I was hoping some of you might have better knowledge of how and when these procedures are done. It doesn’t seem to me like a c-section would ever be necessary, unless the baby was breech or blocked (vasa previa), and that an episotomy would only be necessary if the baby’s oxygen supply was in jeopardy. I’ve read that rates of both surgeries are high, and that they’re often done when labor is taking too long. My mother was in labor for 28 hours with my brother, and fortunately no surgeries were needed. I’m worried that having a long labor, on top of being insured by the state, may lead my doctor to decide that it’s been long enough. I’m willing to live with the possible scars of carrying a baby, but not those of an unwanted surgery (or two). Is there any way to express in writing your intentions or to legally prevent these procedures..?