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 labour intensified, so did her concern for this unborn child.

The sun had set hours ago. The nearest clinic was 80km away over rough 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 a 15-cm knife and began to cut.

By 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.