Sex & Romance in Fantasy Gaming: Pregnancy & Childbirth



Commission by Nikulina-Helena

"Commission" by Nikulina-Helena (resized) is licensed under CC BY-NC-ND 3.0


Who Gets to be Parents in Your Game?

Some gaming groups never deal with pregnancy at all; it happens entirely off screen and NPCs show up when they aren't with child. Many Dungeon Masters only mention the pregnancies of friendly NPCs and creatures. One way to give NPCs depth - and give the impression that the world is moving on while the PCs are off adventuring - is to show them becoming parents and their resulting children.

Highlighting pregnant monsters and foes can complicate encounters and lead to spirited moral discussions, but can also lead to fierce arguments. Is it okay with the group to slaughter pregnant kobolds? What if one player character doesn't care but the others do? So before this kind of decision brings your game to a crashing halt, it's best to think it over and discuss it with your group first.

Pregnancy becomes even more likely to lead to problems when player characters are involved. Many people don't plan to become parents and not all reactions are positive. One of the few times I've seen someone literally gray in the face in real life was when a friend had just been told his girlfriend was pregnant. He showed up on my doorstep looking for all the world like someone had died. In a way, something had perished: His image of himself had been irrevocably altered. These things should be kept in mind for all characters involved, not just the gestating ones. How do relations between the parents develop? Are their families involved? How do other relationships change - particularly within an adventuring party?

Female player characters have these things to contend with and more. One of the more interesting things that happened when one of our female PCs got pregnant was that the party started to treat her differently. The other PCs wanted to keep her from doing the more dangerous jobs, even if that meant limiting her participation in the group - and even if she wanted to participate. They also sought new, magical measures to shield her from harm. None of us expected that protectiveness to kick in and it wasn't always pleasant. It can be helpful to keep in mind how people will react to a pregnant character, inside and outside the party.

A PC pregnancy can easily sidetrack the whole campaign, but it doesn't have to. Great storylines can be conceived, too. Carrying a child can bring parties and key NPCs closer together. Allies may be revealed that the characters didn't know they could count on. It can be an interesting point of development for villains, as well. But no matter what, the desires of the whole group have to be taken into account from start to finish. Many choices can be made but they should not be restricted to a pregnant PC or the DM alone.

What I've Learned

A pregnant player character in my game offered me a great opportunity to experiment, but also a great opportunity to screw up in new ways. The group knew about our rolls for conception and was okay with the possibility of pregnancy. The party regularly bought and used birth control methods, though sometimes they took risks. I didn't foresee that our pregnant character would feel utterly trapped by her circumstances. I had expected that if she wasn't ready she would take one of the available options, but she was unwilling to abort or give up her child. I had hoped that if the player was unhappy she would say something directly, but she went with it. I imagine it only got worse as time went on because she wanted to be fit for battle. She had a cousin to rescue and bigger, worldly matters to attend; her pregnancy hindered all of that.

From our game, I learned that while it can be okay for the character to feel trapped and alarmed by becoming a parent, it is important that the player be comfortable with the experience. It's also vital to keep checking in with everyone about it over time. Discuss any rules up front and be willing to make changes if players have serious objections. While it might make logical sense that pregnancy will hinder stats or performance, especially further along, it's a game and everyone should have fun. Experiences of pregnancy and childbirth vary widely. You're also engaging in a fictional story in a fantastic environment, not a life simulator. Concerns about "realism" need to take a backseat so everyone's desires are respected.

To this end, I suggest the following for DMs:

Let Players Keep Control

First and foremost, allow the player of a pregnant character to retain control of their character's personality and decisions as much as possible. Remember, a PC is the player's avatar and is their only way to influence the fantasy world. Taking their agency away due to harsh symptoms is going to get frustrating fast. This isn't like a spell that disrupts a character for a few rounds of combat; it's a continuous condition that advances over months.

Consider Rules Carefully

If you don't feel the need for dice rolls, that's fine; you can handle pregnancy narratively. If you decide you do want mechanics to follow, avoid rulesets that demean women or turn pregnant characters into comedic puppets. While there are moments of hilarity during any pregnancy, reproduction is a humanizing experience and should remain so. It can also be a vulnerable and stressful experience, and you don't know everything your players have endured. And rules which demand roleplaying gymnastics from players and demean their characters - such as wild mood swings at the whim of the dice - can ask far more than they want to give.

Collaborate & Listen

Ideally, the player of a pregnant character should have a hand in any rules about what happens during gestation. You can describe symptoms to them and allow them to decide how their character responds. You can put it in their hands completely and let them volunteer any changes that occur, and you can encourage a full range of options, including positive benefits. But always remember this: the player still wants - and needs - power in the party, story, and world to feel fulfilled. Everyone in the group deserves to feel comfortable there. The experience can be what you all want it to be and the best way to foster collective enjoyment is to be kind about it.

Being careless or cruel in these matters leads to gaming horror stories, failed campaigns, and even broken friendships. I've heard these things a lot over the years and would like to help you avoid them, so please take these words to heart.


If mechanics are desired, they exist in various places around the internet and in gaming supplements like the Book of Erotic Fantasy. What's available might not suit your needs or cover extended parts of the experience, or at least that's been my experience. I've had to piece systems together and come up with my own, and pregnancy has continued to arise in my games, so I've had plenty of time to think about it.

If players are happy with the idea of their characters becoming parents, determine if they want more random chances for pregnancy. If so, then the contraception rules below can offer ways for players to influence their characters' outcomes. If players want more control and the DM agrees, highly effective magic spells can prevent pregnancy completely until their characters are ready.

Finally, the group should discuss whether or not players want to make pregnancy-related rolls for their characters. This might mean that players will know what's going to happen in advance, but it could make them feel more involved and in control. If players would like to be surprised, then the DM can take over all rolls and present the results as the characters discover them.


During sex, a contraception check is made by one character (the PC, if sex occurs with an NPC; otherwise, the players can agree on who rolls or the DM will choose). If using a 100% effective method, no roll is needed. Otherwise, if the characters are fertile, roll percentile dice based on the contraceptive method first. A roll within the percentage means that the characters are protected; a result outside of the range indicates that a conception check needs to be made.


Table: Contraception





Magical, most effective means

100-90% protection


Alchemical, highly effective means

89-60% protection


Common herbal and other methods

59-30% protection


Rhythm and coitus interruptus

0-29% protection


For example: Aseir, paladin of Sune, regularly uses lambskin condoms. The group has decided they're relatively affordable and provide 70% protection. During a night of fun with an NPC, his player wants to roll the contraception check. He rolls 89%, which is outside of the condom's range of protection. So the DM reasons that the condom breaks and a conception check should follow.

Base Fertility

Each character has a base fertility rating that should be determined as soon as possible, if not at character creation. These rates can be updated as circumstances change due to major factors, such as age.


Table: Fertility



Highly fecund race (goblins, kobolds, lizard folk)

Roll 1d10. On a result of 1, the character is infertile until significant technological or magical means provide aid. Otherwise, the character's base fertility is 75%.

Moderately fecund race (centaurs, humans, orcs)

Roll 1d10. On a result of 1 or 2, the character is infertile until significant technological or magical means provide aid. Otherwise, the character's base fertility is 50%.

Less fecund race (dwarves, elves, halflings)

Roll 1d10. On results of 1-3, the character is infertile until significant technological or magical means provide aid. Otherwise, the character's base fertility is 25%.


Reduce a character's base fertility by 20% for each age category above or below adulthood. You may also do so due to extraordinary circumstances such as radiation and magical curses. Once natural fertility is reduced to 0%, it can only be restored through extraordinary means.


To determine if mating ends in conception, the DM (or player) should average the fertility ratings of both parents and then roll percentile dice. If the result falls within that range, conception occurs.

Multiple Offspring

To determine if fertilization results in twins, triplets, or more offspring, average the percentage rates of multiple pregnancy for both parents (see the second column in the table below). If the conception check falls within that range, more than one offspring is conceived.

Then, roll the die indicated in the third column below to determine how many offspring result. If there is a gestating parent, use the die typical for their species; otherwise, the DM or players involved can decide.

Finally, assume offspring will be identical only 30% of the time. If the result of the conception check is 30% or less, identical offspring result.


Table: Conceiving Multiple Offspring

Character Type

Rate of Multiple Offspring

Roll for Number of Offspring

Highly fecund race (goblins, kobolds, lizard folk)



Moderately fecund race (centaurs, humans, orcs)



Less fecund race (dwarves, elves, halflings)




Rates can be adjusted as desired. If you'd like to do separate percentile rolls to figure out if multiple offspring result or what kind, feel free.


Tika the halfling PC (an adult with a fertility rating of 25%) enjoys a tryst with an NPC who appears to be a halfling but is actually a young silver dragon (75% fertile -20% for his age category = 55%). No contraception is used, so the range is 40% or lower. Since the group has said they don't mind being surprised, the DM rolls the percentile dice. The result is 10%, which means conception occurs.

Tika has a 1% chance of multiple offspring and the dragon has 20%; together, they have a 10.5% chance. Since the conception roll was 10%, they're going to conceive more than one child. The DM rolls 1d4, since the halfling Tika will be the gestating parent, and rolls 2 (twins). The DM decides to roll percentile dice once more to see if the twins will be identical; with a result of 80%, they'll be fraternal.


Each trimester brings new changes to the carrying parent. Since a wide variety of fantasy races exist, the carrying parent will not always be female; these rules, however, cover the basics for any race that gestates in a womb. Many changes do not need mechanics to govern them; they can be described by the DM or decided by the player. As the body transforms to give birth, major shifts will probably affect a character in notable ways. If you wish to add mental or emotional changes and the group is on board, you may do so, but be careful that they don't make a character into a caricature or constantly stymie the player.

First Trimester

Sexual organs begin to form in the offspring of human-like races at the end of the first trimester; divination methods used before then are notoriously unreliable.

Nausea may strike at inopportune moments. Each week, roll a DC 15 Constitution check for the gestating parent; failure indicates that nausea will be a problem that week.

The character can make a Constitution check at random up to 1d4 times a day. Failure means the character is nauseated for 1d20 rounds. Each successful check grants a +2 bonus on the next roll. At the start of the second trimester, the check should be made again. If the roll is a 1, then nausea will continue to be a problem into the second trimester. Otherwise, it will fade away.

Second Trimester

The character's movement rate may be reduced by a quarter and a -2 penalty may apply to Dexterity as the body takes on weight and their center of gravity shifts. Magic can be used to ease or negate these penalties, but they will recur once the magic fades.fades.

Third Trimester

The character's movement rate can be reduced by half. They may also suffer a -4 penalty to Dexterity and -2 to Strength. These penalties should not stack with those from previous trimesters and can be affected by magic, but they will automatically recur when the magic fades.


Tika succeeds at her first nausea check so her first week is free of morning sickness; every other week of her first trimester, however, she battles nausea. She succeeds on her roll at the start of her second trimester, so the nausea goes away for the rest of the pregnancy. She is able to adventure in her second trimester and relies heavily on her mount, Rasha the war dog, to carry her swiftly wherever she needs to go. Her party mate, the paladin Lance, stands ready to cast Shield Other at any sign of danger. As a Dexterity-based character, Tika decides to spend her third trimester at home, where she is safe. Her player creates another character to portray in the meantime but the party checks on Tika regularly.

Downtime or Retirement?

Women in the real world work hard and even fight for their lives while pregnant, so it's not out of line for pregnant characters to adventure while carrying. But as the process goes on, it will probably become more difficult to be effective and more dangerous to the offspring if significant damage is sustained. The group should talk about whether or not to include a pregnant character in outings that are dangerous; if someone is seriously disturbed by that idea, a compromise should be in order. Magical or technological support can help, but it's likely that the character will have to step back in the final trimester.

This doesn't have to affect the group in a bad way; another character can be made or an NPC can be taken over, so that questing can continue. If everyone agrees, though, this could be a fine opportunity for group downtime. The PCs can stay close to home and the DM can speed up the flow of time, passing over the rest of the pregnancy in whole or in part. If the party has other goals to work on, downtime can be a welcome change of pace. Once the downtime is finished, the parent(s) will have to decide if returning to travel is desirable. Some players might decide to retire their characters, but it shouldn't be forced upon them. Many parents travel with and without their children and many options can exist for care.


Miscarriage and stillbirth can be dangers that pregnant characters face in your game, but only if everyone is truly okay with these options. It's vital to talk openly with everyone in the group before bringing up miscarriage or stillbirth, even for NPCs. You may have no idea how much someone at your table suffers due to such a loss, so please tread carefully.

If the very idea of bringing these matters into a game is upsetting, please stop reading here. If you download the full copy of my guide, feel free to delete this portion and any other sections you don't want.

First Trimester

The base chance of a miscarriage is highest in the first trimester. A roll for this natural risk must be made (up to 50% chance) each week after the second; if the results are outside the range, the character begins to miscarry immediately.

If a pregnant character loses more than half their hit points in a single round, they should make a Fortitude check to avoid miscarrying.

Bleeding begins and should be noted as minor damage, but is not usually life-threatening. Most times, it will stop in 2 to 6 weeks; simply roll 1d6 to determine the duration. If the character fails a DC 10 Constitution check, complications will require medical or magical intervention to complete the process.

Second Trimester

For natural risks per month, roll up to a 20% chance.

If a pregnant character loses more than a third of their hit points in a single round, they should make a Fortitude check to avoid miscarrying.

If the fetus is 75% of the way through gestation, it can likely survive outside the womb if provided with immediate, high-quality care.

Third Trimester

For natural risks per month, roll up to a 10% chance.

If a pregnant character loses more than a fourth of their hit points in a single round, they should make a Fortitude check to avoid miscarrying.

It may be more likely that the child will survive premature birth at this late stage, but that also depends on environmental risks.


During childbirth, a chance of stillbirth can be in effect. There may be a very low chance, from 1-5%. Factors like disease, major physical trauma, and poor delivery care may add percentage points to the risk.

It's worth noting that in fantasy and sci-fi worlds, methods to prevent miscarriage and save offspring might exist. Just which forms they take are up to the group, but they can range broadly from genetic alteration to resurrection magic. Their cost, availability, and effectiveness should also be taken into account. But no matter what the cost, don't be surprised if many characters are willing to do just about anything to save their children. And don't price things out of sight because you don't really want options to be available.

If you don't really want to run a game that involves pregnancy, don't. If you don't want to deal with children in-game, say so. Be kind, but be honest. It might not be easy, but it may just save your group down the line.


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