My wife had her tubes tied. It was a point of contention for a while and her doctor always said no as she was still strongly within child bearing age. As soon as RvW was overturned, her obgyn said yes without hesitationnand 45 days later it was done.
I understand her reasons, and I respect them, even if there is some sadness and in part mourning on my end as it's a potential loss of something that might have ever happened. But the fact is, I have a child, and they were tough to raise. My wife doesn't want to do that again, even if she had her own child with me.
I think here in Belgium it goes something along the lines of: "ok, you want this... These are the ups and downs of doing that... You still want it? We plan you in at least 6 weeks from now, so if you would change your mind let us know".
Oh, and all things medical are virtually free compared to the US ;)