Desperate operation

RIO TALEA, Mexico -- Alone in her one-room cabin high in the mountains of southern Mexico, Ines Ramirez Perez felt the pounding pains of a child insistent on entering the world.

Three years earlier, she had given birth to a dead baby girl. As her labor intensified, so did her concern for this unborn child.

The sun had set hours ago. The nearest clinic was more than 50 miles away over rough terrain and inhospitable roads, and her husband, her only assistant during a half-dozen previous births, was drinking at a cantina. She had no phone and neither did the cantina.

So at midnight, after 12 hours of constant pain, the petite, 40-year-old mother of six sat down on a low wooden bench. She took several gulps from a bottle of rubbing alcohol, grabbed the 6-inch knife she used for butchering animals and pointed it at her belly.

And then she began to cut.

Under the light of a single dim bulb, Ramirez sawed through skin, fat and muscle before reaching inside her uterus and pulling out her baby boy. She says she cut his umbilical cord with a pair of scissors, then passed out.

That was March 5, 2000. Today, the baby she delivered, Orlando Ruiz Ramirez, is a playful 4-year-old. And Ines Ramirez is recognized internationally as a modern miracle. She is believed to be the only woman known to have performed a successful Caesarean section on herself.

Doctors astounded

In an interview with an Associated Press reporter in front of her isolated, wood-plank home, she described her experience in halting Spanish, heavily accented by her native Zapotec language.

"I couldn't stand the pain anymore," she said. "And if my baby was going to die, then I decided I would have to die, too. But if he was going to grow up, I was going to see him grow up, and I was going to be with my child. I thought that God would save both our lives."

Though there were no witnesses available to confirm her account, the two obstetricians who examined her 12 hours after the birth are wholly convinced. And no one in her village challenges her story.

"We were astonished," Dr. Honorio Galvan said in an interview at the San Pablo Huixtepec hospital south of Oaxaca City, where Ramirez was taken. "I couldn't believe that someone without anesthesia could operate on herself and still be alive. To me, it is incredible."

A diminutive woman who stands about 5-feet-2, Ramirez displayed the 6-inch knife she used to perform the operation.

Ramirez believes that she operated on herself for about an hour before extricating her child and then fainting. When she regained consciousness, she wrapped a sweater around her bleeding abdomen and asked her 6-year-old son, Benito, to run for help. Several hours later, two health workers found Ramirez alert and lying beside her live baby.

One health worker sewed her 7-inch incision together with a regular needle and thread. A professional C-section incision measures about 4 inches, Galvan said.

The two men lifted mother and child onto a thin straw mat, lugged them up vertical rock-strewn horse paths to the town's only road, and drove them to the clinic 2 1/2 hours away.

Ramirez was given basic emergency medical attention before she was transferred with Orlando to the hospital in San Pablo Huixtepec, an 8-hour drive over dirt roads.

"When she arrived, she was conscious, with no signs of shock, perfectly fine," Galvan said. "Considering what she had put her body through, she at least should have been unconscious from the blood loss and the pain."

Ramirez left the hospital after four days, and today her scar is almost invisible.

By sitting forward in the traditional Indian birthing position instead of lying down, Ramirez unknowingly ensured that her uterus was directly under the skin and that she would not cut her intestines. Her incision was considerably higher than the one a doctor would make, and Galvan believes she was very lucky she didn't do serious damage.

Asked what guided her in the operation, she replied, "I had slaughtered chickens and other animals."

That she survived so much pain and developed no infections "may tell us that there are populations with an innate resistance so strong that they can tolerate what urban groups can't," Galvan said. "It is an incredible response of the human body."

Ramirez, who had her tubes tied to prevent additional pregnancies, says she would never recommend her desperate action to other women.

"It was very painful, and people could die," she said, her hands folded modestly over the lap of a bright blue and red traditional Zapotecan dress.