The American made things sound quite simple to her, "I'll go with you and I'll stay with you all the time. They just let the air in and then it's all perfectly natural- (pg. 235). The girl is angry with him. She is angry at his inconsideration for her and her emotions. She is angry at his ignorance and smugness about the whole situation. He has coerced her into doing something that obviously makes her very uncomfortable, "I think it's the best thing to do. But I don't want you to do it if you don't really want to- (pg. 235). Although the girl does not want to have this operation she does it to please the American, to keep him by her side "Then I'll do it. Because I don't care about me-(pg. 235). She longs to have a "perfect- relationship with him, to please him and make him a happy man. He believes that "it's the only thing that has made them unhappy- (pg. 235). Unhappiness is not what she is searching for. Torn between self-gratification and accepting what the American gives her, to save face she chooses the man because there is no other way. .
It is significant to understand that when the story was written, women's roles were very different than the modern day woman's. In the late twenties, women had very little independence and heavily relied on men to sustain them. Individuality was rare and opinionated women were shunned. It is quite meaningful that the girl is given no identity other than her gender in this story whereas the man is immediately identified as "The American-. The hills/mountains in the story represent the pregnancy. Here we have a young girl who becomes pregnant and forced into having an abortion. Specifically stated because Hemingway empowers his story through the use of a metaphor and because the subject matter of abortion was taboo and immoral in Spain in 1927. She wishes she could keep the child but the man doesn't want it. Being an American in Spain, he feels inconvenienced by it all and finds that when there is a problem, he can fix it, just like they do in America.