nights are not real
Certainly, but you first encounter the certificate (which suggests neonatal death) is during the day! It only appears in a nightmare later. Also, genuinely almost everything in the game suggests neonatal death or maybe stillbirth, down to the climactic scene, which does not suggest the pregnancy was unwanted. I can't point to a single thing indicating that it was a choice, even a compelled one. Everything points to it being a health issue on the part of the fetus.
While I have your attention, I do want to commend that the second person camera in that one shot was an excellent call, though.