Sunday, June 13, 2010

A Woman C-sections Herself and Survives

Inés Ramírez Pérez (born 1960) is a Mexican woman from the state of Oaxaca who gained media attention after performing a successful Cesarean section on herself. Both she and her baby survived!

Ramírez was alone in her cabin in Rio Talea, Southern Mexico when her labor started. The nearest midwife was more than 50 miles away over rough terrain and rough roads. Her husband, who had assisted her through her previous labors, was drinking at a cantina. Rio Talea has 500 people and only one phone, but it was not nearby. Ramírez had given birth to eight children, seven living, at the time of the pregnancy in question. The last pregnancy, three years prior, had ended in fetal death during labor. Rather than experience the loss of another child in the same way, Ramírez decided to operate on herself.

At midnight, on 5 March 2000 — after 12 hours of continual pain and little advancement in labor, Ramírez sat down on a bench, drank from either a bottle of rubbing alcohol or "3 small glasses of hard liquor" (accounts vary), and assumed the traditional Zapotec birthing position, sitting up and leaning forward. She then used a large kitchen knife to cut open her abdomen in a total of three attempts. Ramírez cut through her skin in a 17 cm vertical line several centimeters to the right of her navel, starting near the bottom of the ribs and ending near the pubic area. (For comparison: a typical C-section incision is 10 cm long, horizontal and well below the navel, the so-called "bikini-line incision".) After operating on herself for an hour, she reached inside her uterus and pulled out her baby boy, who breathed and cried immediately. She then severed the umbilical cord with a pair of scissors and became unconscious. When she regained consciousness, she wrapped clothes around her bleeding abdomen and asked her 6-year-old son, Benito, to run for help.

Several hours later, the village health assistant found Ramírez alert and lying beside her live baby. He sewed her incision with an available needle and thread.

Ramírez was eventually taken to the local clinic, two and a half miles away, and then to the nearest hospital, eight hours away by car. Sixteen hours thereafter she underwent surgical repair of the incision site. On the seventh post-operative day, she underwent a second surgery to repair complications resulting from damage to her intestines incurred during her C-section. She was released from the hospital on the tenth day post-surgery, and went on to make a complete recovery.

Describing her experience, Ramírez said, “I couldn’t stand the pain anymore. 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.”

Ramírez is believed to be the only person known to have performed a successful Cesarean section on herself. Her case was written up in the March 2004 issue of the International Journal of Gynecology & Obstetrics.

She is also believed to have been profoundly lucky in several ways: to have put herself in the position she chose, which put her uterus — rather than her intestines — against the abdominal wall under the incision site; to have not succumbed to infection from the large open wound in a non-sterile environment; to have not passed out from the pain part-way through, or died from shock; and, if her drink of choice was indeed isopropyl alcohol to have drunk a sub-lethal amount of it. She did say, afterward, that she didn't advise other women to follow her example.

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