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nights are not real

(+1)

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.