Dr Wilhelm Horkel
Starnberg Obstetrician/Gynaecologist
& EPI-NO Inventor

I had for a long time been concerned about Episiotomy performed routinely on first time mothers. I had become aware of the pain and discomfort this caused women, and had avoided this procedure in my Clinic at Starnberg unless the delivery made it unavoidable. Starnberg Clinic enjoyed a reputation for Natural Childbirth practice and followed closely the philosophy of Dr Le Boyer, a pioneer in this field.

In the 1980s I visited a German medical mission in Africa focused on Women’s Health issues. I became interested in a local childbirth preparation practice of gradually stretching the perineum using a series of dried gourds of progressively increasing size.

I returned to Germany and designed an inflatable silicone balloon of the dimensions required to stretch the perineum evenly. When connected to a hand pump, I was able to replicate the effect of the different sized gourds. 

With the support of my staff of midwives we commenced the first EPI-NO test and experienced immediate and significant improvement in reducing perineal injuries. Together we achieved over 70% intact perineum rates for first time mothers at Starnberg Clinic. It was determined that not only did the stretching benefit the women, but the reduction in anxiety levels contributed to a more controlled, and shorter second stage of labour. With no adverse effects experienced, the EPI-NO concept was born.

“There are many variables in the natural childbirth equation, – but one constant: 10.0cm. EPI-NO is now helping women in over 20 countries to more easily achieve this goal” 

Dr Wilhelm Horkel
Starnberg Germany