What does Exodus 1:16 mean?

Pharaoh assumes that midwives are present when Hebrew women give birth. This makes sense, as this is the distinctive role of a midwife. So, he commands them to kill the newborn Jewish sons. The mention of a "birthstool" literally means "two stones." In its most primitive form, the birthstool was two bricks or stones placed under the buttocks of a woman in labor. Later, the birthstool was an actual chair with an opening in the center where the baby would come out into the hands of a midwife.

The idea here is that a midwife is the first to hold the baby and discover its gender. If the child was a male, Pharaoh's command is to end his life immediately. The practice of infanticide is evil in God's sight (Genesis 9:6). Knowing this, the Hebrew midwives feared God and would not follow Pharaoh's command (Exodus 1:17). Whether their response was openly immediately defiant, or simply a matter of later disobedience, these Hebrew women would be risking their own lives to protect children. This passage suggests they followed the latter path. Theirs is an act of heroism often forgotten when remembering the events of the book of Exodus.

Later, when Pharaoh sees that his orders are not being followed by the Jewish midwives, he will resort to having infant Jewish boys thrown into the Nile River by any Egyptian who was so able (Exodus 1:22). In this troubling context, Exodus will introduce Moses (Exodus 2:1–2), the main figure God uses to deliver the Jewish people from bondage.