The EPI-NO: For a Better Birth with Less Pushing

childbirth epi-no incontinence organ prolapse pelvic floor pelvic floor muscles perineum Dec 22, 2019

By Kim Vopni, The Vagina Coach — Certified Pelvic Floor Fitness Specialist · Published December 22, 2019

EPI-NO Delphine Plus childbirth trainer with blue carry pouch, pressure gauge, hand pump and inflatable balloon in front of its box

Direct Answer

The EPI-NO is a biofeedback device used during pregnancy to learn how to contract and relax your pelvic floor muscles and, in the last three weeks, to stretch the perineum in preparation for birth. Preparing with the EPI-NO can reduce the likelihood of tearing, shorten the pushing stage and speed up postpartum recovery.

Key Takeaways

The EPI-NO is a biofeedback tool that helps you “see” your pelvic floor exercise and learn to contract and relax the muscles.
In the last three weeks of pregnancy it is used for perineal massage, stretching the perineum to prepare for birth.
Clinical trials show a significant reduction of perineal injury in vaginal births.
A shorter second stage of labour means less stretch and compression time on the muscles, nerves and connective tissue.
Postpartum, the EPI-NO helps you regain and maintain the strength and integrity of your pelvic floor muscles.

Why I Highly Recommend the EPI-NO

Over the centuries, different cultures have used creative methods to help lessen the pain of labour or ease delivery.

In Africa, for instance, women use gourds of increasing size to help stretch the perineum in preparation for birth in order to reduce the likelihood of tearing.

This seemingly archaic practice was actually the inspiration for a modern-day device called the EPI-NO that women can use to prepare their pelvic floor for birth by stretching the perineum.

I used the EPI-NO in both of my pregnancies and can't recommend it highly enough.

Protecting Your Perineum

The perineum is the area of skin between the vagina and the rectum and it is an area worth protecting! During pregnancy and childbirth, your perineum and pelvic floor muscles will face an ever-increasing load and will be extensively stretched during delivery.

Without proper preparation, the perineum can tear during childbirth, or be cut in a procedure called an episiotomy (to enlarge the space for the head to come through - well-intended but we now realize that it causes much more dysfunction and pain such as incontinence, decreased sensation and even organ prolapse postpartum).

Fortunately, the perineum can be protected and the pelvic floor muscles can be optimized with the EPI-NO.

What is the EPI-NO?

The EPI-NO is a biofeedback tool that allows you to connect with your pelvic floor - a part of your body that you have probably not given much thought to.

You use the EPI-NO during pregnancy to learn how to contract and relax your pelvic floor muscles (learning to relax is key!).

In the last three weeks of pregnancy, you use the device to help prepare the perineum for birth by using it for perineal massage (stretching the perineum and learning to yield against the discomfort you will feel as the baby’s head is crowning).

Pelvic health is a very neglected topic in childbirth preparation classes and health care visits, so unfortunately many women don’t know about this information until it is too late. By getting to know your pelvic floor prior to childbirth, you will be ready when it comes time to push your baby out and will be better able to prevent unnecessary pain and dysfunction.

Pelvic floor exercise is the best way to prepare your pelvic floor for birth and protect the perineum. Strong, flexible muscles are able to support the weight of the growing baby, are able to relax to allow the passage of the baby’s head, and are able to recover more quickly post-partum.

Women with a strong and functional pelvic floor will also be less likely to experience postpartum pelvic floor dysfunction.

'See' Your Pelvic Floor and Other Benefits

Because the pelvic floor is not visible, it can be difficult to identify the muscles and know if you are contracting and relaxing them. The EPI-NO is a biofeedback device, meaning it can help you ‘see’ your exercise!

Here are a few other benefits of this amazing product:

Clinical trials show a significant reduction of perineal injury in vaginal births
The second stage of labour is considerably reduced, which lessens the likelihood of interventions, and a shorter pushing time means less stretch and compression time on the muscles and nerves and connective tissue
Reduces anxiety and enhances self-confidence about the delivery
Simple to use and easier than perineal massage
Optimal device for speeding the regeneration/recovery process

Creating a Strong Foundation

As a mother, you are taking every care to ensure your baby is healthy and protected. You need, however, to ensure that you are healthy and protected as well.

By strengthening your pelvic floor with the EPI-NO during your pregnancy you are creating a strong foundation to carry the weight of your growing baby and support the anatomical changes that are happening to your body.

By preparing the perineum with the EPI-NO in the final weeks before delivery, you will reduce the likelihood of tearing, therefore decreasing your healing time the likelihood of developing challenges such as urinary incontinence, pelvic organ prolapse or painful, less pleasurable sex.

Postpartum, your EPI-NO will help you regain and maintain the strength and integrity of your muscles ensuring your continued pelvic floor wellness.

How to Use the EPI-NO

Like I said before, this is a product I used in both of my pregnancies and as a postpartum regeneration tool. I highly recommend it and have created a general video (below) explaining how to use the EPI-NO.

I've also created a second shorter video complete with a vulva puppet showing you how to use the biofeedback aspect of the device and a third video talking about the perineal massage training so you can get the most out of this amazing birth preparation tool!

Where to Buy the EPI-NO

EPI-NO is manufactured in Germany by Tecsana. There are many international distributors listed on their website

Why is the EPI-NO NOT available in the US and CANADA?

In 2019 Health Canada implemented a new medical device licensing mandate that was much more costly and had more hoops to jump through. As a result, many smaller manufacturers chose to leave the Canadian market. You can learn more HERE

In the early 2000s, a woman in the US used the product incorrectly and had a negative experience that she reported to her doctor. (The mother and baby were both unharmed). The doctor reported it to the FDA and the FDA declared it a dangerous device that required a higher-level classification that was very costly. Tecsana chose not to maintain classification in the USA.

Frequently Asked Questions

What is the EPI-NO? The EPI-NO is a biofeedback tool that lets you connect with your pelvic floor. You use it in pregnancy to learn to contract and relax your pelvic floor muscles and to prepare the perineum for birth.

When do you use the EPI-NO during pregnancy? You use it during pregnancy to learn how to contract and relax your pelvic floor. In the last three weeks, you use it for perineal massage, stretching the perineum and learning to yield against the discomfort of crowning.

Does the EPI-NO help prevent tearing? Preparing the perineum with the EPI-NO in the final weeks before delivery reduces the likelihood of tearing. Clinical trials show a significant reduction of perineal injury in vaginal births.

What are the benefits of the EPI-NO? Less perineal injury, a considerably shorter second stage of labour, reduced anxiety and more confidence about delivery. It is also simple to use, easier than perineal massage, and helps speed recovery.

Can you use the EPI-NO after birth? Yes. Postpartum, the EPI-NO helps you regain and maintain the strength and integrity of your pelvic floor muscles.

Where can I buy the EPI-NO? The EPI-NO is manufactured in Germany by Tecsana. International distributors are listed on their website.

Why is the EPI-NO not available in the US and Canada? In Canada, a 2019 Health Canada medical device licensing mandate made licensing much more costly. In the US, the FDA required a costly higher-level classification that Tecsana chose not to maintain.

Kim Vopni, The Vagina Coach, certified pelvic floor fitness professional and menopause support practitioner

Kim Vopni, known as The Vagina Coach, is a certified fitness professional, menopause support practitioner, women’s health educator, and author specializing in pelvic floor health. For over 15 years she has helped women worldwide address issues like incontinence, organ prolapse, pelvic pain and core dysfunction through fitness and education. Kim is the creator of the Buff Muff Method and founder of Pelvienne Wellness Inc., and co-founder of Buff Muff Wellness Inc where she provides online programs, in person professional teacher training, and other resources designed to help women build lifelong pelvic health.

Credentials & Experience

Creator of the Buff Muff Method™
Founder of Pelvienne Wellness Inc.
Co-Founder of Buff Muff Wellness Inc.
Creator of Kegels & Cocktails™

Certified fitness professional specializing in pelvic health
Certified Menopause Support Practitioner
Author of multiple books on pelvic floor health
Speaker and educator featured on prominent media, podcasts and health platforms