I don't see why this image was approved at all. Bad proportions, low quality overall, Ami's "pregnant stomach" looks like a large mono-boob more than anything else... gah.
And you're probably wearing your yuri goggles a little too tightly to get that vibe off Makoto here.
it should be noted that sometimes when women are pregnant, their innie can become an outie. and since she's likely to be sporting at least 3 or more in there. thats probably what the artist was aiming for. though another weird thing is and it could just be the shirt but she doesn't seem to have any boobs at all either.
To add on, it's perfectly fine to have realistic details on a drawing of a pregnant woman, but taking into consideration the style? It looks out of place. It would be the equivalent of adding extreme spongy detail to Spongebob in the cartoon, which has been done somewhat. The effect makes it look ridiculous and poorly done.