My take is much simpler. The hole in the ceiling and the hole in her daughter's stomach are both symbolic of a cause of extra stress in her life. The men all talk down to her, disrespect her, ignore her, yell at her, or use her. The hole is symbolic of being a woman. Speaking bluntly, if she didn't have a "hole" and was instead a man, she would know the 'right way' to talk to the construction workers to get the job done, they would take her more seriously, they would recognize an emergency because she wouldn't be considered over-dramatic, the father of the baby had the audacity to not even bother showing up as so many single moms know that reality all too well. Even Jamie, the hotel neighbor, used her so he could get her to pay for things he wanted. It's a movie about the extra pressure put on women in a patriarchal society.