I don't think the issue is internals during labour, it's internals done during pregnancy. If you ask for one and want one before you have gone into labour, that's a bit different to a doctor telling you you need to have one because it is routine or just something that they have always done. But either way, they are mostly unnecessary. In labour it's different - they can be very handy to give an indicator of how things are progressing, and if you want pain relief they will often do one just to make sure you are not too far along to have it. But even then, you don't have to have one at all if you don't want to. I prefer as few as possible. I think I had two last birth, but the midwife was very good and they really didn't hurt.

Ali - a standard internal exam (as I have experienced it anyway) is just a doctor or midwife inserting a couple of fingers into your vagina and feeling the cervix to see whether it has dilated, and if so by how much. I guess a speculum could be used, but the only time I have ever had a speculum in there is for a pap smear.