Yes, she had already had the tubal ligation too.
Her children I don't think were removed from her, she just seemed to have no interest in raising them. I think the second one she didn't contest custody in the divorce, and the first she had very young.
I saw on reddit that she seems to have brain damage issues from her childhood/ teens. Also a sexual assault brushed under the carpet by her guardian, huge weight gain as a child, various health issues, a gastric sleeve, a baby in her teens, a hysterectomy she hadn't herself consented to. Certainly not making excuses, just that there was a lot more to this story with a lot going on in her background before this. Too much to fit into the documentary.
This wasn't even the first pregnancy she faked with Wade. She'd claimed to be pregnant with his twins right at the start of the relationship too, but "lost" them in an accident.
I know I'm a lone voice on here thinking Wade bears some moral responsibility. On Reddit though, many agree. The outcome of Reagan's husbands civil claim is unclear; it may still be ongoing. His legal claim against Wade seems to be limited to him owning the vehicle she used to kidnap the baby.
Wade was blinded by the money. He was expecting to reap millions so didn't rock the boat with her despite everyone telling him that she wasn't pregnant. He must have known too, but just had his eyes on the prize.
Obviously no-one could expect what actually happened, but the medics cared enough to fear an abduction and try to prevent that possibility.
The way he treats and abuses animals doesn't make him a sympathetic character either. I don't know if he is low IQ or simply low in morals.