C.,
First of all...Congratulations! You mentioned that you are hoping to have a natural delivery. If its vaginal, it's natural. That seems to be a misconception - women who use drugs don't have a natural delivery. I had an epidural with my daughter (I was in labor for at least 24 hours) and wouldn't have survived without it. The anticipation of a needle that big going into your back is more scary than the actual thing. I was so uncomfortable from the contractions that I didn't really feel the needle going in. After the epidural, I no longer felt pain from the contractions, with the exception of a hotspot - an area where the epidural doesn't take. Not all women get hotspots. Mine was in my lower left back and I could feel everything there. But when I pushed the pain went away. I pushed for two hours and not once felt pain from that. The epidural worked so well that I didn't even know I had an episodomy until I heard my husband and the nurse talking about it.
Getting an epidural is a personal choice. You don't have to get one, but you should have that pink card with you just in case you need it.
As for your breast pump, your milk won't come in for at least 2-3 days after giving birth and you should be home by then. But if you want to practice and have the breast feeding coach (supplied by the hospital) to come work with you, by all means bring it.
The epidural had no affect on my daughter (now 4 1/2). She is happy, healthy and very smart. I however did feel the effects of it for the rest of the day. I good thing though, since I didn't feel pain.
Good luck! Hope you let us know how it goes.
J.