Alright, so checking the Sanskrit sources, it seems that the sense of “distress, suffering” predominates there. Not only that, but we have the occurrence in Mārkaṇḍeya Purāṇa 22.45 of the compound garbhakleśaḥ, which occurs in the verse:
Not such gratification did my mother or my sister get, O king! as I have felt in hearing that my son has been slain while protecting the Muni. Those who die, sighing, in great distress, afflicted with illness, while their relatives lament,—their mother has brought forth children in vain. Those who, while fearlessly fighting in battle to guard cattle and dvijas, perish crushed with arrows, they indeed are really men in the world. He who turns not his back on suppliants, friends, and enemies, in him his father has a real son, and in him his mother has given birth to a hero. A woman’s pain of conception reaches, I think, its success at the time when her son either vanquishes his foes or is slain in battle.
Charming. /s
Here it would seem that “distress” or idiomatically, “travail” would be the more suitable sense.
Thanks for getting me to look at this more closely, I’ll adjust my translation accordingly.
Oh, beings undergo such travail!
For the record, I just noted that I had previously made a comment on this line, which is now superseded, but for history’s sake here is what I thought when I made the original translation:
This is a difficult line. I have not traced a parallel in the Chinese versions, nor does comm or tika say anything. While obviously kilesa and variants normally refer to mental defilement, here it seems the bloody messiness of childbirth is meant. Compare, say, Snp 3.10, referring to people being immersed in blood and pus in hell, or Iti 83, where the deva’s cloths become “dirtied”. BB has “afflicted”, Thanissaro has “tormented”, and Nyanamoli had “what defilements they suffer”: but none of these capture the organic mess of it. We should not ignore the strong taboo notions around childbirth. The point here is that in samsara, birth is undergone by all beings, and the messiness of it afflicts both mother and child.