大般涅槃經義記 4.159

4.159

明治業中，三罪之人能生出世菩提心子，故說為「女」，起菩提心名為「產時」，三罪嬰纏說為「兒衣」，不能除遣故云「未出」，授以法藥名「與令服」，三罪除遣名為「已出」，除障行立名「令嬰兒安樂無患」。

In treating karma: a person of the three offenses can give birth to the child that is the supramundane bodhicitta, hence spoken of as a "woman"; giving rise to bodhicitta is called "time of childbirth"; being entangled in the three offenses is spoken of as the "afterbirth"; being unable to eliminate and dispel them is why it says "not yet come out"; conferring the Dharma-medicine is called "giving it to be taken"; dispelling the three offenses is called "already come out"; the obstacles being eliminated and practice being established is called "making the infant peaceful and free of ailment".