This was hilariously written and I love your sense of humor.

This phenomenon is clearly being politically and culturally pushed because it used to be a little easier to get a tubal ligation. My mother had one after my sister was born; she too had a difficult pregnancy and at 3 kids was done. In my early years, once I started paying attention to female discussions around me, tubal ligation a were often discussed and seemed a lot more common. I don't recall ANYONE talking about how hard it was to get one. Particularly if you already had children.

At any rate, there's a business opportunity here for an enterprising OB/GYN. This can't be absolute. There has to be some doctor somewhere who's not so tight fisted with sterilization. I'd be willing to bet that if they advertised that fact women would flock to them to get it done. You can do it on vacation. That might also be a good way to bring tourism to an area.