constancereader - I'm a doula and have just supported a woman giving birth with vaginisimus, which it sounds as though it might be something you have?
The woman I supported had a number of appointments with the midwife counsellor at her local hospital and discussed the issues surrounding vaginal exminations, epidurals and even elective cesareans and then saw the consultant so that everything was written up in her notes in advance of her going into labour so that there weren't going to be any arguments on the day.
Generally, before an epidural is administered the midwife or doctor will want to do an internal exmination to check that you're in established labour. The main problem with early epidurals is that they may increase the likelihood of having a cesarean, although the evidence on this isn't clear-cut.
However, my client was so obviously in established labour that they agreed to put one in anyway before they did any examinations so that she wouldn't feel very much when it was happening. Once you do have an epidural in though it does generally mean that you're going to need regular vaginal examinations to check progress and you would also need to be continuously monitored which you mentioned as being a possible issue with your first birth.
Another thing which might be an issue for you is that even with an epidural in place you will still be able to feel the sensations of pushing a baby out. According to the midwife caring for my client about 50% of women with vaginisimus find that giving birth more or less cures them, but the other 50% find that it can cause things to become much worse than they were previously. If you don't like the sensations of the baby in the birth canal then they can give you a much stronger epidural, but this can then mean that you need help getting the baby out - ie forceps or ventouse.
Another possible downside with epidurals and a VBAC is that they can cause contractions to slow down or stop which can necessitate drugs to speed up labour ie a syntocinon drip which can increase the risk of uterine rupture, so again this might be something to discuss with your consultant.
My client also did hypnobirthing which she said she found very helpful. As somebody else said, another option is a homebirth where you are likely to feel more relaxed and comfortable generally. At home or in hospital you don't have to have any examinations, but it might be worth discussing your plans in advance as mentioned earlier so that it can all be put in your notes. I know I'm bound to say this, but do consider having a doula as they can be really valuable in helping you in planning your birth and also with negotiating with doctors and midwives.
Hope this helps!