The EPI-NO Childbirth Trainer

Clinical Studies have shown a link between perineal injuries during childbirth with decreased bladder control, long-term incontinence, and sexual dysfunction. Women delivering over an intact perineum experience a more rapid recovery from childbirth and increased mobility. EPI-NO Delphine Plus was developed in Germany as a dual purpose birth trainer. EPI-NO reduces the risk of tearing and episiotomy (stitches) during childbirth by working with the natural pregnancy hormone Relaxin  to prepare the perineum with gentle stretching exercises after Week 36. EPI-NO also conditions the pelvic floor muscles both before and after delivery.

EPI-NO consists of: 
(1) a narrow contoured silicone balloon.
(2) a hand pump, 
(3) pressure display, 
(4) an air release valve, 
(5) connected by a flexible plastic tube.

The EPI-NO balloon is soft, easily inserted, and naturally shaped so that it fits the vagina perfectly. EPI-NO must be used only with a water based lubricant.

Preparation can begin early in Pregnancy

EPI-NO Delphine Plus is a DUAL PURPOSE training device.

1. EPI-NO Pelvic Floor Muscle Exercises can commence early in pregnancy. A strong pelvic floor supports the weight of childbearing, and is more resilient in it’s recovery after the birth.  A strong pelvic floor provides more control during delivery. In these exercises the balloon acts as a sensor and is only minimally inflated. Following the birth Pelvic Floor Muscle Exercises recommence after 4-6 weeks and can continue indefinitely.  EPI-NO provides bio-feedback on Pelvic Floor strength.

2. EPI-NO Stretching Exercises commence after Week 36 and continue until the end of the pregnancy term. These exercises gradually stretch the perineum in daily sessions of 20 minutes comprising several cycles of 5 minutes duration. In these exercises the balloon is inserted and inflated at the perineum. Women training with EPI-NO will normally achieve a dilation of between 8.5cm and 10cm over 3-4 weeks. Women achieving 8.5cm will achieve the extra 1.5cm when the head is crowning. Following the stretching exercises the balloon can be glided out, simulating the experience of control during delivery.

Childbirth Preparation in Stages

Position of EPI-NO when deflated

Childbirth Training (preparing the perineum) commences after Week 36. The balloon is inserted two thirds into the vagina and inflated to the level of personal comfort. The balloon size is gradually increased daily, from one training session to the next, each session lasting about 20 minutes. (usually 4 cycles per session).

Position of EPI-NO when inflated to 10cm after 3+ weeks of training.

Optimum training is achieved when the balloon size has reached a diameter of 8.5 -10 cm (3-4 inches) and can be pushed out while inflated. EPI-NO pelvic floor muscle exercises can be practiced throughout the pregnancy, and recommenced 4-6 weeks following birth after consultation with your doctor.

A German Study indicated a shorter 2nd Stage of Labour and better APGAR Scores for EPI-NO babies.

It is recommended that women consult a health professional before using EPI-NO to determine whether EPI-NO is the right choice for their individual circumstances and medical history.

EPI-NO vs Perineal Massage Graph


EPI-NO Delphine Plus is an easy to use Pelvic Floor Muscle Trainer and the first line of defence for women experiencing poor bladder control. EPI-NO training is based on the principle of building strength through “Active Resistance” which can easily be performed by all women at home. Effective exercising of any muscle is achieved by a degree of stretch and resistance. EPI-NO anatomically formed balloon sensor provides a soft, yet rigid form against which the muscles can be flexed. The Pelvic Floor Muscles are identified by simultaneously squeezing, and drawing up the balloon. Regular active resistance training with EPI-NO reinforces muscle group focus and provides motivation through biofeedback.

“Pelvic Floor training with the EPI-NO device is based on a therapy concept that has been known for many years (pelvic floor training against resistance with biofeedback). It is known from literature that this form of pelvic floor therapy can be an effective and inexpensive form of therapy for urinary incontinence”.
Dr. Christian Dannecker, Senior Physician Urogynaecology. University of Munich, 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