I'll say this:
After having 4 pregnancies, with 1 miscarriage, I "normal one, and 2 life-threatening ones, I was all for a tubal ligation. My OB/GYN was all for my tubal ligation. So after my 3rd was delivered prematurely via c-section, I had a tubal ligation done.
However, NOTHING could've prepared me for the emotional turmoil I went through. Some of it, I'm sure, was a result of pregnancy hormones. Some of it was a result of knowing I made that choice after struggling with severe infertility issues (those who dealt with the same will understand what I'm trying to say here). And yet most of it was the realization that I COULD NOT get pregnant. Yes, I know it sounds weird, because that is the whole point. But it's different to say you don't want to get pregnant and YOU are the one in control. It really is different to know you no longer are in control.
Maybe that doesn't sound like a big deal, and I'm sure others felt/feel different about theirs. But what I'm trying to say is that it can have a highly emotional impact regardless of how solid you are in your decision.
However, with all that said, I do wish it were easier for woman to get the procedure done.