Does the Epi-No Birth Trainer reduce levator trauma? A randomised controlled trial.

INTRODUCTION AND HYPOTHESIS

The purpose of this study is to evaluate whether antepartum use of a birth trainer may reduce levator trauma.

METHODS

Two hundred nulliparous women were examined with four-dimensional translabial ultrasonography at 35-37 weeks of gestation and 3 months postpartum in a randomised controlled pilot study. Women in the intervention group were instructed to use the birth trainer from 37 weeks onwards.

RESULTS

One hundred forty-six women returned for follow-up 5.6 months (range 2.3-22.1) after childbirth. Seventy-eight of them had had normal vaginal deliveries (53%), 32 vacuum/forceps (22%) and 36 a caesarean section (25%). The risk of avulsion was halved in the intervention group (6% vs 13%, P = 0.19) on modified intention to treat analysis. A treatment received analysis revealed a nonsignificant 42% and 30% reduction in levator avulsion and microtrauma, respectively (P ≥ 0.22).

CONCLUSIONS

This pilot randomised controlled trial showed a nonsignificantly lower incidence of pelvic floor muscle injury in women who used the Epi-No device from 37 weeks onwards.