The subject of EPO comes up here and other forums quite a bit; it seems that ingesting and/or inserting EPO is commonly recommended by moms and birth professionals as a way to hasten cervical ripeness and bring about birth 'sooner' and possibly 'easier' way. What I understand about EPO is that it contains compounds that aid a woman's body in production of prostaglandins--a type of hormone that is associated with producing changes in the cervix necessary as part of labor. EPO contains, in other words, some of the 'nutrients' needed for a woman to build the prostaglandins she needs to build for a normal labor.
Of course, various foods also contain components used in prostaglandin production, just as food contains proteins, vitamins, minerals and so forth that our bodies use to perform the all the different tasks of being alive and making babies. To put it in a simplified, general way.
While I understand the logic of using EPO, I have seen a few births in which it proved to be overkill--and have heard stories from other mws who have seen this as well. In brief, too much EPO (for the particular woman involved) seems to cause *too much* cervical ripening--ripening/softening that does not occur in balance with oxytocin and contractions that help to open the cervix.
The result is that the cervix is so soft/stretchy that the baby's presenting part is enabled to descend much farther into the vagina than is warranted by dilation....a baby who may be at an advanced station, with the cervix only slightly or partly open. In one case, baby's head was visible at entroitus--with the cervix still around his head, only 4cms or so. The problem with this is that for one, moms get an overwhelming urge to push with the baby so low--but the cervix, being dragged so low, has reached the limit of it's stretchability and is usually very rigid at this point. It can't relax and open--labor becomes nearly unbearable between the intense pain at the cervix and the tremendous urge to push.
I had one primip mom do most of her labor in knee-chest (3+hrs) to get from 1 to fully--because only in knee chest, bringing baby up a little bit out of her pelvis, eased the urge to push *just enough* for her to resist. No fun whatsoever! Above, I mentioned the one with cervix over baby's head at introitus--she was having her 10th child, which surely figured into things as well. But both of these moms had one thing in common--EPO in great quantities. The primip was taking 2,000mgs orally every night, and inserting an additonal 1,000mgs most nights during the last 5wks. The Grand Multip, wanting birth to happen NOW, used most of a bottle of EPO (not sure of mgs, not my client) inserted every couple of hours over 2days time. These are just 2 examples.
Anyway--seems to me that it is wise to be careful about disturbing the balance of things that bring about labor. Again, generally speaking--a woman needs prostaglandins working on her cervix, oxytocin for contractions, and also compelementary chemical signals from the baby showing his/her readiness to be born (and to participate otherwise in being born). It also seems to me that we don't know enough about EPO to have a good idea of how much to use, when to start it and such--but because the compounds are lipid based, I suspect that it is possible to build up EPO in the system and potentially create an 'overdose' situation over time. People are individually more or less sensitive to the effects different herbs, nutrients, medications--our chemistries differ.
I can see the place of EPO in a woman's pregnancy/labor--but the same as with other herbs, my first question is going to be "Why take it?" If there seems to be a good reason to take it--great. And while perhaps almost any woman benefit from ingesting EPO to be sure they are getting 'enough' of the 'nutrients' it contains (which may not be adequately present in her diet), we don't really seem to know what constitutes a 'nutritive amount'--a min. daily req. And as seems to be happening more and more with herbs in general, a lot of people (consumers and pros alike) seem to feel that since it's an herb, it's safe....and if some is good, more is better. (Again, speaking generally here--I know many who exercise due caution and research). I know for instance that EPO is commonly sold in 1,000 mg caps--how did that amount get arrived at?
Anyway, gotta run but there are some of my thoughts. I hope others will add their own--including any research you have. I did not take the time to find my (few) EPO links, but will do so later.