Importing Contacts from Access
It is a bit complicated. You will need to do at least 2 different imports, with external IDs. The CSVs for imports would look at this
1st import
first_name, last_name, extID
Jane, Doe, 1

2nd import
first_name, last_name, extID, Spouse-extID
John, Doe, 2, 1

Take a look at CiviCRM 5.29.0 - import relationships