Each verse of “You’re A Big Girl Now” begins and ends with a couplet, which might be expected of a love song.  But as with most songs on Blood On The Tracks it’s a song about love with pain attached, mainly because of the lovers’ distance from each other; the corkscrew analogy says it all:

I’m going out of my mind, oh, oh
With a pain that stops and starts
Like a corkscrew to my heart
Ever since we’ve been apart

The distance is geographical:

And I’m back in the rain, oh, oh
And you are on dry land

But it’s what’s gone on between them that has caused the distance from each other, necessitating promises:

I can change, I swear, oh, oh

and distrust and accusations:

Oh, I know where I can find you, oh, oh
In somebody’s room

The beginning and ending couplets show that love was there and maybe still is as this line suggests:

Oh, but what a shame if all we’ve shared can’t last

That oh, oh in the middle of each verse expresses so much, most of which is probably doubt–doubt that they can ever be again what they were together.  And that’s why the end word after each oh, oh sometimes rhymes with the ending couplet rhyme:

Time is a jet plane, it moves too fast
Oh, but what a shame if all we’ve shared can’t last
I can change, I swear, oh, oh
See what you can do
I can make it through
You can make it too

and sometimes doesn’t:

Love is so simple, to quote a phrase
You’ve known it all the time, I’m learnin’ it these days
Oh, I know where I can find you, oh, oh
In somebody’s room
It’s a price I have to pay
You’re a big girl all the way

I’m sure of our love, I’m not so sure–a word that joins the sound of love, a word that doesn’t.

It’s an absolutely beautiful song and Dylan sings it beautifully.

As in this version from the Rolling Thunder Review time period: