You can use a midwife at the hospital. We've noticed a huge difference between a doctor and midwife. The doctors gave us the impression that they just want the baby out ASAP--load 'em up with Pitocin! Also, ANY doctor will tell you there are side effects and complications that can come from epidurals. It's an anesthetic block, with which there are always risks. My wife hasn't used an epidural for our last two.