Should I have a normal delivery or CS plus tubal ligation?

I am a soon to be mom of 4...I am thinking of delivering our 4th baby thru CS but I had my 3 babies delivered normally/vaginal birth.I have been thinking of CS because i am suffering from vein ulcers and if I will exert too much effort thru vaginal delivery Im afraid my veins will rupture and it endanger me or my baby. And at the same time I'm also turning 40 yrs old. Is it safe to do CS and have a tubal ligation at the same time? I am used to normal deliver that recovery time for CS will be longer and more painful. Seeking expert advice..Thank you so much