These words recall the Lord’s difficult promise to the woman in Genesis 3:16 that childbearing would be exceedingly painful. That reference is not just to the hours of birthing itself but also to the discomforts a pregnant woman experiences during the months of her pregnancy (and the pains of mothering that follow in raising the child). Given the promise of Genesis 3:15, the OT church has been pregnant for centuries (in a manner of speaking) with the expectation of the coming of the Promised Seed and has struggled with the diabolical enmity that accompanied that expectation. In this sign the hour of the OT woman/church has finally come.
2 She was pregnant and was crying out in birth pains and the agony of giving birth.