Foreshadowing is a literary device authors use to hint at what is to come and to set up expectations for the reader which will be fulfilled as the narrative progresses. These hints can range from subtle details that are not necessarily understood as significant by the reader until the story concludes to more obvious clues. Hawthorne employs heavy-handed clues with his use of foreshadowing in “The Birthmark.”

For example, Hawthorne establishes the interconnectedness of the birthmark and Georgiana herself. The mark is described as “deeply interwoven, as it were, with the texture and substance of her face” (Paragraph 7). Aylmer’s dream confirms the connection between Georgiana and the birthmark. He sees in his dream that the hand shape of the birthmark is wrapped around her heart; this image reinforces its connectedness with Georgiana’s life and communicates the extreme potential danger of removing the birthmark. In his dream, Aylmer fully understands the birthmark’s connection to Georgiana’s mortality, but he is horrified to find himself still willing to remove it forcibly. The dream foreshadows the actions he will take which will end Georgiana’s life.