Among the conflicts and themes present in the story "Hills Like White Elephants" are the problem of an unwanted pregnancy, the relationship between men and women, and the aimlessness and emptiness of expatriate life.
The central conflict in the story stems from the fact that the woman, called Jig, is pregnant. Her partner, who is unnamed, wants her to get an abortion, and although he insists that she doesn't have to if she doesn't want to, it is clear that he himself wants her to get rid of their unborn child. The man tells Jig repeatedly that "it's really an awfully simple operation," and that if she will consent to have it, "everything will be fine." He also says that he doesn't want anybody but her; he doesn't want "anyone else" - meaning a baby. The woman, however, is not so sure that having an abortion will make things better for them. She understands that things will never be the way they were, arguing that "once they take it away, you never get it back."
A second conflict and important theme in the story is the relationship between men and women. The woman is clearly subordinate to the man in the situation described; the man speaks to her rudely, and disregards much of what she says. The reader gets the sense that the woman is considering having an abortion she does not want just to please the man and to avoid losing him. She says to him pathetically, "if I do it you'll be happy and things will be like they were and you'll love me."
A third theme in the story is one that recurs in many of Hemingway's works - the aimless, empty life of American expatriates in Europe in the years between the two world wars. The two main characters in the story are expats in Ebro who are waiting for a train, and as they share drinks and argue, the woman says, "That's all we do, isn't it - look at things and try new drinks."