Nearly one in five women in the state of Oaxaca gave birth outside hospital in 2011

A disturbing photograph of an indigenous woman from Mexico delivering a baby on a patch of grass outside a medical center has set off a firestorm online and sparked a national debate that led to the head of the clinic that turned the mother away being suspended.

The shocking image, taken by a passerby, shows 29-year-old Irma Lopez , who is of Mazatec ethnicity, squatting after giving birth, her face contorted in pain and her tiny newborn son still bound by the umbilical cord and lying on the ground.

The government of the southern state of Oaxaca announced Wednesday that it has suspended the health center's director, Dr. Adrian Cruz, while officials conduct state and federal investigations into the October 2 incident.

Scandalous: This disturbing photo of Irma Lopez, 29, squatting in pain outside a Mexican health clinic after giving birth without help from the staff caused outrage after appearing on the front page of La Razon de Mexico

Mrs Lopez, a married mother of three, said that she and her husband were turned away from the Rural Health Center of the village of San Felipe Jalapa de Diaz by a nurse who said she was only eight months pregnant and ‘still not ready’ to deliver, even though the woman was reportedly fully dilated.

The couple, who are Mazatecs and do not speak Spanish, could not understand much of what the nurse was telling them beyond the word ‘no,’ so they went outside.

Addressing the controversy later, the nurses blamed the incident on the language barrier and claimed that they did not have enough staff on hand to treat the woman due to a partial work stoppage.

An hour and a half later, at 7.30am, the woman’s water broke. Knowing that the time has come, Lopez kneeled on the grass outside the clinic and started pushing while grabbing the wall of a house.

‘I didn't want to deliver like this. It was so ugly and with so much pain,’ she said, adding she was alone for the birth because her husband was trying to persuade the nurse to call for help.

Eloy Pacheco Lopez, who was among a number of people drawn to the site by the mother’s screams, took the photo and gave it to a news reporter. It ran in several national newspapers, including the full front page of the tabloid La Razon de Mexico , and was widely circulated on the Internet.

Happy mother: Irma Lopez stands next to her newborn son Salvador at a clinic in the town of Jalapa de Diaz, Mexico, where a health center director was suspended for failing to help her during birth

Pacheco López also shared the image on Facebook, writing that 'after waiting and demanding attention for two hours, she gave birth in the yard of the hospital after being ignored by personnel under the direction of the supposed doctor Adrian René Cruz Cabrera,' Latin Times reported.

The case illustrated the shortcomings of maternal care in Mexico, where hundreds of women still die during or right after pregnancy. It also pointed to still persistent discrimination against Mexico's indigenous people persists.

Suspended: Health director Adrian René Cruz Cabrera

‘The photo is giving visibility to a wider structural problem that occurs within indigenous communities: Women are not receiving proper care. They are not being offered quality health services, not even a humane treatment,’ said Mayra Morales, Oaxaca's representative for the national Network for Sexual and Reproductive Rights.

Lopez said she and her husband walked an hour in the dark to the clinic from the family's one-bedroom hut in the mountains of northern Oaxaca.

It would have taken them longer to get to the nearest highway to catch a ride to a hospital. She said that from the births of her two previous children, she knew she didn't have time for that.

Silvia Flores, the mayor of the town where then now-infamous medical center is located, told the site Clarin that it was the second time in a year that a woman in labor has given birth on the lawn: in July, another indigenous woman delivered a baby on the same grass patch.

The Mexican federal Health Department said this week that it has sent staff to investigate what happened at the Rural Health Center of the village of San Felipe Jalapa de Diaz.

The National Human Rights Commission also began an investigation after seeing news reports.

Nearly one in five women in the state of Oaxaca gave birth in a place that is not a hospital or a clinic in 2011, according to Mexico's census.

Health officials have urged women to go to clinics to deliver their babies, but many women say the operating hours of the rural centers are limited and staffs small.

Growing brood: The 29-year-old mother of three talks to her children as her newborn son Salvador sleeps on her lap at her hut in the town of Jalapa de Diaz, Mexico

Although some have praised Mexico for improving its maternal health care, the mortality rate still stands at about 50 deaths per 100,000 births, according to the World Health Organization, similar to Libya, Barbados and Kazakhstan. The U.S. rate is 16 per 100,000.

Oaxaca is one of Mexico's poorest, most rural states and many women have died of hemorrhaging or preeclampsia - a condition causing high blood pressure and possible organ failure.

The Mexican states with the highest indigenous population have the highest rates of maternal deaths, by a wide margin.

Lopez was taken in by the clinic after giving birth and discharged the same day with prescriptions for medications and products that cost her about $30, she said. Health officials say she and her baby were in good health.

She said that poverty-stricken villagers are used to being forgotten by Mexico's health care system and left to fend off for themselves.