When Ugandan Mariam Nabatanzi gave birth to her first twins at just 13 years old, she had no idea that their lives would become one of the most extraordinary stories in modern medical history. Over the next two decades, she gave birth to 44 children through a remarkable series of multiple pregnancies, including six pairs of twins, four pairs of triplets and three pairs of quadruplets. Her story attracted global attention, with many media outlets dubbing her the most fertile woman in the world. However, behind the astonishing numbers, lies a deeply human story of child marriage, a rare medical condition, poverty and one mother’s determination to raise one of the world’s largest documented families.
How did the world’s most fertile woman become the mother of 44 children?
Mariam Nabatanzi, born in Uganda in 1980, was married at the age of 12 in what was widely reported as child marriage. A year later, she became a mother after giving birth to her first twins. Instead of spending her teenage years in school, she found herself babysitting children as they grew up.In the interview with Reuters, Mariam revealed that she had only ever hoped to have six children. She wanted to rebuild the family she had lost after being abandoned by her mother, and according to her account, her five elder siblings later died after allegedly being poisoned by their stepmother. Reflecting on her early life, she said, “I started taking on adult responsibilities at an early stage. I feel like I haven’t had any happiness since I was born.”“Over approximately 25 years, Mary gave birth to children 38 times, resulting in 44 children due to repeated multiple births. Her pregnancies included six pairs of twins, four pairs of triplets, three pairs of quadruplets and two singleton births. Tragically, six of her children later died, leaving her with 38 surviving children to raise.The extraordinary frequency of multiple births made her case one of the best documented in modern medicine. Contrary to many historical claims about exceptionally large families, Mary’s pregnancies have been extensively reported and medically documented, making her story unique in contemporary cases.
Rare medical condition behind multiple births
Doctors later diagnosed Maryam with hyperovulation, a condition in which the ovaries release multiple eggs during a menstrual cycle instead of normal. When multiple eggs are fertilized, the chances of having twins, triplets or quadruplets increases dramatically.According to Dr. Charles Kiggundu, a gynecologist at Mulago National Specialized Hospital in Kampala, Maryam’s unusually large ovaries were causing her to repeatedly release multiple eggs, making her more likely to have multiple pregnancies in a row than the average woman. While hyperovulation itself is not unheard of, experts say a case involving repeated high-order multiple births over so many years is exceptionally rare.Medical experts also note that genetics play an important role in hyperovulation, which is why twins often occur in families. However, multiple pregnancies resulting in triplets and quadruplets are an extremely uncommon occurrence.
Why didn’t doctors prevent pregnancy earlier?
After several pregnancies, Mary sought medical help because she did not want any more children. However, according to interviews she later gave, doctors initially advised against certain birth control methods due to concerns about complications associated with her enlarged ovaries.As a result, she continued to be pregnant until her final delivery. After giving birth to her last child, doctors performed tubal ligation, a surgical procedure that permanently stops pregnancy, ending one of the most remarkable childbirth histories of all time.
Raising dozens of children on her own
Life became even more challenging when Mariam’s husband reportedly abandoned the family in 2015. Left alone to care for dozens of children, she took whatever work she could find, including farming, tailoring, hairdressing, selling herbal medicines and decorating for events.In a Reuters interview, Maryam described the constant struggle to support such a large household, saying, “All my time has been spent taking care of my children and working to earn some money. I grew up in tears, my husband put me through a lot of suffering.”Her eldest son, Ivan Kibuka, also described the family’s daily reality, saying, “Mother is overwhelmed, the work is crushing her. We help wherever we can, like cooking and washing clothes, but she still bears the entire burden of the family.”Reports indicate that the family needed about 25 kilograms of maize flour every day to prepare enough food for everyone, while meat and fish were sometimes considered luxury items due to their cost.
Life inside one of the world’s largest families
At various points, Maryam’s family consisted of more than 60 people, including children, grandchildren, and daughters-in-law. The family lives in several simple brick houses with corrugated iron roofs, where older siblings help with cooking, cleaning, and caring for the younger children.Despite heavy responsibilities, Mary has repeatedly stressed the importance of education. Whenever possible, they have preferred to send their children to school, believing that education provides them with opportunities they never had before.Mariam Nabatanji’s life is much longer than giving birth to 44 children. Her story highlights the lasting effects of child marriage, the importance of maternal health care, and the challenges of raising a large family in poverty. While the world may remember him for his extraordinary medical rarity, his greatest achievement is raising dozens of children despite enormous financial and personal difficulties.