In the next version of Anamnesis, renascents in heterosexual relationships will go through actual pregnancies.
I've actually resisted adding full fledged pregnancy mechanics to the game in the past as they are inherently unfair towards female player characters. Then again, I've come to think, that very historical unfairness has created a lot of very powerful drama and conflict in fiction, and the historical experience of being a female in the ages in which the game is inspired just cannot be captured without said unfairness.
Therefore, from the next version on, if your player character is female and gets romantically or even just sexually involved with males, rather than having a magical baby pop up, there's a chance you'll be notified a few weeks after the deed that you're pregnant. This will give you the choice to either keep the child or interrupt the pregnancy, which will be far more expensive in low-tech cycles or even outright impossible if certain social contexts are in effect.
Should you choose to keep the child, you'll experience small, growing increases in weariness as the pregnancy progresses over for the variable several weeks it will last. Should you risk continuing having an active, rough and tumble adventurer life accruing extra weariness, you run the risk of severely afflicting your health and losing the baby. Once the gestation period is over, the birthing itself will also significantly increase weariness and even temporarily reduce the character's EX stat. The one bit of good news is that those descendants you've personally given birth to will be far more likely to feel a strong bond towards you during their adulthood in future cycles.
Male player characters will only notice this if they become romantically involved with a female renascent. The female renascent will go through the same process as female player characters, accumulating weariness and risking losing their child if subjected to too much weariness. Furthermore, they have the most agency over whether they choose to keep the child or not. You might have the money and means to interrupt the pregnancy, but the renascent might not be willing to allow it if she really wants to have the child.
As for player characters involved with others of their same sex or even males involved with mundane female lovers, at least for the time being, the old, more nebulous system of magically popping babies still applies. Make anything you want of that in your headcanon.
A number of related small auxiliary features have also been added, most visibly a "Love" info screen to include all the new information and expand on other love life stats, giving you more information about your past and present lovers and the sexual techniques you've mastered. Renascents will now also be less active overall if their weariness is too high, be that due to pregnancy or other reasons, and there will be small token checks to prevent heavily incapacitated player characters from doing things like hard labour in territories.
I think I've only played 2 other games in my whole life that explored the intricacies and ordeals of pregnancy in a manner that's neither fetishized nor idealized. So I'm actually pretty proud of how this turned out despite my years-long reservations to go with it.