Copyright © 2001 by Larry G. Overton
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Exodus 1:15-21

¹⁵ Now the king of Egypt spoke to the midwives of the Hebrews, one of whom was called Shiphrah and the other called Puah. ¹⁶ And he said, “When you assist the Hebrew women in childbirth, and see them upon the birthstool [literally, the two stones], if it is a son, then you shall kill him. But if it is a daughter, then she shall live.” ¹⁷ But the midwives feared the God, and did not do as the king of Egypt had commanded them. Instead, they spared the lives of the male children. ¹⁸ So the king of Egypt called for the midwives and said to them, “Why have you done this thing, and spared the lives of the male children?” ¹⁹ And the midwives said to the Pharaoh, “Because, unlike Egyptian women, Hebrew women are lively. Before the midwife goes in to them, they have given birth.” ²⁰ So God was good to the midwives, and the people multiplied and became very numerous. ²¹ And so it was, because the midwives feared the God, that He made for them families. {LGO}

 

Beth is too busy this month being a midwife to write about it in this newsletter, and so she asked me to write this final installment in the Midwifery and the Bible series. The passage under consideration in this installment (Exodus 1:15-21) records no specific birth stories. This makes it possible for one who is lacking in midwifery expertise (in other words, me) to comment on what this passage reveals concerning the history of midwifery. Even so, rest assured that the editor and publisher of this newsletter (in other words, Beth) will examine and approve the final form of this article. The first chapter of the book of Exodus summarizes the growth and subsequent oppression of the Israelites in Egypt. Pharaoh’s oppression of the people of Israel was motivated primarily by a fear of their population growth (verses 7-14). The account we are considering (see verses 15-21 above) records the second phase of this Egyptian ruler’s plan of subjugation and oppression. In order to deal with the perceived threat of Israel’s growing population, the Pharaoh resorts to a plan to murder Hebrew babies, specifically the male babies.

 

The Hebrew Midwives

And that’s where the midwives come in. The king of Egypt addressed two Hebrew midwives, Shiphrah and Puah by name, and ordered them to implement his murderous plan by killing all of the newborn sons of the Hebrews. Although it’s not clear why, the Pharaoh obviously expected their full cooperation. In an attempt to account for this expectation on the part of the king, some commentators try to make these women out to be Egyptians rather than Hebrews. This position is justified by appealing to the phrase “midwives of the Hebrews,” which can also be translated “midwives to the Hebrews.” I suppose the thought here is that if these women were Egyptian, it would better explain the Pharaoh’s expectation of complicity. However, since the names Shiphrah (“Fair”) and Pua’h (“Fragrant”) are Semitic and not Egyptian, this is not likely. Other statements from this passage also point to the midwives being Hebrew rather than Egyptian. Verses 17 and 21 tell us that they “feared God.” Actually, in both of these verses, the text of the Hebrew Bible literally reads “the midwives feared the God” (Hebrew, ha ‘elohim), that is, the God of the Hebrews, the one true God. Furthermore, the fact that God established families (literally, “made houses”) for the people of Israel is directly tied to the fact that the midwives feared God rather than the Pharaoh (verses 20-21). The idea that God blessed His people with numeric growth is paralleled to His blessing these midwives. All things considered, viewing these two midwives as Israelite or Hebrew women makes the most sense. But if these midwives were Israelites and not Egyptians, then why did Pharaoh expect them to carry out his orders? My guess is that it just didn’t occur to the king of Egypt that these lowly midwives would disobey him. I believe that he just assumed that the very act of his summoning and giving orders to them would frighten them into complying with his wishes. At any rate, the Pharaoh summoned and addressed the midwives, giving them orders to kill all of the newborn sons of the Hebrews.

Another interesting aspect of this passage is the picture of the Pharaoh interacting with midwives, and Hebrew midwives at that. This passage shows us, among other things, how widespread the practice of midwifery was, and how respected. Notice, for example, the Pharaoh of Egypt’s familiarity with the equipment that these midwives would use, namely, the “birthstool” (more on that particular item in a moment). Remember that he was addressing “Hebrew midwives.” This is a significant point. The Hebrews were detestable to the Egyptians, so much so that eating with and living near them was considered a loathsome thing, a cultural taboo (see Genesis 43:32; 46:34; Exodus 8:26). This is evidenced by the fact that the Israelites lived in Goshen, a region in the eastern part of the Nile delta. They were segregated from the Egyptians.

Why bring all this up? The fact of the segregation of the Israelites from the Egyptians makes the Pharaoh’s acquaintance with the Hebrew midwives and their equipment and practices all the more significant. I doubt that the Pharaoh went to Goshen to witness firsthand the births of Hebrew children. How, then, was he able to speak knowledgeably about how midwives performed their duties? Midwifery must have been standardized to such a degree that Pharaoh could refer to practices common to Egyptian and Hebrew midwives.

Which brings me back to that “birthstool.” The standardized practices of Egyptian midwifery are well documented, both in archaeological and historical sources. On ancient Egyptian vases with figure paintings and wall paintings of the palace of Luxor in Upper Egypt, the mother is represented as being placed upon a stool, while two midwives supporting her by the arms, and the baby is caught by a third. Less than 200 years ago, English traveler and author Edward William Lane (1801-1876), wrote of Egyptian midwifery practices in his own day in his An Account of the Manners and Customs of the Modern Egyptians (1836).

Two or three days before the expected time of delivery, the Layeh (midwife) conveys to the house the kursi elwiladeh, a chair of peculiar form, upon which the patient is to be seated during the birth.

So the Pharaoh, in referring to the birthstool, was speaking of a birthing technique and its accompanying equipment, and this technique was well known. Even in more recent times, the procedures and equipment had changed little. And by the way, this reference indicates the typical birth position favored by women in Biblical times. They labored and gave birth in a seated or squatting position. See also 1 Samuel 4:19, which refers to a woman kneeling down or squatting down and giving birth. This position is a good one for the mother, certainly a more advantageous one that the semi-supine position that women are typically subjected to in the modern hospital setting. Before leaving this discussion of the Pharaoh and midwifery, it is important to notice also that he believed that involving midwives in his genocidal scheme would be effective. He assumed two things in this scheme. First, as I mentioned above, he assumed that the midwives would comply because of his authority as Pharaoh. Secondly, he assumed that the practice of midwifery was widespread enough that involving them in his plot was the most effective means to his ends.

One might ask, “If midwifery was as widespread as you say, then why are there only two midwives mentioned?” The key word to this question is “mentioned.” The fact that only two midwives are named in this text is no proof that only two midwives practiced among the Israelites. As I just said, the fact that the Pharaoh considered the involvement of midwives to be an effective means of eliminating Israelites would indicate that more women were involved than just a couple of midwives and their apprentices and assistants.

Furthermore, the Israelite population at the time of the exodus was reported to be “about six hundred thousand men on foot, besides women and children.” (See Exodus 12:37.) Scholars estimate that the total population of Israel in Egypt was around two million. The idea, therefore, that these two midwives could handle the amount of births of such a population is just unbelievable.

The role that these two women filled was most likely that of a supervisory nature. Under such a scenario, Shiphrah and Puah would be in charge of a midwifery “guild,” and they would be the ones accountable to the authorities. This view has wide support, both ancient and modern, including the twelfth century Jewish Bible commentator Abraham Ibn Ezra. And actually, if that was the case, then there is something of a correspondence between these guilds and modern day midwifery “associations.”

 

Midwifery & Ethics

There’s just one more point that I want to bring up. Much has been made of the midwives’ lying to Pharaoh. Some commentators have even used this to call into question the ethics and integrity of these two midwives. Before jumping to such a conclusion, however, consider this: they are described in Scripture as God-fearing (verses 17 and 21) and blessed. The Bible’s assessment of their spiritual status is indeed a favorable assessment. From a Scriptural point of view, Shiphrah and Puah were counted as fearing the God of Israel, with the consequence of God causing good to come to them.

“But didn’t they lie to Pharaoh?” you may ask. That is a good question. Did they totally fabricate that line about the Hebrew women being “lively”? Probably not. That statement was most likely true. Remember, the Israelites were being enslaved and forced into all kinds of servitude (v. 14). Women accustomed to an active lifestyle typically have less trouble in childbirth than women with a more sedentary and (dare I say it?) pampered lifestyle.

Admittedly, though, there is little doubt that the midwives told Pharaoh this as an excuse, for they had already determined not to obey his edict. So in essence, they spoke true words, but still with intent to deceive. So Shiphrah and Puah were not perfect. Their being blessed by God, therefore, was based, not upon their living perfect lives, but upon God’s grace. He used these women to accomplish His purposes and then blessed them. God dealt with these midwives in the same way that He dealt with Abraham and Isaac (who were both guilty of telling lies): by examining their hearts and blessing them for their obedience.

 

This passage demonstrates for us that midwifery practice in Biblical times was extensive and well respected. We also get a glimpse of the preferred birthing posture, as well as some indication of equipment used. But what moral lessons can we learn from this passage?

The key thought here from a practical and moral standpoint is that of fearing God, even in the face of seemingly dire temporal consequences. I know that “fearing” God is a foreign, even abhorrent concept to many religious people today. It is true that this word for “fear” (the Hebrew term yare‘) can have the connotation of reverence, awe or honor. However, its basic meaning is that of “fearing,” of being “afraid.”

And that primary meaning of “fear” certainly applies in the case of these two midwives. Remember that Shiphrah and Puah were faced with fearing Pharaoh by obeying his horrible decree or fearing God by showing reverence for Him and doing the right thing. They certainly must have been afraid for their lives. And yet they knew that their obedience to such an evil edict would affect far more lives than just their own. They must have known that their actions would affect their relationship to God even beyond this life. And so they feared God.