The passage reads that the curse would cause “her thigh to waste away and her abdomen to swell.” This is figurative language for infertility. It indicates a physical malady or reproductive problem that would prevent a woman from bearing children. During this time the Israelites viewed the inability to have children as a divine punishment for personal sin (see Deuteronomy 7:14), though not necessarily limited to adultery. God’s Word, however, does not make such blanket generalizations. Sarah, for example, bore disgrace for decades, though later she was called “holy” (1 Peter 3:5-6).
–The Quest Study Bible