't notice them happening at the time (there's too much other stuff going on!). I'd just trust your body to do what it is made to do

 

[Buttercup84]

Never tried it and not sure I would. I didn't want an actual episiotomy ith dd unless necessary for using a ventouse, preferred to tear naturally if it was gonna happen otherwise. I got a second degree tear which was painful initially but healed with no probs so I'm happy to go with the same approach this time around. Out of everything to do with labour tearing really isn't something I'm that anxious about tbh. Did you tear badly with your first?