Conflicted

 I'm really happy and now we have our boy and girl. Everyone wants to know if I'm done having kids. I don't know. I want to get my tubes tied but I'm also worried I may want more kids. I have always wanted a big family but my pregnancies are not easy (are they ever) nausea sever cramps and my hips popping out causing hard sharp pain. Can I handle this another precnacy?