This month’s Pioneers profile focuses on another veteran of Royaumont Military Hospital: Frances Ivens. Before becoming a founding Fellow of the RCOG, Ivens was a recipient of the Legion of Honour for her heroic efforts treating wounded allied soldiers, often just miles from the front lines during the First World War.
Born Mary Hannah Frances Ivens, she was the youngest of five children and the daughter of a timber merchant. She was encouraged to study medicine by Margaret Joyce, a student at the London School of Medicine for Women, and graduated in 1900 with a Gold Medal in obstetrics and Honours in medicine and forensic medicine. By 1902, she had secured a First-Class Honours degree in surgery and, in 1903, she became the third woman to achieve a master’s degree in surgery. Early in her career, she worked at the Royal Free Hospital in London, the Elizabeth Garrett Anderson Hospital, and the Canning Town Mission Hospital for Women in East London.
In 1907, she went to Liverpool where she was appointed Consultant in Charge of the obstetrics and gynaecology department at the Stanley Hospital (making her the first women to be appointed to a consultency role in the city). She extended her reach beyond surgery and campaigned for various social causes, including sex education for women and awareness of the dangers of venereal diseases. Ivens also established a clinic for the babies of poor families in a time before infant welfare clinics were commonplace.
In 1913, she was part of a panel discussion on the moral education of the young at the National Union of Women Workers in Great Britain and Ireland. Like many women in her professional circle, she was involved in the suffrage movement. She was Chair of the Liverpool branch of the Conservative and Unionist Women’s Suffrage Society, proving to be a leading influence in the formation of the North of England Medical Women’s Society. She was remembered by her colleague Dr Catherine Chisholm as ‘the protagonist in all our feminist struggles’.
When the world went to war in 1914, Ivens joined up with the Women’s Unit in Belgium. But, much to her disappointment, the unit was forced to withdraw early. She then focused her efforts towards the newly-formed Scottish Women’s Hospital (SWH), which was founded by Dr Elsie Inglis when her offer of medical services were rejected by the War Office. Inglis had successfully raised funds for the SWH and by the end of August 1914 they had raised more than £5,000 to fund voluntary all-women medical units in Europe. The SWH offered rare and challenging opportunities for the country’s medical women, many of whom had been denied entry to the Royal Army Medical Corps.
In December 1914, the first SWH unit was established as a 100-bed auxiliary hospital at the vacant Royaumont Abbey, in northern France. While spacious and grand, Royaumont was grim and dilapidated when Ivens and her team arrived. They toiled to get the abbey into shape, not giving up even after failing their first inspection from the French authorities.
Records left by visitors to Royaumont during the war reveal an intense admiration for Ivens for her charm, patience and tact as well as her concern for the moral of her staff and patients, who affectionately referred to her as ‘Madam la Colonelle’. She repeatedly surrendered her own bed when mattresses for patients were in short supply, held regular parties, and would personally bestow medals on dying soldiers.
She convinced French Military authorities to send medical cases to Royaumont, providing ample opportunity for her team to prove their worth to the war effort. During the Battle of the Somme, Royaumont increased its number of beds to 600 and its doctors worked for eight days with only sixteen hours of sleep, often performing surgery by candlelight when the electricity was cut. Ivens shared major surgeries with her second-in-command and close friend, Ruth Nicholson.
In addition to emergency surgery, Ivens and her team pioneered new approaches to the treatment of gas gangrene and on the use of x-ray and bacteriology for diagnosis. From 1914 to 1919, Royaumont treated over 10,861 patients, including 8752 soldiers, and reported an impressively low mortality rate of 159. This was likely the result of the hospital’s research into infection and the co-operation of its surgeons, radiologists and bacteriologists in treating infection and saving limbs affected by gangrene.
The hospital staff also experimented with the use of natural sunlight in healing the injured, arranging for patients’ beds to be placed in the abbey’s picturesque courtyards during warmer months. Towards the end of the conflict, they were asked to establish advanced treatment centres closer to the fighting to provide more urgent care. Ivens and her team operated at one such station, at Villers Cotterêts, under shell fire during the 1918 German advance.
After the end of the war, Ivens was awarded the Croix de Guerre with Palm and the Médaille d’Honneur des Epidémies. In addition, she was decorated France’s highest honour, the Croix de la Légion d’Honneur. Despite these achievements and her official appointment within the French military, Ivens was not granted a commission as a doctor in the British Army and no British medals were given to the staff.
On return to Liverpool, Ivens resumed her work at the Stanley and Samaritan Hospitals and helped to found the Crofton Recovery Hospital for Women. She was elected President of the Medical Women’s Federation in 1924 and was the first woman elected Vice President of the Liverpool Medical Institution in 1926.
As President of the Medical Women’s Federation from 1924 to 1926, she raised the issue of the status of women doctors and female medical students. She continued to campaign for access to birth control as a tool in preventative medicine.
In 1929, she was made a Commander of the British Empire and, a year later, married barrister Charles Matthew Knowles. At her wedding, fifteen of her Royaumont colleagues formed a guard of honour and shouted ‘Vive la Colonelle’ as she came out. After her retirement from private practice, she worked for the Red Cross as a County Medical Officer in Cornwall and she published a book on caesarean section in 1931. Up until her death in 1944, she continued to work with organisations caring for the wellbeing of soldiers and their families.
Veterans of Royaumont continued to meet regularly decades after the end of the war. In a speech at the first Royaumont Association dinner in November 1919, Iven’s colleague and Royaumont’s x-ray technician Vera Collum, said ‘[had] there been no Miss Ivens, there would never have been a Royaumont … it was the Chief who made Royaumont. We only held up her hands.’