I would never choose a caesar over a vaginal birth even if there were instruments involved.

Instrument births don't always involve an episiotomy, although your risk of having one is certainly higher where instruments are used.
The midwives there told me that a lot of obs won't use forceps now and would have simply sent me for a c-section.
This is true I reckon. I have only seen one forceps birth which was in a public hospital, and it would have been a ceasar if she'd been with the private OB that she ditched a week beforehand. Forceps are most often used when the baby is still high - high enough to do a caesarean. The use of forceps is on the decline with obstetricians because they are opting for c/sections instead.

Ventouse most often comes out when the baby's head is on view (ie. baby is very low in the birth canal) and there is a desire to get things over with. Sometimes that's from the mother but most often it's from the caregiver. I have seen one situation where the baby's heartbeat was seriously bottoming out and not recovering and the ventouse was probably justified...but most of the time I see it used it's purely impatience.

The point of all that ramble being that it's rare that instrument use is a life and death scenario.