I am very much the 'leave me alone to get one with it' kinda girl so my first was a homebirth and my second was a water birth in hospital (couldn't afford the midwife for home the second time). So I avoided an epi because if you are in the right headspace and your body is working right then interventions just get in the way. I wanted to give my body the best chance to do it by itself. I honestly don't think I could give birth out of water though. I mean, I guess I could if I had to but I don't want to imagine it. That being said. My first was born after 5 hours of active labour and my second was born after about 2. He was out within an hour of arriving at hospital. So who knows what decisions I may have made if my labours went for ages.
As for internal exams. I have never had one. I have serious hang ups about strangers being near that area so I requested no internal exams unless desperately needed and discussed beforehand. At both hospital and home the midwives could tell by how I looked how far I was in the process so they weren't needed. It definitely helped me to stay calm as it took that stressor away from the equation.