"The Birthmark" fits into Hawthorne's body of work in the Dark Romanticism genre, which means it holds up to scrutiny the flaws of mankind. In this case, the main character Aylmer suffers from over-ambition and blind obsession. He seeks to remove his wife's birthmark – the symbol of necessarily flawed humanity – and make her perfect. In his single-minded pursuit of this ideal, Aylmer ignores all the warning signs urging him to stop. Through his story, Hawthorne illustrates the flaws of mankind and the consequences that come with foolish obsession.
Aylmer subconsciously knows his wife will die if he tries to remove the birthmark; but he chooses not to face this reality.