A French midwife taught peasant women who couldn't read to deliver babies on a body of cloth and leather
How do you teach childbirth to a woman who can't read? The Paris midwife Angélique du Coudray answered with her hands. In October 1759 Louis XV commissioned her to train rural midwives: about 200,000 newborns a year were dying in the French countryside, write the German doctors Scharf and colleagues in a 2022 review, for want of skilled help.
Her model is known simply as La Machine. The first dates from 1756, three years before the king's commission. Others had built such models, but hers was probably the most sophisticated of its time: the lower half of a woman's body in leather, linen and canvas, stuffed with cotton, that opened to show the uterus, bladder and rectum. Some versions were built around a real woman's pelvis. Silk bands drawn tight like a tobacco pouch stood in for the cervix at different stages of opening. A 50-centimetre doll had limbs that moved and a fontanelle you could feel.
A course ran about two months: 40 lessons, six days a week, mornings and afternoons. Most of her students couldn't read. Her textbook came out in 1759 without pictures, and by 1769 it was the first book on midwifery with plates printed in several colours. Nearly forty cities and a quarter of a century on the road, or a full thirty years by the publisher's account of her biography. Estimates of how many she trained run from 4,000 to 10,000, physicians among them. The same publisher credits her with a real share in France's demographic upswing after 1760. We found no numbers for that.
She died at the height of the Terror. The only fully preserved machine stands in Rouen, at the Musée Flaubert et d'Histoire de la Médecine. Scharf and colleagues call her course the first national simulation-based training for rural midwives. Her students' hands learned what they couldn't read.
Sources
- Scharf J. L., Bringewatt A., Dracopoulos C., Rody A., Weichert J., Gembicki M. La Machine: Obstetric Phantoms of Madame Du Coudray … Back to the Roots. Journal of Medical Education and Curricular Development, 2022; 9: 23821205221090168. doi:10.1177/23821205221090168
- Gelbart N. R. The King's Midwife: A History and Mystery of Madame du Coudray. Berkeley: University of California Press, 1998. ISBN 9780520924109 (publisher's description of the book)
- Le Boursier du Coudray A. M. Abrégé de l'art des accouchements. Paris: Debure, 1777: entry no. 919. Heirs of Hippocrates, University of Iowa Libraries