Sometimes an episiotomy is unavoidable, noted the New York Times. Like when a woman's perineum (the part of your anatomy between your vagina and anus) is exceptionally tight and won't stretch enough to allow the baby's head to crown, or a baby needs to be delivered immediately and there's just not enough time for the mother to push. Another reason, according to the same New York Times article, in which an episiotomy might be indicated is when a baby has a really large head and your physician wants to prevent a rectal or urethral tear (ouch).
A study published in Obstetrics & Gynecology by the American Congress of Obstetricians and Gynecologists (ACOG) recommends against the standard use of episiotomies. This is kind of a big deal in the medical community. The Practice Bulletin published by the ACOG suggested that physicians should take precautions against making episiotomies routine. Instead, the study suggested another suturing technique, and use of antibiotics at the slightest obstetric anal sphincter injuries. Preventative measures like long-term monitoring and pelvic floor exercises (practice kegels throughout pregnancy) as well as massage and warm compresses applied to the perineum during second stage labor (what Mayo Clinic referred to as the final stage of active labor) were encouraged by the ACOG.
Additionally, the aforementioned New York Times article brought up the issue of consent when you're giving birth. You have the right to refuse an episiotomy. However, if an episiotomy is unavoidable, you will get through it because it will help bring your baby into the world. Some weird things will happen to your vagina, but you've got this.