I don't think anyone here would refuse any interventions that would result in the life of their baby being saved. Isn't that just a given? Most episiotomies are not given because a baby is about to die, just as many extractions are not performed for that reason. Unfortunately the two are often mutually exclusive. I would be devastated if somebody cut through my perineum without my permission. The rate at which they're done, it's pretty clear they are not all necessary, otherwise our bodies must be faulty beyond belief. I also don't think the situation (birth) is generally that dire as to fall straight into the whole life or death scenario. A large proportion of women are given episiotomies because it's easier for the person delivering, or quicker. Falling back onto the whole 'whatever has to happen to save me or my baby' just perpetuates the feeling that birth is unobtainable without medical intervention. While it is needed, it should never be routine.