The poem's devastating imagery portrays the bleak reality of life in an extremely poor, patriarchal society. Early on, for example, the speaker describes abandoned children "Covered in garbage" and "stuffed in bags." This disturbing imagery illustrates how worthless these children are considered: they're treated like pieces of trash. In one of the poem's most horrific scenes, the speaker describes a little girl who "was dug up by a dog." The dog, catching sight of the child's "head barely poking above the ground," thought the child "Was bone or wood, something to chew." The mention of "bone" casts a deathly shadow over the scene, symbolizing the fact that many children in this world are doomed from the moment of their birth.
The imagery in the poem's final section considers things from the point of view of the mothers who abandon these children, revealing that they, too, have no real control over their lives. The speaker describes how these women give birth in broken down "hut[s]" outside of town, where they "squeeze out life, / Watch body slither from body." There's nothing remotely romantic or exciting about such scenes; birth instead seems traumatic, isolating, and painful. The word "slither" is particularly disturbing; normally one would think of snakes slithering, not children. This suggests how disconnected these mothers are from their babies. Perhaps they had no say in getting pregnant and birth feels like another violation. Or, maybe, they are trying to protect themselves. Having no means of keeping these children alive, they dissociate from an event that, in more fortunate circumstances, would be celebrated.
They then "Feel for penis or no penis," and if there is no penis, they "Toss the baby to the heap of others." This imagery is cold and clinical. These women simply can't afford to love their female babies, the poem implies. They throw them out without acknowledging their humanity, then "Trudge home to lie down for their men again." The word "trudge" means to walk slowly and heavily, with great difficulty, so it's clear that these women aren't running off to their men out of love or pleasure. They are prisoners of their society's rules about gender, no more valuable than the babies they left to die.