In Bujold's work, those issues are part of the overall theme and are a key element in her worldbuilding. For a book which isn't aiming at gender issues or simply isn't taking the worldbuilding in that sort of direction the old gender/pregnancy issues still apply. Whether it's a necessary or even useful to eliminate those matters depends entirely on whether or not the author is interested in going that direction or not. If the story takes them there, great. If not, why bother?