I suspect maybe she was being cynical/making the kind of joke you do when you're pretending it's ironally funny as an alternative to just getting angry? There's this terrible history of forced sterilization of poor/disabled/black women in the US, and yet now she's asking for safe/effective birth control and doctors won't give it to her.

(Doctors are oddly reluctant to do permenant birth control for women - when my mother asked for one in the 80s, after her second high-risk pregnancy and emergency C-section, the surgeon tried repeatedly to convince her that she she should wait because she was "still so young" and "might want more children," despite the fact that she already had two kids)