It is the opinion of this author that very few women require to subject themselves to the intrabdominal procedure of a tubal ligation.
There are occasions where it makes sense, like a seventh baby at c-section, the tubal takes two minutes and then it is over. But one must be certain they want irreversible sterilization and the possibility of the rare, unproven post tubal syndrome.
Simply, the vast majority of couples who are done with child bearing may let the man get a vasectomy, a much simpler and safer procedure. Men must be educated as they feel they loose their “Maleness” when this occurs.
As well women who are unsure, or the man refuses the vasectomy, most often will tolerate one of the IUDs on the market and since they are approved for such along time – the Paragard 380T was approved for 10 years – it can always be taken out, with a high degree of success, everything else being equal in regards to their fertility. As well they last long enough to almost take the average women to menopause after enough childbearing.
So the options are significant to avoid the tubal ligation which is irreversible for the most part, unless you have lots of $$s and are happy with a below 50% success rate – I am not.