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She's being merged with a contradictory historical figure who is variously viewed as a tyrant or a saint or both. So I think it's meant to be deliberately ambiguous. There are moments when she gloats, but others when she sounds much more... human.
I don't think the pregnancy is mentioned elsewhere? I can't remember if Jacques says anything about it after the fact. So yeah. Ambiguous.
a fairly common coping mechanism for when relationships ends, especially if they're messy break-ups, is to vilify the other party, thus we get the classic "he/she never loved me in the first place" (often failing to realise that "love" isn't a strictly binary state) and slew of other revisionist takes on past situations/conversations making them far more cruel/sinister than they probably ever were - in an attempt to make it easier to let go, e.g. if they never loved me or they were this cruel to to me, then in theory it should be much easier to move on/deal with the break-up. I think that, while we can't be certain whether or not Dolores were abusive towards Harry(dysfunctional relationships has a tendency for this going both ways) , these are probably heavily exaggerated versions or entirely imagined.
I don't think you'll find a definitive answer for the "pregnancy" it's one of those things in the game that is left ambiguous enough that it could any number of the scenarios Du-Vu mentioned and none would be more correct than the others, and I think the game is better for it. Now if you want my personal take on this, I think that at the height of their relationship there were probably talk about starting a family, but it fell apart before they got there.... the abortion part is likely Harry being extra self-flaggelating that he let the relationship slip in the first place. my main reasoning for this scenario is that outside this dream sequence the pregnancy(as far as I'm aware) is not mentioned or hinted at anywhere else in the game, even the twin-scene "the saddest phone-call" does not mention it nor can Harry bring it up. It's unclear from your post if you're aware of this segment in the game thus the spoiler tag. but if you use the pay phone on the coast by the boardwalk and you keep making prank calls, eventually you'll get to a skill check(interfacing) that lets you call your ex, this segment is equally brutal but besides Harry's general ♥♥♥♥♥♥♥♥♥♥ filters out the dream aspects and thus gives a more grounded representation of his ex and might help you to decide if she's worthy of your sympathy.
I do figure that Harry went on the drug and alcohol binges as a result of his refusing to move on with life after breaking up with his girlfriend (7+ years ago?!).