How far should the balloon be inserte into the vagina during EPI-NO training?
The balloon is inserted two-thirds of the way into the vagina. It will protrude about 2cm out of the vagina. Ensure that the balloon is inflated once inside the vagina. Securing the balloon can be achieved by closing the legs. This would also prevent the EPI-NO from slipping out of the vagina during training. To prevent the balloon from being drawn too far into the vagina, the protruding end can be held with the hand. It will take only two or three training sessions to determine the optimal position of the balloon.
Is it still helpful to massage the perineum?
EPI-NO has been clinically proven to be the most effective method of avoiding injuries to the perineum, but perineal massage can nevertheless be additionally applied.
Can the balloon burst?
This is extremely unlikely provided the balloon is not inflated beyond 10cm. Each balloon has been tested up to the size of a football.
Is EPI-NO covered by warranty?
EPI-NO is covered by a 2 Year manufacturer's warranty by Tescana GmbH. Munich Germany. EPI-NO has a recommended Product Life of 5 years from date of manufacture and should be used beyond this date. This date is stated at the bottom of each EPI-NO box. For example it may state: 2015-02, which means product can be used until February 2015.
Is there any risk of infection?
The danger of an infection was investigated in clinical trials. If the device is cleaned and disinfected according to the Instructions for Use, no increased risk of infection is expected. We recommend EPI-NO for personal use only!
Can EPI-NO be used if the woman has already had a previous episiotomy or a perineal tear?
Yes, the EPI-NO training stimulates blood circulation and the muscles. This can make scar tissue more flexible and easier to stretch. If a woman experiences local pain and discomfort she should consult her physician before commencing training.
What frequency of EPI-NO Childbirth training (preparing the perineum) is recommended?
It is recommended that EPI-NO be used once or twice daily, 10 to 20 minutes for each training session of 3 to 4 dilation cycles. After the first week the length of training can be extended to 30 minutes.
Does using EPI-NO guarantee no tears or episiotomy?
There is no guarantee. For clinical reasons a physician may be required to perform an episiotomy. However, the probability of an optimum birth outcome with an intact perineum is significantly increased by training with EPI-NO. Mothers have experienced less anxiety after simulating pushing using EPI-NO.
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.
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.
Are there any circumstances under which EPI-NO should not be used?
Under the following specific situations the EPI-NO should not be used:
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 obstetrician if they
are unsure whether EPI-NO training is suitable for them. It is recommended that EPI-NO Training commence after Week 36. Women expecting twins should consult their obstetrician before using EPI-NO due to the shorter term of a multiple pregnancy.
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 10cm 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.
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 opening. The balloon does not come into contact with the cervix.
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. The EPI-NO training should be undertaken under the guidance of a clinician, and any questions of a medical nature should be directed to a doctor with knowledge of your medical history.
What Lubricant should be used with EPI-NO?
EPI-NO should ONLY be used with a water-based lubricant such as KY Jelly. Non water-based lubricants must NOT be used. Essential Oils, Fragrant Oils, Almond Oil and petroleum based lubricants will damage the balloon.
When should EPI-NO Training commence?
EPI-NO Delphine Plus Childbirth Trainer is a "Dual Purpose" Trainer and should be used under the guidance of a physician.
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 opening. These exercises commence after Week 36 of the pregnancy up until the time of delivery. The exercises are progressive and will result in a stretch of between 8cm and 10cm. Women who achieve 8cm will reach 10cm during the crowning of the baby's head at delivery. EPI-NO is used again following the birth (approx 4 Weeks) to re-tone the pelvic floor muscles. Pelvic floor muscle exercises are important for all women following childbirth.
Is EPI-NO 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).
Listed in this section some of the more frequently asked questions with regard to the EPI-NO Delphine Plus® Childbirth Trainer.
It provides a few tips on how you should use your EPI-NO Delphine Plus® Childbirth Trainer. And if you have any more questions or are unsure how to get the best value out of the EPI-NO product, please feel free to contact us any time.
Before using the EPI-NO Delphine Plus® Childbirth Trainer. product, please consult your physician.
