Frequently Asked Questions

The Following is a selection of frequently asked questions. If you cannot find the answer that you are looking for, please contact our midwife at Ask A Midwife. We cannot provide advice relating to any specific medical condition, only guidance in training with EPI-NO. If you are unsure whether EPI-NO is suitable for you, consult a health professional familiar with your medical history.

Is EPI-NO suitable only for women having their first baby?

Although German and Australian clinical studies were of first time mothers, EPI-NO is used by many women for a subsequent birth. It is estimated that 30-40% of EPI-NO use is by second and third time mothers. EPI-NO is also used by VBACs (Vaginal Birth after Caesarean).

What lubricant should be used with EPI-NO?

EPI-NO should ONLY be used with a water-based lubricant such as KY Jelly, or Ansell Water Based Lubricant. Non water-based lubricants must NOT be used. Essential Oils, Fragrant Oils, Almond Oil and petroleum based lubricants will damage the balloon over time.

Of what material is the EPI-NO balloon made?

The EPI-NO balloon is produced in Germany of non-allergenic medical silicone. Damage to the balloon is extremely unlikely provided the balloon is not over-inflated or misused. Each balloon has been individually burst tested to stringent EEC safety standards for medical devices. (similar to the testing of condoms). EPI-NO should be stored safely in the pouch provided, and the balloon protected from risk of damage.

Is EPI-NO covered by a warranty?

EPI-NO is covered by a two year manufacturer’s warranty by Tecsana GmbH. Munich Germany. EPI-NO has a recommended Product Life of five years, or two births, whichever is the lesser and should not be used beyond this date.

When should EPI-NO Training commence?

EPI-NO Delphine Plus and EPI-NO Delphine are “Dual Purpose” Childbirth Trainers.

a) Pelvic Floor Training during pregnancy. It is recommended to commence using EPI-NO Delphine Plus EARLY in the pregnancy to strengthen pelvic floor muscles. A strong pelvic floor supports the added weight of pregnancy and assists in control during the delivery and in bladder control. In these exercises the minimally inflated balloon acts as a sensor. 

b) Exercising the Perineum. This is a set of stretching exercises in which the balloon is gradually inflated at the vaginal os. These exercises commence after 36 weeks of the pregnancy up until the time of delivery. The exercises are progressive and will result in a stretch of between 8.5cm and 10.0cm. Women who achieve 8.5cm will reach 10.0cm during the crowning of the baby’s head at delivery. EPI-NO is used again following the birth to re-tone the pelvic floor muscles. Pelvic floor muscle exercises are important for all women following childbirth.

How do I measure the size of the balloon on the gauge?

The size of the balloon is not measured on the hand pump gauge. The gauge only measures the pelvic floor muscle strength when EPI-NO is used to exercise the pelvic floor. The size of the balloon is measured against a template in the Instructions for Use. Hold the balloon above the template and note the balloon diameter.

Can the EPI-NO balloon be purchased separately?

No. EPI-NO is a Single-User device and not designed, or registered, as a medical disposable product. For hygiene, and warranty reasons EPI-NO should NOT be passed between women. Under no circumstances should EPI-NO be purchased from any source unless in the original manufacturers sealed package.

Can premature contractions or a premature delivery be unintentionally initiated by training with EPI-NO?

No. In the EPI-NO clinical trials there were no indications whatsoever for any premature initiation of contractions or of premature birth. EPI-NO training should be undertaken under the guidance of a clinician, and any questions of a medical nature should be directed to a medical professional with knowledge of your medical history.

Is it possible to accidentally puncture the amniotic membrane by training with EPI-NO?

There are no indications whatsoever from the clinical studies or from the observations made by obstetricians and midwives that it is possible to puncture the amniotic membrane during EPI-NO training. The balloon is inserted 2/3 into the vagina and sits at the vaginal os. The balloon does not come into contact with the cervix.

Will EPI-NO training over-stretch the vagina?

EPI-NO perineal training is facilitated by the natural hormone Relaxin produced by the expectant mother in the late third trimester. Relaxin enables a elasticity of the perineum essential for a vaginal birth. EPI-NO gradually and gently stretches the tissue increasing the elasticity uniformly at the perineum. During childbirth the opening of the vagina must expand to 10.0cm to allow the passage of the baby’s head. The EPI-NO training accustoms the vagina to the stretching required in childbirth and facilitates its return to normal. Perineal injuries are generally the result of spontaneous tearing or of an episiotomy, often both. Clinical evidence shows EPI-NO training reduces this risk.

Are there any circumstances under which EPI-NO should not be used?
Contraindications: 1) The baby is in an unusual position or if there are identifiable risks making a vaginal birth impossible (eg.placenta praevia) 2) There is a risk of ascending infection (eg. Premature amniorrhexis, infection of the vagina) 3) Injuries to the genital area that have not healed 4) Under the influence of drugs or alcohol. 5) vaginal bleeding. 6) the presence of a malignant disease of the genital area. 7) Nerve damage or other disease reducing sensation in the genital area. 8) Paraplegia 9) Multiple Sclerosis 10) Analgesia administered to the vaginal area 11) Marked varicosity (varicose veins) at the vaginal entrance Women should consult their medical professional if they are unsure whether EPI-NO training is suitable for them. It is recommended that EPI-NO Training commence after 36 weeks. Women expecting twins should consult their medical professional before using EPI-NO due to the shorter term of a multiple pregnancy.
Where can further EPI-NO information be obtained?
Contact our Australian Registered Nurse/Midwife on our website.

“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