The Great Debate: Natural Childbirth vs. Epidural

I haven't been posting here much, mainly because I'm working on my 'professional' blog and chasing Max around the house all day. So to catch up: I'm 33 wks preggers with number 4, or 'baby Reagan' as she is affectionately called by her older sibs.

Although we've been through the whole L&D thing three times already, this one will be the first time (assuming everything goes smoothly and on schedule) since Karol that I will actually wait to go into labor instead of being induced. Both Patrick and Maximilian were scheduled inductions - 1 wk and 1.5 wks before their due dates, respectively - due to their inheriting some sort of giant-gene from Matt's side of the family. Well, I guess there are some big dudes on my side, too. Anyway, I developed a sort of system based on some good advice I got from a co-worker about how and when to do an epidural during an induction, and since I was bound to be hooked up to an IV from the start, I didn't really struggle with the decision to get one or not - the question was more at what point in the labor process to get one.

This time, however, short of Reagan being very tardy or something, I'll most likely have no reason for an induction and therefore will be doing the crazy, timing-contractions, rush to the hospital thing (which I really am not looking forward to doing in NYC traffic - or on the SUBWAY). So now I'm wondering, when should I get an epidural? Should I actually be open to the idea of NOT getting one at all?

When Karol was born, I figured I'd hold out as long as I could, but keep the option on the table. I ended up spending 12 hours in labor and got the epidural around hour 6. I had no regrets. I've never regretted getting the ep, in fact. So maybe I'm crazy for considering passing on it this time.

So now I'm back in research mode, looking at the pros and cons of epidurals versus natural childbirth. Here's the list Babycenter.com came up with, and my reaction in green.

Here are the pros:

• Most natural childbirth techniques are not invasive, so there's little potential for harm or side effects for you or your baby. I never had any side effects, but I guess that doesn't mean I never would.
• Many women have a strong feeling of empowerment during labor and a sense of accomplishment afterward. And despite having to endure pain, many report that they'd want an unmedicated birth again the next time. For some women, being in charge helps lessen their perception of pain. Um, I felt empowered and accomplished enough without the pain the first 3 times, thanks. This is really stretching it for a 'pro'
• There's no loss of sensation or alertness. You'll be awake and active during labor and birth — so you can move around more freely and find positions that help you stay comfortable during labor and remain able to aid the delivery process when it's time to push your baby out. I was always alert with the epidural, but the numbness and inability to move my own legs was annoying.
• If you don't need to be hooked up to an IV or amonitor, you can move around with ease This is really the only true 'pro' to me.
• You're less likely than women who get epidurals to need interventions such as oxytocin (Pitocin)to make your contractions stronger, bladder catheterization, or a vacuum extraction or forceps delivery. Didn't need that with Karol, but again that doesn't mean I won't need it this time.
• Your partner will feel involved in the process as you work together to manage your pain. I'm pretty sure Matt does NOT want to be involved in my pain. Because I will involve him. Oh yes, I will.
• Breathing exercises, visualization, and self-hypnosis can be practiced ahead of time — and used again later. Many new mothers find themselves drawing on their relaxation techniques in the early days of breastfeeding, while coping with postpartum discomfort, or when caring for a newborn feels especially stressful. Self-hypnosis? Really?

So for the 'cons'

• An epidural provides a route for very effective pain relief that can be used throughout your labor. I agree.
• The anesthesiologist or nurse anesthetist can control the effects by adjusting the type, amount, and strength of the medication. This is important because as your labor progresses and your baby moves farther down into your birth canal, the dose you've been getting might no longer cover the pain, or you might suddenly have pain in a different area.
• Since the effect of the medication is localized, you'll be awake and alert during labor and birth. And, because you're pain-free, you can rest if you want (or even sleep!) as your cervix dilates. As a result, you may have more energy when it comes time to push. Haha, now wait a second, I wouldn't exactly say 'pain free...'
• Unlike with systemic narcotics, only a tiny amount of medication reaches your baby.
• Once the epidural's in place, it can be used to provide anesthesia if you need a c-section or if you're having your tubes tied after delivery.

Well I'm obviously pretty pro-epidural looking at these lists, but I'm still unsure. Chances are no matter how much I plan for it in advance, we'll really just be winging it when the rubber meets the road anyway.

I guess I'm looking for more anecdotal evidence that natural childbirth is worth giving a shot. Any advice? I'm all ears.