The EPI-NO Story

Dr Wilhelm Horkel
Starnberg Obstetrician/Gynaecologist
& EPI-NO Inventor

I had for a long time been concerned about Episiotomy performed routinely on first time mothers. I had become aware of the pain and discomfort this caused women, and had avoided this procedure in my Clinic at Starnberg unless the delivery made it unavoidable. Starnberg Clinic enjoyed a reputation for Natural Childbirth practice and followed closely the philosophy of Dr Le Boyer, a pioneer in this field.

In the 1980s I visited a German medical mission in Africa focused on Women’s Health issues. I became interested in a local childbirth preparation practice of gradually stretching the perineum using a series of dried gourds of progressively increasing size.

I returned to Germany and designed an inflatable silicone balloon of the dimensions required to stretch the perineum evenly. When connected to a hand pump, I was able to replicate the effect of the different sized gourds. 

With the support of my staff of midwives we commenced the first EPI-NO test and experienced immediate and significant improvement in reducing perineal injuries. Together we achieved over 70% intact perineum rates for first time mothers at Starnberg Clinic. It was determined that not only did the stretching benefit the women, but the reduction in anxiety levels contributed to a more controlled, and shorter second stage of labour. With no adverse effects experienced, the EPI-NO concept was born.

“There are many variables in the natural childbirth equation, – but one constant: 10.0cm. EPI-NO is now helping women in over 20 countries to more easily achieve this goal” 

Dr Wilhelm Horkel
Starnberg Germany

“The human body performs to maximum efficiency in any physical activity when correctly trained and prepared. Childbirth is no exception” 

Dr Wilhelm Horkel, Starnberg Germany
EPI-NO inventor