On Epidurals

This post is dedicated to Danielle. :-) In a comment, she asked me about the whole not having an epidural thing. I gotta say I'm not sure I'm qualified to really comment, having no basis for comparison, but I'll throw some thoughts out there. I hesitate to do so because I've seen some really strong opinions in the articles I read during pregnancy, and I don't want anyone to think that I'm telling them the "right way" to do things. So, just remember if you're reading: this is just my opinion and you are, of course, entitled to disagree. :-)
One of the first moments of feeling overwhelmed I had with my pregnancy was reading about "choosing a doctor" in the baby books. From the start, I was really glad that this was not an option for me. As someone who generally takes a medical condition to the doctor and then does what the doctor says about it, the idea of forming a birth philosophy and then finding a doctor with the same birth philosophy was absolutely terrifying to me. How, exactly, was I supposed to know how I felt about things like pain medication, birthing positions, and what not until I had actually been in labor? I think what the books are really trying to say is don't just assume that any doctor is the right doctor for you, not "go in with a 100% idea of what you want and then find someone who will do it for you." But to start off, it was scary. So I was relieved that I just would have to live with Dr. Higashijima, who (by the way) turned out to be very much in agreement with what I would have wanted anyhow.
That was way back in month 1-2 of the pregnancy before I'd spent hours and hours reading pregnancy books, internet articles and birth stories (which seem to tend to be from really eccentric people if you search for them online). By the time I got to actual labor, I can't say that I knew for sure what I wanted, but I had a much better idea. And part of that idea was that I probably didn't want an epidural. Here's why (in order of importance):
1) I'm scared of needles. The idea of someone sticking a needle into my spine was about a million times scarier than labor pains (which I had never experienced but didn't involve needles). I recognized that this opinion could easily change, and if it did, I was willing to go the epidural route, but for the time being, that was it.
2) I had heard about as many epidural horror stories as stories about women who were happy with it. (I'm only counting first hand from women I knew stories, not the crazy people online.) These ranged from mild dissatisfaction (ie: "I couldn't feel and that made it harder to push") to serious issues (ie: "the needle was inserted wrong, I leaked spinal fluid and had a severe headache for several days afterwards as a result.") Why exactly, would I overcome my fear of needles for something that I might not especially like when the time came, either?
3) Dr. Higashijima's epidurals are not American epidurals. He calls them 70% strength. American women note that you can still walk with these Japanese epidurals and wonder if it might not be more like 50%. If someone's going to stick a needle in my spine, I want it to really make a difference in how much pain I'm feeling.
4) Drugs in general have always had really funky effects on me. Any medication that says "might cause drowsiness" is likely to knock me out cold. Because I know that medication reacts that way with me, I tend to avoid it when I can. It's easier sometimes to deal with pain than with the side effects of the medication.
In addition to these four reasons not to have an epidural, I'd read countless articles talking about the many reasons not to have one ranging from the effect it has on the baby to the fact that women who have epidurals tend to have longer labor. I didn't worry much about these because I'd also read countless articles about why an epidural is sometimes the better choice. So while I went into labor with a plan to not have an epidural, I was by no means against it if the situation required. If the doctor had said "Look, you're tired and you're not going to have any strength left to push, let me give you an epidural to help you rest now." I probably would have been okay with that. Similarly, if I had been in more pain earlier in the labor process, I totally would have gone the epidural route.
The nurses advised me that the best time to ask for the epidural is at 4-5 cm dilated. At that point in my labor, I was not in enough pain to feel justified in asking for an aspirin, much less a needle to the spine, so when the doctor asked me, I refused. He was delighted, since he prefers the more natural way of doing things by and large. He asked again several times over the course of my labor, but the first time I would have been tempted was during transition, and I knew that I wanted to be able to feel to push in hopes of making that part go more quickly. My thought was "it'll be over soon, I can make it a bit longer". So the result was that I didn't end up with one. If I were to do it all over again, I wouldn't change my choice in the slightest. Does labor hurt? Yes. But in my case, it didn't hurt so badly that I felt the need for medication.
That said, I also firmly believe that ever labor and every situation is different. Reading all the stuff online, I found that there are those out there who would make women feel guilty or weak for having medication. I am not one of those people. I'm sure some women have more pain during labor than I did. I'm also sure that there are situations where an epidural really is the best choice. Finding fault with the women who get them is just a bit crazy in my mind. I am glad that I made the choice I did, but may be next time I won't feel the same way. Who knows. I'm just glad that there are options out there so that women can get the best birth experience possible for them.