So before I was pregnant and found out I was having with twins, I always thought I wanted to try to have a pain med-free birth. *Try* I'm not anti-meds.

Well, now that I'm in the hospital at 33 weeks with PPROM and with no strong contractions, it looks like I will likely be induced.

The thought of having a cold induction at 34 weeks sounds like I might need meds that will make me have stronger contractions versus if I go into labor on my own. So I might be in more pain.
I'm also hearing that although both babies are head down (great for chances of a vaginal birth), there is a risk of baby B (second baby) of turning breech once baby A is delivered. Oh, baby B has a risk of turning breech because once baby A is out, baby B will have more room and therefore turn from head down to breech or transverse. (There is also a chance that baby B might be bigger and baby A (who is smaller) can fit through the birth canal but baby B can't... But I'm assuming that since I'm delivering at 34 weeks that the babies are smaller and I should be able to get them both through.) I can have a breech extraction in which the Dr pulls the baby out by its feet. But, that's if the Dr is comfortable with that technique. So it sounds like a c-section could be possible.
So since a c-section is possible, they would like me to have an epidural in and flowing when I get to 5cm (active labor and when I'll be moved into the OR... Where I will be delivering the babies since the nicu is very close.)

So with all of this in mind, if I don't have an epidural and I need a c-section, I would have to be put under general anesthesia and not be awake during the delivery of my second baby (or both babies, if there are other complications).

So my thoughts are if I had to have a choice between being awake with an epidural during a c-section or being unconscious during a c-section... I would prefer to be awake.

I know, it's possible that the epidural might not work for me and I might have to get general anesthesia if I have a c-section.

I think my decision makes sense but I wonder if there's anything I'm not thinking of.

Well, other than if I do have both babies vaginally and no complications that maybe I might regret getting the epidural. Oh, in this case, I might request to turn down or turn off the epidural meds while I push out the babies. But I have to remember that, right now, I'm making my decision based on the possibility of a c-section and wanting to be awake.