Or HaChaim on Exodus 1:17/אור החיים על שמות א׳:י״ז

1 ותיראן המילדות את האלוקים, The midwives were G'd-fearing, etc." Why did the Torah repeat that: 1) "they did not do what the king had told them to do," 2) "they kept the children alive?" According to Sotah 11 they supplied food and water for these boy babies. If so, why had they not been doing this before the king's decree came into effect? Perhaps all the Torah wanted to tell us is that they did not stop to provide these services at their own expense. The Torah therefore would describe the level of the midwives' fear of G'd. They did what they could to keep these babies alive; they most certainly did not kill the babies.

2It is also possible that as long as everything was normal they never even thought about providing food and water for the babies. Once Pharaoh had decreed that the boy babies should be killed, the midwives feared that if by chance one of those children should die they would be blamed for the death. They now began to provide food and water for these babies in order to deflect such suspicions. Perhaps this is the reason for the word את when the Torah describes the midwives as G'd-fearing. They also wanted to be seen as G'd-fearing in the eyes of man.

3כאשר דבר, as he had said. The letter כ which precedes the word אשר is a Kaf hadimyon describing a comparison, a similarity. The Torah tells us that not only did the midwives not do what the king had ordered them to do, but that they did not even do anything similar to what the king had demanded of them. The Torah could also be telling us something about the general fate of Royal decrees. Normally, when a powerful king issues a decree it is observed by his subjects due to fear. As people notice that not every violation is followed by severe penalties, more and more people begin to ignore irksome decrees. In this instance the Torah tells us that the decree was not even observed when it was still new. The midwives לא עשו, never carried out, כאשר דבר, as soon as he had said it. The word כאשר may be understood as "as soon as," just as in Genesis 27,30: "as soon as Isaac finished speaking."