Angélique du Coudray: Mother of Obstetric Simulation

Example of the Machine of Madame du Coudray kept at the Musée de l’Homme in Rouen, France. Photo from: Wikipedia

In the heart of the 18th century, in an era dominated by men, a French woman distinguished herself as a pioneer in obstetrics and entrepreneurship: Angélique Marguerite Le Boursier du Coudray. Her invention, the “obstetric simulator”, revolutionized the training of midwives, saving countless lives and paving the way for women in the world of healthcare simulation.

At a time when childbirth was a deadly risk and obstetric science was still in its infancy, one woman managed to change the fate of thousands of mothers and newborns. Angélique du Coudray not only challenged the barriers of gender in medicine, but also invented the first obstetric simulator in history, transforming the training of midwives forever. But who was this visionary really? And how did her Machine influence modern obstetrics?

Angélique du Coudray: A Visionary in Obstetrics

Born in 1714 in Clermont-Ferrand, Angélique du Coudray came from a family of doctors. She cultivated her passion for medicine from an early age and, determined to follow in her family’s footsteps, obtained her diploma as a midwife on September 26, 1739 and began practicing in Paris, where she trained numerous apprentices.

In an era when obstetrics was often relegated to folk practices and women faced significant barriers in accessing medical professions, du Coudray recognized the importance of practical training for midwives. To meet this challenge, he devised an obstetric mannequin, known as “La Machine”, which allowed apprentices to practice childbirth techniques in a controlled and safe environment.

The Machine: The First Obstetric Simulator

In 1756, du Coudray presented a “Machine” to the Académie de Chirurgie intended to “demonstrate the practice of childbirth”. Described in a concise but precise manner, this “Machine” made of cloth had the shape of a woman’s pelvis, which allowed trainee midwives to learn and practice the correct gestures to assist a woman in labor, regardless of the position of the baby in the womb. The object faithfully reproduced the anatomy of the “parts used for generation”, representing the uterus, its orifice, its ligaments, the vagina, the bladder and the rectum. The Machine was flanked by handmade neonatal mannequins, with articulated limbs so they could move freely in any position. Thanks to this flexibility, which also applied to the neck, the mannequin could

A concrete example of impact on health

In October 1759, King Louis XV entrusted Madame du Coudray with a crucial mission: to educate midwives in rural areas of France to counter the alarming rate of neonatal mortality. At that time, around 200,000 newborns died every year due to poor obstetric preparation, contributing to the demographic decline of the kingdom.For over 25 years, between 1759 and 1783, Madame du Coudray traveled through France and part of Belgium with her Tour de France, training thousands of midwives and even some doctors. Her most extraordinary innovation was the creation of the first national training course based on simulation, combining theory and practice in a structured and standardized program. The course lasted about two months and consisted of 40 teaching units, each lasting one day. Classes were held six days a week, both in the morning and in the afternoon, ensuring intensive and in-depth training. With this revolutionary approach, Madame du Coudray laid the foundations for modern midwifery training, improving the safety of childbirth throughout France.

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Madame du Coudray’s entrepreneurship

In addition to her medical skills, du Coudray showed considerable entrepreneurial spirit. She made several models of her manikin: a “luxury” one, intended to serve as a reference and which the connoisseurs of the provinces visited were obliged to purchase at the price of 500 livres (about €4000); and a second, simpler one, used for demonstrations, offered at the price of 300 livres. This strategy provided a consistent income for her business, which was probably entirely female, given the sewing work required.

Her ability to combine technical innovation and commercial acumen makes her one of the first entrepreneurs in the field of healthcare simulation, a sector that is fundamental in healthcare training today.

The Lasting Impact of the Obstetric Simulator

The influence of du Coudray and her obstetric simulator was profound. Her lessons helped standardize obstetric practices in France, significantly reducing maternal and infant mortality. Her practical approach to midwifery training inspired future innovations in healthcare education, laying the foundation for the modern use of simulators in clinical training.

In fact, for 300 years obstetrics has made use of training through simulation not only to teach the theory of anatomy and physiology, but also to apply them in practice.

Conclusion

On International Women’s Day, remembering the figure of Angélique du Coudray means celebrating a pioneer who, with determination and ingenuity, overcame gender barriers, revolutionizing obstetrics and saving countless lives. Angélique du Coudray’s legacy lives on in every modern obstetric simulator, testifying to the importance of her innovative vision. Her contribution remains a beacon of inspiration for women in healthcare and in all fields of innovation.

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