Angélique du Coudray

'The Machine', the first lifesize obstetrical mannequin

Du Coudray invented the first lifesize obstetrical mannequin, for practicing mock births. It was usually called "The Machine." Each cost about 300 livres to construct, usually out of fabric, leather, and stuffing, and occasionally including actual human bones to form the torso. Various strings and straps serve to simulate the stretching of the birth canal and perineum to demonstrate the process of childbirth. The head of the infant mannequin has a shaped nose, stitched ears, hair drawn with ink, and an open mouth (with tongue) into which a finger can be inserted to a depth of 5 centimetres (2.0 in).[lower-alpha 1] This detail was important, as it allowed the midwife to put two fingers into the mouth, to facilitate the passage of the head in a case of breech presentation. [10] These mannequins were very detailed and accurate.[11] The invention is often attributed to a Scotsman, William Smellie, but the Royal Brevet of 19 October 1759 already mentioned du Coudray's model, giving her a prior claim on the invention.[12] An historical example of 'The Machine' is kept in the Musée Flaubert et d'histoire de la médecine in Rouen, France,[13] and a copy in the Musée de l'Homme in Paris.[14]

Du Coudray first traveled to Moulins in November 1761 from Claremont France. Le Nain, who had heard and learned a lot about du Coudray's childbirth courses in an exchange with letters with Ballainvilliers, was extremely excited about her arrival. He was one of the first people to secure her services in his city. In her first lesson in Moulins, eighty students appeared and the second lesson brought seventy. Fewer students came because this was also harvest time and many women could not be spared from their farm duties. Du Coudray noted how many women had no aptitude and even sent them home, and only a few women really stood out to her. Her course cost the women 36–40 livres, which included the final certificate of completion. She worked her students hard and taught them just the basics, but even this was enough for them to be extremely useful in their cities. Classes took place six days a week, all morning and all afternoon, and lasted around two months, so that every student had plenty of time to listen to lectures and practice each maneuver several times on the machine. Occasionally she would allow her best students to attend live births with her supervision. In most cities she was paid 300 livres a month of her teaching.[5]

Throughout the next year and a half she traveled to Burgundy: to Autun in 1761, Bourg-en-Bresse and Chalone-sur-Saȏne in 1763, and in the same year to Limognes-en-Quercy and Tulle. She then traveled to Angoulȇme in 1764 and Bourdeilles in the same year, then to Poitiers in 1764–65, to Sablés-sur-Sarthe in 1765, and finally to Périgueux and Agen in 1769. She held a similar course of instruction in all these regions of France.[15] In a new development, Du Coudray taught midwives to stop the practice, when an infant was delivered near death, of putting it to one side and focusing on recovery of the mother. She instructed them to attempt to revive the infant, which could be successful.[5]

The Abrégé de l'art des accouchements contains du Coudray's lectures in the order that she taught them, starting with the female reproductive organs and the process of reproduction. It then explains the issue of proper prenatal care. Finally, it discusses how to deliver infants, including how to handle common obstetric problems. The Abrégé also covers rare cases that occurred during the birth process, which Du Coudray notes as her "observations". Throughout the book, she refers to her "machine" as a way to explain concepts. Despite its important contributions to the field of midwifery, the Abrégé was neglected when it was initially published, because it was a small, light, unobtrusive volume. Still, the existence of the book served as an influential model for midwives during the eighteenth century.[5]