Sterilisation for women is a much more invasive operation; and, I don't think that this has changed a very great deal since contemporaries of my own were seeking sterilisation for the very good reason of having no intention ever of being pregnant, there was then and I suspect still is a whole lot of gate-keeping and assumptions that She Might Change Her Mind About Baybeez, is she really, really, really sure? so there's a massive amount of hassle.

I'm totally going WOT!!!! over the suggestion of 'fertility awareness or natural family planning' AAARRRRGH. That used to be known as the rhythm method, aka Vatican roulette.