While I agree that a lot of calls for realism tend to run into bad cases of "reality is unrealistic" and "fits my preconceptions", I do tend to prefer and run more gritty and grounded games, so I can understand where they're coming from.
Also, while I have definitely seen some misogyny throughout the thread, "rampant" is a bit of an exaggeration. Things like sex, child-bearing, and parenthood are major aspects of human existence. So naturally, some people are going to want to roleplay in that space, and their games can be richer for it. As long as everyone at the table is comfortable handling them, there's nothing wrong with adding mature themes to your game.
In my prior example, my friend's PC being pregnant added a humanizing element to the campaign, and increased the depth of roleplay for everyone invested in the characters and their growth as people. In a different game that I ran, one of the PCs slept around a lot, and accidentally got a powerful merchant's daughter pregnant in a forbidden tryst. His character later adopted a street kid who was helping them, and the player got to explore the idea that their PC had abandoned their blood-child and was compensating for the loss by taking in this orphan, whom the PC developed a close fatherly relationship with.
Can it be handled wrongly? Certainly! For one thing, I would NEVER spring pregnancy on a player with no warning. If someone thinks it would be interesting to have the chance of pregnancy in a scene, they bring it up with the other players and we hammer out what that entails before anything actually happens in-game. Usually that person would be the GM, but occasionally we'd have players who want their PCs to experience it, and bring up the idea for themselves. Both of my examples were in the latter category.
