Yes, healing from an episiotomy I have heard is tortuous. The perineum (the space between your vagina and your anus) is opened with "sissors" usually to have the baby born more quickly and most often to facilitate a forceps delivery or a manipulation of the babies position.

Episiotomy is most often done to facilitate an instrumental birth (one where forceps are used primarily). In the bad old days all women were given an episiotomy.

It has been shown that women that tear in childbirth have a quicker and more successful rate of recovery than women who have an episiotomy. For this reason many of the front runners in obstetrics avoid episiotomy now days - except in an instrument birth.

Midwives don't generally speaking facilitate forcep births so the man or woman on the end of the episiotomy sissors is most certainly a doctor!

Midwives getting back to bed. I can ASSURE you if you need support and someone to sit by you as you labour through the night it won't be the $2000 + obstetrician. It will be a midwife! Generally speaking (and of course it's not always true) but generally so. Midwives are very dedicated supporters of the natural birthing process who will work a double shift just to see that little head poke out and a slimy baby held in her Mamas arms...

You are right. If you want a c/s and you are fully informed of the risks and consequences involved and you have a doctor who is happy with the decision than it is your decision.