I had my babies in the 1970s. At that time, the Medical Defence Union (doctors’ insurance organisation) said that the moment a woman set foot over the threshold of a maternity unit/hospital she had given implicit consent to any treatment she was given. What that meant in reality was that there was no need for explicit consent, no explanations, no information, routine episiotomy – they just did what they decided and you just had to accept it.
That was, of course, some fifty years ago, and none of those working then will be in post now. But they would have taught students, who would have taught students, and by the sounds of it there’s still a lingering after-effect of “doctor knows best”.
(As for pain relief: while in labour with my first, I got jabbed with a needle and don’t remember much after that. In the post-natal ward, the woman in the next bed was a nurse who had asked the question – apparently, all patients under the care of that particular obstetrician were routinely given a cocktail of pethidine, morphine, and chloral. Slowed down labour, forceps delivery, floppy baby. Yes, I’m still angry.)