Hi Dikla,
I am one of the distributors of the Epi-no in Israel and also a nurse midwife who has a passion against cutting women! In 1999, I got 10 samples of epi-no to try with first births. It seemed crazy to me but after having 10 births with not a single tear and no stitches and fast and easy pushing stages I was convinced. Also several studies were done comparing women using it and not-using it. They all demonstrated a definate advantage to using the epi-no, with less tearing and stitches and episiotomy. Keep doing the exercises but these do not physically stretch the perineum and prepare it for birth, rather more work on the pelvic floor muscles. I know that my personal rate of tearing has dropped very much since my private birthing clients are all using the epi-no for their first births, and I havn't changed my technique of birthing babies, so it must be the epi-no. I think it is the most important investment that you can make in the first pregnancy. Although it is not 100% guarantee against stitching, it is the best there is and much more effective than perineal massage. Also second stage is faster, and since hospital protocols usually do a vacuum after 2 hours of pushing, this can help prevent vacuum births as well. That is another side-benefit.