And she herself will answer you introduces another embedded quote, which Good News Bible expresses as indirect speech.

Those born in the strength of youth are different from those born during the time of old age, when the womb is failing: Old age is not meant here in the Latin text; that idea would conflict with verse 49. The point of this quote is that children born in a woman’s later child-bearing years are different from those born earlier. The text does not specify in what respect they are different, but Good News Bible‘s rendering is a good interpretation. There is medical evidence that children born in a woman’s later child-bearing years are more apt to have certain problems. Good News Bible‘s “while she was young and healthy” is actually closer to the Latin than Revised Standard Version‘s the strength of youth. This phrase is worded differently in Latin than the phrase so translated in verse 55.

Good News Bible provides a helpful model for this verse.

Quoted with permission from Bullard, Roger A. and Hatton, Howard A. A Handbook on 1-2 Esdras. (UBS Helps for Translators). Miami: UBS, 2019. For this and other handbooks for translators see here.