Sal's mother Sugar suffers a miscarriage, which, combined with a subsequent hysterectomy, causes her severe depression. So disturbed is she by this tragic event and its aftermath that she leaves her family behind to go stay with her cousin in Idaho. The miscarriage has a profound effect on everyone, not least Sal, who even has nightmares about it. Moreover, Sal feels incredibly guilty over the miscarriage, believing that she was somehow responsible for it. One day, Sal had an accident in which she broke her leg. Sugar lifted Sal and carried her for a short distance. In some cases, such physical exertion can cause pregnant women to miscarry, and that's what Sal thinks happened here. There's no evidence to show that she's right about this, but there's little doubt that Sal is utterly convinced of her own guilt.
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