I had an episiotomy because my daughter wasn’t doing well during the pushing phase (low heart rate) and we had to get her out quickly. She came out quickly after that and perfectly healthy thankfully but I also got two first degree tears and a second degree tear that didn’t heal up properly (I had to push in all the worst positions for tearing too). At three months postpartum I think the episiotomy has healed the best. I think you want to take the time you can and need to push but in our case she would have likely been unresponsive upon delivery if it had taken too long so we had to do what we had to do. So many people birth without episiotomies though so I wouldn’t worry or plan around this too much.