Pioneering French Midwife: Angélique du Coudray

The pioneering French midwife, Angélique du Coudray, gained fame in the 1700s. She was born in 1712, the same year as the King of Prussia (Frederick II, known as Frederick the Great) and the Enlightenment writer Jean-Jacques Rousseau. Little is known about Coudray’s early years. However, at twenty-five she graduated from the College of Surgery École de Chirurgie in Paris and completed her three-year apprenticeship that allowed her to become an accredited midwife.

Soon after Coudray’s graduation, schools began to bar women from gaining instruction in midwifery. Surgeons also began to expanded into the birthing field and this further reduced the medical community’s willingness to train female midwives. Women were upset and began to petition that they be allowed to receive proper instruction to become midwives.

Coudray was among those who supported female midwives. She argued that if proper training was not given to female midwives, midwives would continue to practice untrained and might cause harm to their patients. Moreover, she declared that without training, there would be shortage of midwives.

The medical community listened and decided they needed to solve the situation. This resulted in midwives once again receiving proper instructions in birthing techniques. Because of Coudray’s role in helping women become midwives and her acumen in getting things done, she was appointed as the head accoucheuse at the famous Parisian Hôtel Dieu Hospital.

Coudray met Louis XV because he was worried about France’s decreasing population. After the Seven Years’ War, he decided he needed to do something to increase it and because of Coudray’s accomplishments in midwifery, he appointed her to teach rural midwives in 1759.

To aid in her teaching of rural midwives, Coudray created what was called a “machine.”* The machine was actually a life-size obstetrical mannequin created from leather and cloth. It was used to teach future midwives about obstetrics and childbirth using various strings and straps to simulate the stretching of the birth canal and perineum. Moreover, the machine was extremely detailed and very accurate so that students could understand how to properly deliver a baby not only during normal deliveries but also under unusual circumstances, such as breech. 

The Academy of Surgery examined the machine on 13 May 1756 and approved it in 1758. They deemed it “worthy of its approbation.”[1] Coudray noted that her machine was invented because

“I hit upon the plan of making my lessons clear to my pupils by setting them to work before me on a machine that I constructed for the purpose, representing the pelvis of the a woman — I added to it the model of a child life-size of which I made the joints flexible enough to be able to put them into different positions, etc.”[2]

In 1785, the same year that Marie Antoinette gave birth to Louis-Charles (the future Louis XVII), the pioneering French midwife Coudray published “Abrégé de l’Art des Accouchemens.” This book was based on her traveling lectures that she gave to midwives and was an updated and expanded version of midwifery textbook from 1667. This 38-chapter book was arranged in the order she gave her lectures and was said to contain “clear and luminous principles” for midwives. It covered such topics as the female reproductive organs, proper prenatal care, obstetrics, various problems during birth — breech, knee-first, arm-first, twins, stillborns, — and various rare cases, such as a woman who was supposedly pregnant for 22 months.

Coudray was successful in pioneering many ideas related to obstetrics and child birth. She also hoped to prevent unnecessary deaths by training midwives properly so that they would give up antiquated practices and save lives. For instance, one common practice among midwives was to help exhausted mothers by immediately removing near-dead infants from the birth canal. The near-dead child was then set aside and left to die.

Coudray believed that such infants might survive if midwives did not give all their attention to the mothers. She suggested midwives care for these infants and revive them.  (One twentieth century author noted that life expectancy in France indicated a marked increased around 1750 and that “historians do not credit or even mention Mme du Coudray’s mission in this connection, but they should.”[3])

In the 1700s, most people believed baptism was necessary for a newborn’s salvation. A discussion ensued about whether it was proper to take an ill child to be baptized or allow the midwife to baptize the child. As Coudray was considered an expert related to birth and babies, partly because she trained over 4,000 French midwives, her advice was also sought on this subject. She made her position clear, stating, “there is usually danger in carrying children to baptism during the night.”[4] She bolstered her opinion by citing such nighttime dangers as bad roads, inclement weather, and loose dogs and noted that “a false step … can make [the child] lose his life without baptism.”[5] In the end, her reputation was such, she was allowed to baptize infants.

Coudray was extraordinarily successful at a time when most women in the medical field were not. Part of her success was because she knew how to compete in a man’s world. She did it by not competing as a woman but rather by de-emphasizing her feminine qualities. She also made acquaintances with many powerful males. For instance, César Verdier, a well-respected French anatomist, surgeon, and university lecturer, examined her machine and then popularized it. In addition, she considered herself equal to men and demanded equal pay and recognition for her accomplishments.

The pioneering French midwife Coudray also delivered some babies the grew to be important well-known people in France. One story about such a delivery follows:

“Yesterday a baby was born here in the château on the slope with its long flat front two stories high and its circular towers at either end. They say the birth took place in a chamber of the western turret that commands the valley and faces the violet rim of mountains on the horizon. The child’s name is Marie Joseph Paul Yves Roche Gilbert du Motier. … [I]t seems the midwife who delivered him yesterday was none other than du Coudray. She is a celebrity in Auvergne and must have been summoned all the way from Clermont, fifteen leagues northwest of here, because of her great reputation. Despite complications, she brought the child safely into the world. She has not stayed to preside at the baptism; no doubt the pressing business of her teaching called her back to the big city. But her niece will one day declare that du Coudray saved this baby’s life. Had she not done so, he would not have grown up to become the marquis de Lafayette.”[6]

Coudray died on 17 April 1794 in Bordeaux, a year after Louis XVI and Marie Antoinette were executed. For many people, Coudray’s death seemed to be a mystery. She died during the Reign of Terror, a period when France was purging itself of its enemies and protecting itself from foreign invaders. Certain scholars maintain that the pioneering French midwife was secretly executed because Louis XV and Louis XVI had endorsed her and that her death occurred during the night so as to prevent any trouble with those who might have supported her. Other scholars argue that she died of old age, being 82 years old at the time of her death.

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*Englishman William Smellie, is often credited as having been the first to create such a “machine,” but, in fact, the French Academy of Surgeons approved Coudray’s model in 1758, well before Smellie’s appeared.

References:

• [1] Coudray, Angélique-Marguerite Le Boursier du, Abrégé de l’art des accouchemens, 1785, p. 204.
• [2] Art and Letters, Issue 4, 1889, p. 410.
• [3] Gelbart, Nina Rattner, The King’s Midwife: A History and Mystery of Madame du Coudray, 1998, p. 277.
• [4] The Lancet, 1872, p. 501.
• [5] Ibid.
• [6] Gelbart, Nina Rattner, 1998, p. 71.