System crashed, lost my post. Dang.
Anyway…
RE: EPO, don’t take it internally. I was in the study that looked at its efficacy for non-post-dates and shortened duration of labor. The answer is it doesn’t do either. Okay, it does change the curve for duration of labor, making some labors shorter, and some longer, than the normal curve of durations. But you don’t know if you’ll be in the ‘shorter labor’ set or the ‘longer labor’ set. It also increases problems with descent, in that study (which was admittedly small). And it had zero impact on actual gestation period. That is, it didn’t make labor happen sooner.
Topical application is assumed to have fewer implications, but again, has not been studied. The assumption is that if you are not ripening due to a lack of precursors in your system, this will provide them. Personally, I’d still skip it, even though I doubt it has anything like the implications of oral ingestion (not systemic reaction, for example). However, given the implications of induction with a bad Bishop’s score (not ripe for induction), it may be determined to be worth any risks (since it has not been associated with a substantial pattern of negative outcomes to date).
As for what we did, we tried the whole wive’s tale routine to avoid a 42-week-2-day scheduled induction (no scheduled inductions on weekends, but biphysical profiles on weekends to ensure safety of later induction). Sex, spicy meal, glass of port (red wine, usually, but I prefer port), drive over a bumpy road (note to self, do not use someone’s Mercedes for this, as it removes the whole bumpiness thing), and a few hours of bellydancing. And yeah, I went into labor that night.
Was it the sex? The food? The drink? The ride? No idea. Most women go into labor before 42 weeks, anyway, and I was just over 41 and a half weeks. Doing nothing could easily have had the same effect.
Regarding the GD, let me add a note of experience (backed up by research): Ultrasound estimation of birth weight (within 10% of the actual) ranges from 30% to 75% accurate (mostly around the low 60%s across various studies), and appears to become less accurate the higher they estimate the weight. If they estimate that you have a BIG BABY (macrosomia, or a baby over 4500g), do not assume they are automatically right. Ultrasound estimation of macrosomia is not much better than flipping a coin.
(oh, and wasn’t ephedra tested by the FDA? That note could apply to ANY off-label use of any med, including those that have been tested for safety, and approved. Like, say, cytotek, which is often used by doctors for induction of labor, despite its record of increased odds of a uterine rupture, and statements from the manufacturer saying that it is not to be used for induction of labor.)
And just for fun, go in to Medscape or any other system that lists the Cochrane Medical Abstracts, and do a search on ‘Induction labor’ - you’ll find a lot of abstracts reviewing the data. Sex for induction is one of them (inconclusive, not enough studies). So is nipple stimulation (comparable to oxytocin-induction outcomes with an additional reduction in risk of postpartum hemorrhage, but not to be used in high risk pregnancies, and not studied enough to ensure safety). And so are a variety of other approaches, from baths to accupuncture to prostaglandin. Worth looking up, IMHO.