beautiful writing on this by Iain Provan in his essay “Let us Go Up to Zion”
The author explains that the Hebrew word ‘etseb (עצב) refers to emotional pain, hardship, worry, and the difficulty involved in work. It can also describe general suffering. Importantly, he notes that ‘etseb is never used elsewhere in the Old Testament to mean labor pains or birth pangs. Instead, Hebrew consistently uses other Hebrew Hebrew words used for labor pains.