I've now had two babies, one without any medication in labor and one with an epidural. And I can honestly say that if were to go for a third (which I won't, Marc says no way!) that I... have no idea what I'd do. So that's my answer for the perfect birth plan: whatever.
Here are some things I do know:
Those natural birth techniques really do help with managing painful contractions. With Josie it was lamaze breathing and counting that helped me ride out each one. With Olive the pain was different, constant back labor and the contractions felt a lot worse, so the bradley method of "stick to this position, don't move, and relax every muscle in your body" helped the most. So even between natural birth methods there's no perfect one. But it helps to be familiar with some, take a class, read a book, practice.
With both my births the vast majority of the hours of labor happened at home. Home is a nice place to be in labor... no one is poking you, the lights are dim, you can be on your bed or couch or floor and nobody cares. Having those natural birth techniques in your pocket helps you stay at home longer, on nobody's timeline, free to do whatever you want.
Then you go to the hospital and either get the epidural or don't. With my first, I was more exhausted than in pain and I knew the epidural wouldn't make anything over faster, so what's the point? I pushed the baby out, tore some skin, didn't care. There was so much going on I barely noticed that stuff, it was like rock climbing for hours until my muscles shook and having some little bird peck off my toenail, at that point I was like "whatever". With my second, the back labor was so intense and constant I wanted OUT so I opted for the epidural. Getting it was not that big a deal, and after ten minutes or so I couldn't feel the pain anymore.
I will say that with my first I could tell when I was in transition, when the contractions were longer and closer together, I knew about where I was at in terms of progress. With the epidural? No idea. I just laid around and listened to the heartbeat on the monitor and had nurses check my dilation. So when they say natural birth lets you "experience childbirth" they're right... you're a lot more in tune with the pace of things and where your body is at on the timeline.
The baby is born, and then there's the afterwards part... and this is where it gets weird, and they didn't really tell us about this in childbirth class. I was told that "when you hold your baby you just don't care about anything else in the world!" Well, with my first birth, I CARED. I was getting stitches and had a tear towards the front of my lady bits in an "area with lots of nerves that's sort of hard to numb"... they tried locals, but I felt lots of really awful things and mostly just remember wanting to be someplace else.
With my second, the placenta didn't detach correctly, I'm not sure what all went on but there were injections, lots of external rubbing, and finally they just had to manually detach it... I'm not sure how this would have gone with local anesthetic. Since I had an epidural, I didn't feel anything.
I required a catheter after both births, the first because I couldn't walk with the epidural in, the second because I was too swollen to empty my own bladder. Getting a catheter with an epidural is nothing. Getting one without the epidural is absolutely awful. In both cases they removed the catheter after my bladder was empty, and a short few hours later I could pee on my own.
With both births, I was unable to get out of bed. The first birth I tried but blacked out, the second my legs were numb for about 4-6 hours, and still felt weird after that but they did have me get up and go to the bathroom. In either case I did not feel like jumping up and running a marathon.
Lots of epidural advocates bring up the fact that birth is calmer when you can't feel anything, and they're right but I don't really care too much about that. Natural birth advocates say it's unnecessary and keeps you from experiencing the amazing power of childbirth, and they're right too, that feeling that you're along for the ride is kinda cool, but again I'm not sure it's worth considering. They also warn you about gobs of side effects, some real and some theoretical. The more theoretical ones are that medication slows labor down, that it interferes with your brain's ability to pace out the birth, that your baby is born drugged out and won't breastfeed... since I got mine so late, I guess I can't judge that much. Both babies nursed immediately.
For me, the worst side effect of the epidural was that adhesive residue left on my back from the edges of the tape. It was kinda hard to wash off.
I think my conclusion is that it's good to have a natural birth plan so you can labor independently, ride out contractions, know where you're at. And maybe your injuries won't be as bad as mine and the repair work won't be all that noticeable. But there's no way to predict that, so I'm back to my "flip a coin" conclusion. Sure it's great to avoid extra medical procedures when you can, but I wouldn't skip the epidural just out of fear of side effects, I wouldn't recommend any action taken out of fear. Birth has side effects.
I guess I just feel like you can do a lot of labor and childbirth without an epidural, but it's very nice for when the going gets tough, and it's definitely nice for the after-effects of birth. So study up on natural birth, then do whatever the hell you want. I won't judge either way. You will find women on both sides who LOVE natural birth, and who LOVE epidurals, and I'm just not gonna pick a side.