SUBJECT
AREAS TO CLICK ON
Two effective tips
using EPI·NO
What is the
difference between
EPI·NO Delphine
and DelphinePlus ?
What is an
episiotomy
and what
consequences can it have ? When should I
commence using EPI·NO ?
Can I commence
using EPI·NO earlier
to be even better
prepared ?
How often and for
how long
should I train
with EPI·NO ? Can EPI·NO
training over-expand the vagina
?
Can I use EPI·NO
if I already have
had
a previous
episiotomy or a perineal tear ? What can EPI·NO
Training achieve ?
Is it possible to
accidentally puncture the fetal membrane by training with EPI·NO ?
Is there any risk
of infection ?
Can the balloon
burst ? Can I injure
myself in training ?
How far should
the balloon be
inserted
into the
vagina during training ?
Will EPI·NO
training promote recovery after
childbirth,
and how does
it tone the pelvic floor muscles ?
If I train
with EPI·NO is it still helpful to massage the perineum ? If I train
with EPI·NO is it still necessary to take part in a birth
preparation course ?
Are there any
circumstances
under which I
should not use EPI·NO ? Are EPI·NO
Delphine/ Delphine Plus patented ?
My friend is
expecting a baby. Should I hand on my
EPI·NO to her ?
If I have
further questions or wish to purchase
EPI·NO,
whom can
I ask ?
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Two effective tips using EPI·NO
The balloon often slips out of the vagina:
The best idea to
avoid this is the following: Roll up a folded towel, so that it forms a 12
cm (3inch) diameter-roll and put it before the training between your
thighs. If you now start pumping up the epi-no it will stay in the vagina
very comfortable. Releasing the thighs peu a peu, the balloon will glide
out softly.
Best training
(by midwife
Ilana Shemesh, Israel):
Start by inflating the balloon only enough
to make it stiff enough to insert. Insert it 3/4 of the way, and do not
blow it up more. Practice a few pelvic floor contractions and releases and
watch the needle of the manometer. You want to know that you raise the
needle when you contract your muscles and are able to completely relax
your pelvic floor when you relax the muscles, and see the needle back to
starting point.
This is important because you want to build
muscles memory that relaxes your pelvic floor while the head is crowning.
After a few minutes of this, you pull out the balloon a little so that
only half (1/2) is inside. Begin to inflate the balloon, (now you are not
looking at the manometer as it does not play a part in the stretching
exercises) and you inflate until you reach a low level of discomfort. You
should not have pain, just a feeling of maximum stretching. Now you either
hold it with your other hand or lay on your side and legs are bent and you
hold it in with your upper foot or calf of leg. Try to stay like that for
10 minutes. You must hold it in because the balloon wants to jump out and
you invest effort in keeping it in. If you feel comfortable your partner
can assist you by holding the balloon.
Repeat the stretching if
the balloon jumped out. After ten minutes you stop holding it in, and let
it come out. Then you measure how big the diameter is by putting it
against the graph template in the instructions booklet. Relax during those
ten minutes, listen to music, read, practice guided imagery, think
positive birthing thoughts, and do breathing exercises, anything you want
. . .
What is the difference between
EPI·NO Delphine and DelphinePlus
?
The Plus in EPI·NO Delphine Plus is for the Biofeedback function as
represented by the integrated pressure gauge to measure contractions when
exercising the Pelvic Floor Muscles after birth. The EPI·NO Delphine does
not have this biofeedback pressure gauge.
In short:
EPI·NO
Delphine is a Birth Trainer to prepare for birth.
EPI·NO Delphine Plus
is a combi-product: A Birth Trainer to prepare for birth and a Pelvic
Floor Muscle exerciser for post-natal regeneration
of the Pelvic Floor
Muscles with biofeedback.
What is an episiotomy
and what consequences can it have ?
Episiotomy is a surgical procedure in which an incision is made in the
perineum during the second stage of labor when the baby's head is
crowning. It was thought that an episiotomy lessened the incidence of
perineal tears. According to WHO, about 60% of women receive an episiotomy
during their delivery. The cut is surgically stitched after the birth.
The practice of performing episiotomies as a standard procedure is
highly controversial. Women may experience complications after an
episiotomy. Complications include: slow healing sutures; pain when
urinating and during bowel movements and when sitting and walking. For
many women, resumption of sexual intercourse after birth is painful and
for some, long-term sexual dysfunction can result.
When should I commence using EPI·NO?
We recommend commencing the EPI·NO training three weeks prior to the
calculated date of your baby's birth.
Can I commence using EPI·NO earlier
to be even better
prepared?
Optimal results with the EPI·NO training are
achieved in the three weeks prior to childbirth. Commencing training
earlier than the thirty-seventh week should be undertaken only under the
guidance of your physician.
How often and for how long
should I train with EPI·NO?
It is recommended that the EPI·NO be used once or twice daily for 10 to
20 minutes for each training session.
Can EPI·NO training over-expand the vagina?
No, quite the contrary. By gradually and naturally stretching the
perineum as a precautionary measure it is possible to avoid long-term
perineal damage. When you pull a tight sweater over your head, the neck
expands and returns to its original shape. Similarly, during childbirth
the opening of the vagina must expand to allow the passage of your baby's
head. The EPI·NO training accustoms the vagina to the stretching required
in childbirth and facilitates a return to normal.
Can I use EPI·NO if I already have 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 you have
local pain and discomfort consult your physician before starting.
What can EPI·NO Training achieve ?
EPI·NO training occurs in 4 Stages. Stages 1 to 3 begin from the
thirty-seventh week of pregnancy. In Stage 1 the pelvic floor muscles are
exercised. In Stage 2 the perineum and the birth canal are gradually and
gently stretched. In Stage 3 you prepare for the sensation of delivery by
easing the balloon out of the vagina.
In Stage 4 with EPI-NO
Delphine Plus (four to six weeks postpartum) the pelvic floor muscles are
restored (Kegel exercises) by applying pressure "squeezing” against
resistance provided by the EPI·NO balloon. With the built-in biofeedback
gauge you can measure and ensure the exercises are effective.
Can I unintentionally initiate premature contractions
or a
premature delivery 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 your physician
and should ideally begin three weeks prior to the calculated date of the
birth of your child.
Is it possible to accidentally puncture
the fetal 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 fetal membrane during the EPI·NO training.
Is there any risk of infection ?
The danger of an infection was investigated in the clinical trials. The EPI·NO Birth Trainer is not used in a sterile environment. 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 the balloon burst?
This is extremely unlikely provided the balloon is not inflated beyond
10cm. Each single balloon has been tested up to the size of a football.
The balloon is consists of medical silicone. Please treat the balloon
carefully according to instructions for use.
Can I injure myself in training ?
As in all physical training, you should not exert yourself beyond your
personal level of comfort. If you follow this advice there is no danger of
injury. If you are not sure, do not hesitate to contact your physician or
your midwife.
How far should the balloon be inserted
into the vagina during
training ?
The balloon is inserted one-third up to one-half of the way into
the vagina. Ensure that the balloon is inflated not completely inside the
vagina. If you can't inflate the balloon very much in the initial training
session, 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 your hand. It will take only
two or three training sessions for you to determine the optimal position
of the balloon to your body.
Will EPI·NO training promote recovery after childbirth,
and how
does it tone the pelvic floor muscles?
Clinical trials currently underway are investigating the long-term effects of the EPI·NO training on recovery and pelvic floor muscle tone. The balloon is pumped up gently until the pointer on the pressure gauge reaches (4) and then fed into the vagina. Ten minutes of training every day are sufficient to restore strength to the muscles of the pelvic floor. The pointer on the pressure display deflects when the balloon is compressed.
If I train with EPI·NO is it still helpful to massage the perineum ?
Yes. The EPI·NO has proven to be the most effective method avoiding
injuries to the perineum, but perineum massage should nevertheless be
additionally applied.
If I train with EPI·NO is it still necessary
to take part in a
birth preparation course?
Yes. A prenatal course under the supervision of a qualified midwife is
useful and recommended.
Are there any circumstances under which I should not use EPI·NO?
You will find information on contraindications in the Instructions for
Use. This information is also available from the EPI·NO web site at
www.epi-no.com. If you are not sure whether you can use the EPI·NO please
contact your physician for further information.
Are EPI·NO Delphine/ Delphine Plus patented?
Yes. The world wide patents of the unique EPI·NO balloon design are
owned by Dr. Horkel (the inventor) and TECSANA.
My friend is expecting a baby.
Should I hand on my EPI·NO to
her?
No! As it is not possible to sterilize the EPI·NO Birth Trainer, it is
recommended for personal use only!
If I have further questions or wish to purchase EPI·NO, whom can I ask?
Please contact your local Distributor or send us an
email.
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