Are there circumstances when they would just cut me without asking ?
In theory, you should always be consulted but yes, we have known this to happen. There are certain times when an episiotomy is essential, for example in the case of a forceps or breech delivery. Because it is considered part of the delivery proceedure, the staff may simply forget to check with you. Make it clear in your birth plan that you wish to have episiotomy discussed with you under all circumstances.