I definitely think he knows. They go to the ob/gyn together and he mentions how he feels bad. Presumably, he feels bad because he's getting a hell of a "ride" out of her endless self-loathing which she never communicates to him.
She needs reassurance, and help Rodin's something to fill the void of her rushed dreams of motherhood. She needs a new goal in life, and she will always be loved regardless. That and they can use the money they were planning to use on the child to instead indulge in travel, send her to school to fullfill a career centered goal... Or they can just adopt. None of that can replace having a child of their own, but that should not stop them from being happy. Hell if it weren't for Japan's stubbornness towards therapy I would tell them to go get some counciling and go on a Hot Springs vacation.
So the other work by this author “Too Good To Be True”, you see the husband and wife walking out of a building when the MC walks past. I just noticed that the building they walked out of and the gynecologist office in this building have the same anteater(?) statue in front. This makes some more theories about the other now hmm.
Now I understand why the "vanilla" tag is missing.
The MC is married to a Manic Pixie Dream Girl.
Contrary to the male fantasy, that would be a living nightmare in reality
(as this chapter makes clear). It would be easier to live with a tsundere,
or even a yandere. https://en.wikipedia.org/wiki/Manic_Pixie_Dream_Girl
Well, she is arguably manic in a depressive sense at least, though that has little to do with the character archetype being talked about. She seems like a sweet and energetic woman but she also had a major depressive episode that made her unable to function all day until her husband came home, and he seemed like he was fairly used to it.
@zennyz:
That doesn't account for her insanely upbeat demeanor
(which is anything but "somber"). The whole wanting-to-
get-pregnant angle merely serves to highlight her giddy
always-look-on-the-bright-side attitude.