Up to a few years ago, in California, women on Medi-Cal/Medi-Aid who were giving birth by Caesarian were offered a free tube-tie option, if they wanted it. The doctors were already going to open them up, so if they wanted to be sterilized -- no problem. It wasn't pushed, it was just an option. I knew a guy who worked as an orderly in an obstetrics ward, and he spoke some Spanish. So it was his job to explain the option to the welfare-cases who spoke only Spanish. Some of them had already had a lot of kids because frankly, they were poor, undereducated, and Catholic. He said he had women grab him by the wrist and pull him down to the bed and shout "Si! Si! Si!" They just didn't want _any_ more children.
Oddly enough, the state did away with that option a few years ago in one of those budget cuts that actually does more harm than good.
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