March 20, 2004

Using an Epi-No to avoid episiotomy

There was an interesting discussion on the ozmidwifery list a few months ago regarding the use of the Epi-No vaginal dilator as a preparation for birth. Several contributors thought that it was a useful tool and quoted anecdotal evidence of good outcomes. Others thought it was a bit strange, and using a gadget to stretch perineal tissues was seen as mildly distasteful.

A study undertaken in Israel has now been published that compared perineal outcomes for women who used the Epi-No and women who did not, in a culture where episiotomy a is routine part of birth management. In this climate, many women have tried the Epi-No as a means of avoiding this routine procedure and many hundreds have used it over the past 4 years.

Using a descriptive, retrospective approach, all women who had bought the device before April 2002 were contacted and surveyed. The results were compared with published episiotomy rates for the same period. When analysed, the results showed that users of the vaginal dilator had lower episiotomy rates than women generally, and there was an increased confidence in giving birth amongst users, who felt better prepared for pushing and the sensations of birth. There was also a reduced need for episiotomies when vacuum was being used.

It seems that this device may have its uses, particularly for women who fear second stage and face birth in a climate of routine episiotomy. It is expensive and takes time and commitment to use. It may not be attractive to all women but for some, it seems to provide a useful alternative to routine perineal surgery.

Reference: Siome Cohain J. MIDIRS Midwifery Digest. vol 14, no 1, March 2004, pp 37-41.

Posted by andrea at March 20, 2004 05:29 PM

Comments

Hallo Andrea or Siome Cohain !
I am very pleased to read Your letter in Andrea's Diary about EPI-NO. It seems to me as if the midwifes in Australia are much more confident to their abilities and at the same time more openminded then in Europe especially in Germany. It took about 3 years to develope the device and I made first EPI-NO experiences with mothers to be in my gynecological and obstetrical clinic and praxis in Bavaria. Than I trusted my idea and I started the first study worldwide at the University Hospital in Munich together with Prof. Schneider in 1997. The results of this first study and the acceptance by the women in my praxis were so overwhelming that I patented the device and started the production at Tecsana GmbH in Munich. Now a couple of years later EPI-NO is available in over 21 countries in 5 continents. I am shure that EPI-NO will start a revolution in birth and after birth treatment and that it will become standard in birth worldwide in a couple of years... Thank You for Your "openmindness", Your Dr. Wilhelm G.Horkel ( mail: drhorkel@hotmail.com )

Posted by: Dr. Wilhelm Horkel on March 29, 2004 07:55 AM

Comments

where in Israel can a patient perchase this device?

Posted by: Orly Brandes Klein MD on June 20, 2004 11:44 PM