We should be able to trust that our caregivers won't assault us, certainly. But is it really reasonable that we must pick and choose and defend ourselves to ensure this?

And it's not about the procedure itself and how painful/unpleasant it might be. It's about being treated with the respect due another human being and in a particularly vulnerable situation.
I've had 2 episiotomies now. I have had BOTH experiences. I'm not upset just because it hurt or i had to have stiches, or that it tore up to my arse. boo hoo, poor me.

Having a baby shouild never mean a woman must give up her right to her self, or her dignity. Her carers should safeguard it - they hold this woman in trust. Anything less is not good enough.