Did God punish all women with painful and even fatal childbirth because of Eve’s sin? In Genesis 3:16, most English translations say the woman will have painful childbirth as a result of Eve’s sin, however, the Hebrew words used don’t exactly match that.

It reads more like “in sorrow, you will conceive, and in sorrow/toil you will give birth”. The word “conceive” is often translated as “childbearing,” but the Hebrew word for that is not used here. So this passage may be more about infertility than the pain of childbirth. Plus the word used for toil in reference to Adam’s punishment in Gen 3:17 is the same word used for Eve in Gen 3:16. This implies the painful consequences of their sin scale up to all the suffering in uor lives, like the pain of losing a child in childbirth or as a murder victim (Cain kills Abel in the next chapter), as well as struggling for food from a cursed ground.

The KJV matches the Hebrew text very well:
Genesis 3:16 (KJV) Unto the woman he said, I will greatly multiply thy sorrow and thy conception; in sorrow thou shalt bring forth children; and thy desire shall be to thy husband, and he shall rule over thee.

The NLT is close by using the word “pregnancy”, but it puts pain before it:
Genesis 3:16 (NLT) Then he said to the woman, “I will sharpen the pain of your pregnancy, and in pain you will give birth. And you will desire to control your husband, but he will rule over you.”

When looking at the Hebrew lexicon for this passage, one can see that the word for pain (NLT) or sorrow (KJV) is “itstsabon” (עִצָּבוֹן). It means grief, pain, or toil. The word “itstsabon” is used in Gen 3:17 and is translated as “toil” or “struggle,” referring to Adam’s toil over the cursed ground.

Genesis 3:17 (KJV) And unto Adam he said, Because thou hast hearkened unto the voice of thy wife, and hast eaten of the tree, of which I commanded thee, saying, Thou shalt not eat of it: cursed is the ground for thy sake; in sorrow shalt thou eat of it all the days of thy life;

Genesis 3:17 (NLT) And to the man he said, “Since you listened to your wife and ate from the tree whose fruit I commanded you not to eat, the ground is cursed because of you. All your life you will struggle to scratch a living from it.

This word is not about physical pain but more about “struggle or toil and grief or sorrow”. That is why the KJV translates it as sorrow.

The next word to examine is the word “conceive” in the KJV, which is translated as “pregnancy” in the NLT. The KJV states that there is sorrow in “conception”, and since conception is the beginning of a pregnancy, not the end, this is not childbirth. It is used in passages like Gen 21:2 when Sarah finally conceives Isaac.

Genesis 21:2 (KJV) For Sarah conceived, and bare Abraham a son in his old age, at the set time of which God had spoken to him.

Genesis 21:2 (NLT) She became pregnant, and she gave birth to a son for Abraham in his old age. This happened at just the time God had said it would.

Notice that the passage says Sarah “conceived/became pregnant and bore/gave birth to” Isaac. This passage uses both the words for conception and birth in the same passage. The Hebrew word for conception is heron or herayon (הֵרוֹן). A variant word, harah (הָרָה) is used when referring to Eve’s conception of Cain in Gen 4:1. The Hebrew word for childbirth is yalad (יָלַד). Yalad is the root of yeled (יֶלֶד), which means child. These are two separate words because conception and childbirth are distinct processes.

The second word, translated as ‘pain’ in the NLT and ‘sorrow’ in the KJV, is a different word from “itstsabon” (עִצָּבוֹן). This word, translated as pain, is etseb (עֶצֶב), which is more generic and can refer to emotional sorrow or pain associated with hard work or grinding. It is usually used in passages from Psalms and Proverbs, such as Proverbs 10:22, Psalm 127:2, and Proverbs 15:1. It originates from the Hebrew word atsab (עָצַב), which means “grief.” This word first appears in Genesis 6:6, when God was “grieved” by the sin in the world and regretted having made mankind. This grief led to him flooding the world. Jacob’s sons felt “grief” and fury at the news that their sister Dinah was raped in Gen 34:7.

Neither “ashtab” nor “etseb” is used referring to childbearing. Here are some Hebrew words for pain that are used for childbirth. The word tsarar (צרר), which means to bind or restrict, is used in Jeremiah 48:41 and Jeremiah 49:22 to refer to a woman’s labor pangs. The word chuwl (חול) means to whirl or writhe, and it is used in Isa 26:17-18, Isa 45:10, and Isa 51:2 for birth. Jeremiah 22:23, Hosea 13:13, and Jeremiah 49:24 all use chebel (חבל), referring to the pains of childbirth, which means a cord or band. Side note: There is a wordplay with etseb (עֶצֶב) in the name of Jabez or Yabets (יַעְבֵּץ) from 1 Chronicles 4:9-10. In verse 9, it says his mother named him Jabez because his birth had been so painful.

The words used in Gen 3:16 refer to the emotional pain of difficult conception rather than just an arduous, painful childbirth process. Since the word “itstsabon” (עִצָּבוֹן) is also used in reference to the toils of working the difficult, cursed ground in Gen 3:17, the word can expand the meaning of the pain of the woman. This pain would include the higher pain of dealing with the loss of a child, both from miscarriages as well as from the dangers of life. It’s about the struggle of living in a world where the children we produce are vulnerable to death. Eve would experience the loss of her son Abel at the hands of her firstborn Cain in Gen 4:8.

The general suffering that we all endure is the result of our sin or failure to keep God’s commands. We don’t explicitly have to see it as a direct attack from God for Adam and Eve’s sin, but rather the result of it. It’s the sin itself that ruins our lives, not God; after all, he is the one who warns us about sin. God is just stating the facts in Gen 3, but the suffering is the result of our rebellion. God’s ways and thoughts are higher than ours (Isa 55:8-9). Sin has longer-term consequences that lead to death. God is just and must implement a method to stop sin from destroying everything, and death is that mechanism. 

This is why God uses the flood to stop the violence in Genesis 6; they reaped what they sowed. God put Adam and Eve out of the garden to prevent them from having eternal life in a sinful state (Gen 3:22-24). However, God uses the mechanism of death to save humanity from sin by substituting them with a perfect, sinless anointed one (Jesus). This is so that he can provide a means for us to be free from slavery to sin (John 8:31-36). In turn free from death (Rom ch. 6). The birth of the messiah initiated the promise of the “seed of the woman” (Jesus) who bruises the serpent’s (Satan) head (Gen 3:15, Matt 1:20-21), and his death in our place and ressurection to eternal life gives us the option to be free from the permanent eternal of sin. 

In other words, Jesus took the punishment for our sins (Heb 10:1-18) so that justice would be served, without all of humanity being destroyed. The Holy Spirit was promised by Jesus for those who believe in him, and the holy spirit is the one who helps us overcome sin (John 14:15-21, Rom 8:5-17). One day, believers will get new bodies that last forever, and there will be no sin nature (desire to sin) in these bodies and no tempter to tempt us to rebel. This is what eternal life will be like: no sin, no suffering, and no death. Those who do not receive this covenant will be condemned for their sins and receive the justice they deserve. It’s avoidable because of Jesus, but it only applies to those who believe and accept it (John 1:12, John 3:16-21).

Language reference:
Lexicon for Gen 3:16
Lexicon for Gen 3:17
Lexicon for Gen 21:2

Concordence reference:
Pain, Toil, Sorrow – itstsabon (עִצָּבוֹן)
Conceive – heron or herayon (הֵרוֹן)
Conceive – harah (הָרָה)
Childbirth – yalad (יָלַד)
Pain/Toil – etseb (עֶצֶב)
Grief/Pain atsab (עָצַב)
Bind, restrict – tsarar (צרר)
Writhe – chuwl (חול)
Cord, band – chebel (חבל)