I commented some of this in response to a popular comment below, but since you asked for general impressions:

I take this as an anti-natalist statement. Anti-natalism has some implications of nihilism for those already born, which is to say: If I think it’s unethical or wrong to have children, due to the suffering inherent in living a life (or caused by the negative externalities of reproducing), does that logically imply that I must blame my own parents for my conception, and wish never to have existed? (though not, necessarily to end my own life, of course, as that would bring further suffering)

If we are not going to be nihilist, and instead choose a more utilitarian approach with a cost-benefit analysis, to what extent does the added value of reproduction (from your effect on the future increasing through genetic propagation, fulfilled biological imperative, and any derived joy from interaction with the birthed individual) outweigh the potential loss of quality-adjusted life years from health implications of reproduction (especially for the mothers)? Is the risk of negative outcomes high enough to resolve not to reproduce?