From the Austin American-Statesman, Saturday, June 26, 2004:

By Lisa J. Adams

ASSOCIATED PRESS

Saturday, June 26, 2004

RIO TALEA, Oaxaca -- 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 before. The nearest clinic was more than 50 miles away over rough terrain and inhospitable roads, and her husband, her only assistant during her six previous births, was 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 sat 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 said 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 rambunctious, playful 4-year-old. And Ines Ramirez is recognized internationally as a modern miracle. She is thought to be the only woman known to have performed a successful Caesarean section on herself.

In an interview 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 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."

The doctors were so stunned by what they saw that they told Ramirez's story at a medical meeting the following year. But the miracle birth got little attention until it was reported this spring in the International Journal of Gynecology and Obstetrics.

The article was co-authored by Dr. Rafael Valle, an obstetrician at Northwestern University in Chicago, who insisted the story "is not a hoax."

Galvan acknowledges there might be skeptics, but he has heard Ramirez give her account several times, "always with the same details."

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

As she spoke, 4-year-old Orlando hugged her legs and flashed a white, baby-toothed grin.

Ramirez thinks 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, Leon Cruz and another health worker -- whose combined medical knowledge was limited to handing out medicines -- found Ramirez alert and lying beside her live baby.

Cruz 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 straw mat, lugged them up steep 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 and Orlando were transferred to the backs of two different pickups. They bounced for eight hours over winding dirt roads before making it to the hospital in San Pablo Huixtepec, about 240 miles southeast of Mexico City.

"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 wouldn't 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."

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