You can't be said to make a choice when you only have one option.

In a branch of medicine rife with paradoxes, contradictions, inconsistencies, and illogic, episiotomy crowns them all. The major argument for episiotomy is that it protects the perineum from injury, a protection accomplished by slicing through perineal skin, connective, tissue, and muscle.

When intervening becomes routine, meaning there is no reason for it, only risks remain.