I have one of these that I rented (they're sterilized and you use it with a medical grade condom like the vaginal ultrasound) from my midwife's clinic - it's so awesome. They're very popular in the part of Europe where I live, and in Germany as well. I've heard several women mention them in a positive way. I'm due in a couple weeks, and had been trying the perineal massage but was finding that I never felt like I was doing it right and that it hurt. So I talked to my MW about it and she suggested the epi-no. It's great because depending on how you use it it assists with kegel type exercises, and/or you can use it to stretch that area before the birth, and then after the birth to regain strength. It really doesn't go in very far for the stretching exercises, just a few cm deep, it looks a lot scarier and stranger than it is :)
It's somewhat uncomfortable the first time but gets easier and easier. -- you still feel discomfort as you stretch the balloon gradually bigger each day, but you figure out which position works best for you (and may work well during the birth) and i love that you get some idea of what it will be like when you're actually delivering. I like that you choose how big to inflate it (and it increases in tiny increments) and it's nice seeing tangible proof that you're getting close to the max of 10cm. I think the biggest thing is that more than just the stretch, it prepares you for the feeling and helps you learn to relax during that feeling. There are some studies on their site (so take that with a grain of salt!) that show a 50% decrease in tearing among women who 'trained' with it.
I've only had three small problems with it:
- it can be hard to find 20 minutes alone every day somewhere comfortable where you can lie down or lie on your side and KNOW that you won't be interrupted with a blue plastic pump device sticking out of you! you're supposed to keep it in for 10-20 minutes and relax during so I usually read or watch a movie on my laptop on my bed during the 20 min.
- the first couple times i did it i felt a little nauseous - i think i was nervous and it did hurt a little, it's fine now.
- had to find a natural water soluble lubricant, it's NOT comfortable without, and apparently coconut oil or perineal massage oil can degrade the rubber (and the rubber of the condoms if you're renting it)