Exodus 1:15—How Could Two Hebrew Midwives Deliver Children for Hundreds of Thousands?

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“Then the king of Egypt said to the Hebrew midwives, one of whom was named Shiphrah and the other Puah.” —Exodus 1:15, UASV

The question raised by this verse is a valid one when read in light of the broader biblical narrative. How could only two women—Shiphrah and Puah—possibly serve as midwives for what would amount to hundreds of thousands of Hebrew women of childbearing age? After all, Exodus 12:37 states that about 600,000 men, besides women and children, came out of Egypt. Given this, it is likely the total Hebrew population numbered about two to three million, which would imply the existence of hundreds of thousands of families. Clearly, then, this passage cannot be referring to a literal case where two midwives personally handled the births of so many.

Organizational Context in Ancient Egypt

To understand this properly, we must consider the administrative structure of ancient Egypt, which was highly organized and stratified. Egypt’s political and economic systems functioned under centralized control, with administrators, overseers, and specialized functionaries managing every aspect of labor and social life. The Bible confirms this arrangement in the life of Joseph, who, though a foreigner, was elevated to the position of second-in-command and became administrator over the land. (Genesis 41:37–44)

It is reasonable to infer that by the time of the oppression described in Exodus 1, a similar bureaucratic structure was in place to manage the Hebrew population. The Hebrews were enslaved, but they were organized. Labor was divided and supervised. Just as there were taskmasters appointed over Hebrew slaves (Exodus 1:11), there would have been leaders appointed over various domestic and social functions, including midwifery.

Shiphrah and Puah: Leaders, Not Sole Practitioners

Thus, Shiphrah and Puah were not likely the only midwives in Egypt serving the Hebrews, but rather the leaders or representatives of a larger guild or class of midwives. This kind of hierarchical delegation is common even today. For example, a king or government official might speak to the heads of a professional group—not because they are the only ones in that profession, but because they are in positions of oversight or leadership.

The text does not say there were only two midwives. It simply notes that Pharaoh spoke to the midwives, naming two—Shiphrah and Puah. These women likely supervised numerous others, and they would have conveyed Pharaoh’s instructions to the wider group under their charge. Their names are preserved in the record likely because of their courage and faithfulness to Jehovah. They “feared God and did not do what the king of Egypt told them; they let the boys live” (Exodus 1:17). Their reverence for divine law over human command is a major theological theme in the passage.

Cultural and Administrative Implications

In ancient Egyptian and Near Eastern societies, women’s roles in medicine, especially in childbirth, were not insignificant. The use of midwives was widespread, and they often operated in communities or groups. In the case of the Hebrews in Egypt—who had multiplied greatly—midwifery would have been a well-established practice. The two women named in Exodus 1:15 are better understood as key figures—possibly chief midwives—who stood as representatives before Pharaoh.

This mirrors other scriptural patterns. For instance, the Levites later had chiefs among them (1 Chronicles 23:4; Ezra 8:24), and Moses was advised by Jethro to appoint leaders over tens, fifties, hundreds, and thousands to manage the nation more effectively (Exodus 18:21–22). Such delegation ensures function in large communities and allows for communication to flow efficiently from central authority to the grassroots level.

Theological Considerations

The focus of Exodus 1 is not a commentary on the logistics of labor and delivery, but on the moral conflict between divine authority and human tyranny. The midwives feared God rather than man, demonstrating the foundational biblical principle that obedience to Jehovah must override obedience to any earthly authority when the two are in conflict (Acts 5:29).

In the narrative, their faithfulness is honored: “And God dealt well with the midwives; and the people multiplied and became very mighty. And it came about that because the midwives feared God, He established households for them.” (Exodus 1:20–21, UASV) This divine commendation underscores that their courage had enduring spiritual and communal impact, preserving life in defiance of state-sanctioned genocide.

Conclusion

Exodus 1:15 does not imply that two women alone served the needs of an entire nation of Hebrew women. Rather, Shiphrah and Puah functioned in leadership roles, likely supervising numerous midwives within a well-structured system reflective of Egyptian administration. Their inclusion in the inspired record serves not to describe organizational logistics in detail, but to highlight their God-fearing defiance of injustice and their role in preserving the people of Israel. The text stands as a testimony to Jehovah’s sovereignty, the importance of faithful obedience, and the necessity of moral courage under oppression.

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About the Author

EDWARD D. ANDREWS (AS in Criminal Justice, BS in Religion, MA in Biblical Studies, and MDiv in Theology) is CEO and President of Christian Publishing House. He has authored over 220+ books. In addition, Andrews is the Chief Translator of the Updated American Standard Version (UASV).