I think there is a difference between having a relationhip with an OB (through the private system) that you have chosen and you trust to do the right thing when it is game time, versus having your child delivered by someone you have never met before within the public system.

I would also prefer to be cut, with or without my informed consent, if it meant having a healthy child born alive at the end.
I imagine most HCP would see that as their end goal and would assume, rightly or wrongly, that most women would too.
I think n2l is referring to the news article on the other thread where the ob has suggested (right or wrong) that he was denied permission and has attributed it, amongst other factors, to the death of the poor baby.

When I brought up about episiotomies with my ob #2 he said he only ever cuts if he can see damage is going to happen from tearing in a bad direction or way. When I was in labour it certainly wasn't necessary and it never happened. That being said (for me personally) if the ob had to make the call to cut me while I was pushing, and asked me, I would have panicked knowing. Not knowing would have been the more positive experience for me.

I think a pp comment about the relationship you have with your ob is true. To me some random ob coming in and asking to cut me would have envoked outrage, whereas a person I trust and know advising why is a different matter.

I do believe though a woman can say no, and routine episiotomies are ridiculous.