I was unable to consent to having an epi but it was required as they were going to lose both me and my baby if they did not get him out there and then. My doctor also knew that I trusted him to make the right decisions if I were unable to and he also listened to my wishes every step of the way when I could still make my own decisions, including withholding the need for the VE until they had no choice. If I had of consented sooner, it would have been easier on everyone but I am glad he respected my wishes but stepped in where needed
The epi never did heal properly though. The two sides never rejoined each other successfully even though they did get stitched. I say that where possibly, tearing is best but there are most definately times where episiotomies are required.