I have a kinda divided view on this, as a woman and a med student. The med student would like to say that everything is well, but from my personal health situation, I know that it isn't so.
I am a woman and suffer from endometriosis. My gynecologist prescribed me stronger meds to take when necessary. Seeing a specialist for pain management isn't anything out of the ordinary if this and other conditions can't be managed. Not every patient feels like they're getting optimal treatment, but it's not inaccessible.
More difficult. Getting sterilised isn't medically necessary in most cases(so insurance doesn't cover it), and few doctors are willing to do so for young women. But it's not impossible, there are people who will tell you who to go to. A little hush hush, but it's not impossible. Just difficult. With a diagnosis like mine, it will be much easier, and paid for by insurance since it can be seen as medically necessary.
Husband stitch. I don't even know what the german word is for that horrendous practice. I've certainly not seen it done on the delivery ward that I did my internship in. Most doctors are more concerned with stopping the bleeding, restoring a normal anatomy and letting mom rest as soon as possible.
Frankly, some of the stuff I hear from the US... it's not that bad here from my experience, but especially women with conditions like endometriosis, PCOS and others that aren't easily diagnosed need more support. At least we don't pay 60k for surgery though, if we need it. The same kind of surgery cost my insurance 15k.