My own sister-in-law just had her fourth via Cesarean and the doctor asked her several times if she wanted her tubes tied. I thought that was even more invasive than the surgery. But the explanation was, "We've already got you open..."
From an insurance company's perspective, this is a no-brainer: fork over a few more thousand now, but think of the money we won't have to cough up in the future now that she's done having kids!
I particularly love the "We've already got you open" sales pitch. Imagine going to the dentist to get a filling, and he says to you, "How'd you like for me cut out your tongue? I mean, we've already got your open."
Absurd? Of course.
But it only serves to illustrate that which in reality is absurd: the fact that the medical establishment routinely tells women that they should consider having a side effect laden surgery performed on part of their body that is perfectly healthy and merely doing what it's supposed to be doing.