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You can terminate pregnancies with herbal medicine. Even the tubal ligation/vasectomies can be done with herbal medicine. Glitterworld medicine just provides the best surgery chances, it's only required for curing diseases like Blood Rot or Paralytic Abasia. You don't need IVF research either, it's a default operation.
Besides surgery (well, sort of) you can modify your xenogenes before starting the game (or after with research) and add the "Low Libido" gene to your xenotype. Fewer instances of woohoo = fewer babies. You could use the Ugly gene too to help prevent relationships... but that also leads to social fights. The Sterile gene works too, just a little too well.
you do require research to sterilize your pawn (permanently or temporarily)
You do require an herbal medicine to terminate a pregnancy, and have to deal with an unproductive day while waiting for the anesthetic to wear off