I take in account that the "dialoges of the sandbox" make this game a bit boring, the dialog of the quest are not so bad at all.
also he uses the Narrative relative often remeber Alex is writing her adventures.
It seems to be the game where you have to do everything, right?
There don't seem to be any optional quests or quests that are lost forever with different paths, but as I progress a little bit, I get a "courage point" and those points allow me to do more advanced lewd quests.
Is it possible to let her give birth?
In my playthrough I was always forced to get emergency contraception or an abortion.
Never seen Alex with a pregnant belly, let alone with her baby.
Maybe it's like the struggle to let her quit smoking... You just have to fast forward time until her sickness goes away? (Boooooring)