I wanted a med-free birth at the hospital (we don't have any local birth centers, and I didn't want a home birth) and I did get my wish. My OB was very supportive and my husband said he even heard her in the hallway talking to the nurses to make sure that they understood what I wanted. There was actually never a point for me where I even felt like I needed/wanted anything for pain, so I consider myself to be very fortunate!! They did get a little concerned about his heart rate shortly after I started pushing, but I only pushed for 20 minutes so I don't know how things would have gone if it had taken longer.
The bad? I lost a lot of blood and had trouble delivering the placenta. It did not have to be manually extracted, thank goodness, but the blood loss really took a toll on my post-partum recovery, both in the hospital and once I came home. I was offered a blood transfusion, but at the time I didn't realize the extent of my blood loss and I declined. I realize now that it would have helped me heal and recover much more quickly. Also, I had a 3rd degree tear, inside and out.
Overall I am happy with my birth experience. I know there is so much that we have no control over, and I'm thankful that I did get the primary things I wanted (vaginal, med-free).