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 followup 5.6 months (range 2.3-22.1) after childbirth. Seventyeight 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.