I was offered the chance to have an epidural sited just in case it was needed but declined because of the risk of complications from the epidural site, with the full understanding that this meant I was more likely to need a general if I needed a CS for twin 2. In my case twin 2 did do somersaults but the midwives held him in place once he was longitudinal with the understanding that if a bum presented I would flip onto all fours and deliver him that way, but he was head down so I stayed kinda on my back which was the comfiest position after I had already had one baby. I did need a painful internal which would have been nicer with an epidural, but it only lasted 30 seconds and I appreciated the chance to use the pool for labour more than I would have that experience being less painful.