i havent read others replies but heres my opinion, mainly from my experience.

Do you think women should have to give informed consent for an episiotomy?yes

Do you think that it is ok for HCPs to assume consent (for an episiotomy) if consent has been given for vacc or forceps?no, in no shape or form

Do you think that it is ok for HCPs to assume consent (for an episiotomy) because a woman is in labour and has entered a hospital? absoloutely not

Do you think it is ok for a woman to refuse a procedure? When/Why? When is it not ok?yes it is ok to refuse, when it is rountine, just waiting for the perineum to stretch etc etc. its not ok to refuse when it is a matter of getting your baby out alive or when there is going to serious tearing in the wrong place, then consent should still be obtained, if refused, explained why it was really essential to have it occur. most women in that position would not refuse one. if they did i dont know what action should be taken, it would be a hard place for the Drs and middies to be in.

from my experience it is absolutely not ok to assume consent in any situation. for me it was unnecessary (DS tho playing funny buggers, had ridiculasly good apgars and there was plenty of oportunity to explain what and why things were happening) and led to lots of tears and stress post natally, and continues to cause issues now, over 2 years later.