Within stanzas one and two the poet uses imagery and word choice to convey that the narrator is thinking about new life, pregnancy and babies.
"bud puffing out from its knot"
This gives off the image of a flower blooming in Spring time, which suggests new life. "knot" could symbolize the bump in the branch where the flower develops from but could also refer to the narrator being emotionally tied up in knots.
"puckered its mouth"
This conveys the image of a baby sucking from a bottle or a breast. This is effective as it helps convey the narrators emotions at this point.
The poet uses imagery and word choice in stanzas three and four in order to show a change of tone in the poem and the woman's attitude.
"a dark socket from which the coal has poured"
This is intense word choice and puts emphasis on how the narrator views herself. "dark socket" refers to the narrator in a negative way, it suggests she perceives herself as evil.
"wondering when the ground would break"
This refers to the narrators emotions. "ground would break" symbolizes the narrator's emotions breaking down". There is a dark atmosphere created within stanzas three and four.
In the fifth stanza the narrator reaches Pennsylvania and meets the doctor who will be carrying out the procedure.
"not Rumpelstiltskin at all, at all..."
Rumpelstiltskin is a character from a German fairy tale who originally kidnaps a...