I can't use EPO orally because it can reduce platelet function (and hence cause extra bleeding). It basically keeps the platelets from sticking together as well, which is important for blood clotting. Flax and fish oil do this as well. That said, this is really not a concern for mamas that don't have a bleeding problem (which I do).
I'm considering using it vaginally this time, though. I tend to dilate slowly, which isn't a big deal, but it would be nice to soften things up. I'm going to talk to my mw about it this week or next and see what she says. I don't know how much is absorbed into the bloodstream that way so I'd rather err on the side of caution, especially since I'll be at home this time.