MADELEINE BRAND, host:

This is Day to Day. I'm Madeleine Brand.

ALEX COHEN, host:

And I'm Alex Cohen. Six boys and two girls. That's how many babies a woman gave birth to on Monday here in Southern California. The woman remains unidentified, but here's what we do know. These octuplets are record-setters. Eight is the largest number of infants to be delivered and survived so far. How many babies can survive inside one woman is a question Christopher Beam takes on for Slate's Explainer column. He joins us now. Hi, Christopher.

Mr. CHRISTOPHER BEAM (Columnist, Slate.com): Hello.

COHEN: We should preface by saying you usually cover politics for Slate, but you have been researching this question quite a bit. What was the largest number of babies ever in a woman's womb?

Mr. BEAM: Well, it's fair to say there's no limit per se, but the largest number ever recorded was 15. And that's quindecaplets that were recorded in 1971. An Italian doctor, a guy named Dr. Gennaro Montanino, reported that he had removed 15 fetuses from the womb of a 35-year-old woman. That was after she was four months pregnant. So presumably, it was for safety reasons.

COHEN: As you say, there's no scientific limit per se, and you explained that it's not so much about the number of fetuses as it is an amount in weight. Why is that?

Mr. BEAM: Well, for a couple of reasons. First, the fact that if you have enough weight in the womb, that's one thing that can cause the uterus to go into labor. So whether it's one fetus, two, or three, or eight, if you get - if you have enough volume or mass, it's going to signal to the uterus that, you know, it's time to get these things out of here. Another reason is just that it poses a safety risk to the mother. And once the uterus gets too full, it becomes harder to breath.

There's risk of developing pre-eclampsia, which is hypertension during pregnancy. And so for both those reasons, it ends up being more about weight than number.

COHEN: When I first heard about the woman here in California, what really shocked me was that she had all eight babies in five minutes. But of course, that's because it was a cesarean delivery and that, as you write, is pretty normal for multiple births. Why is that?

Mr. BEAM: Well, it's again for safety reasons. I think having a vaginal delivery with eight children is complicated. One, because once they come out of their amniotic sacs, they can get tangled up, and there's an interlocking problem. But also, just the amount of time and energy it would take to get that many fetuses out of the womb is not worth the risk, and cesarean sections are so easy now that there's no reason to take that risk.

COHEN: Christopher Beam's article "Womb for One More" appears now on Slate.com. Thanks.

Mr. BEAM: Thank you.

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How many babies can fit inside one woman?

How many babies can fit in a woman?

A woman gave birth to octuplets in California Monday after 30 weeks of pregnancy. The six boys and two girls ranged in weight from 1 pound, 8 ounces, to 3 pounds, 4 ounces. How many babies can fit inside a pregnant woman?

There’s no scientific limit, but the largest reported number of fetuses in one womb was 15. In 1971, Dr. Gennaro Montanino of Rome claimed to have removed 15 fetuses from the womb of a 35-year-old woman. The largest number of babies ever delivered was in Australia in 1971, when a 29-year-old women gave birth to nonuplets. They all died. (Decaplets were supposedly born in Brazil in 1946, but that report is unconfirmed.) The largest set of children to be born together and survive—not including this week’s octuplets, who are all still alive—is seven. A set of septuplets born in Iowa in 1997 became the first to survive infancy. At least two more sets of septuplets have since been born and survived.

How do so many babies fit in one woman? The limit isn’t so much the number of babies as their volume and weight. In general, once the total weight of the babies inside reaches about 12 pounds, the uterus goes into labor. The greater the number of fetuses, the earlier the labor will occur. (The rough formula for due dates is to start at 40 weeks of gestation for one baby and subtract three weeks for each additional child:  37 for twins, 34 for triplets, etc. It’s remarkable, then, that eight fetuses were able to gestate for 30 weeks, as in the California case.) Labor can also occur if a sac ruptures and introduces bacteria into the uterus or if one of the fetuses isn’t growing correctly and signals the uterus to induce labor. (Scientists still don’t know exactly what causes labor to start.) But for safety reasons, multiple births are often carried out before labor naturally occurs, and almost always by cesarean section. If the uterus gets too big and the fetuses too heavy, it can be difficult for the woman to breathe. The amount of placental tissue can also cause the mother to develop pre-eclampsia, or pregnancy-related hypertension.

Don’t the babies get tangled up?   Usually not. * Normally, each baby is enclosed in its own amniotic sac, which keeps the various umbilical cords and limbs from getting intertwined. Picture a bucketful of water balloons. In each sac, there’s plenty of fluid—about two-thirds the volume of the fetus—for the baby to move around in. After the sacs break, the babies can get tangled up during birth—so-called interlocking twins—which is why doctors usually opt for cesarean section. It is possible to have monoamniotic twins, or fetuses that share the same sac, with dangerous results: Cords can get compressed or entangled and cut off the babys’ oxygen and food supply.

Got a question about today’s news? Ask the Explainer.

Explainer thanks Joshua A. Copel of Yale University Medical School and Thomas Moore of University of California, San Diego.

Correction, Jan. 30, 2009: This article originally stated that fetuses in multiple births always have their own amniotic sacs. ( Return to the corrected sentence. )

The largest number of simultaneously born twins

But this, as they say, is not the limit. A greater number of twins have been born and are being born in the world. What is the largest number of children born at the same time?

Gears

In October 2008, 31-year-old Digna Carpio from New York gave birth to six twins - four boys and two girls. The weight of babies at birth ranged from 0.68 to 0.9 kilograms. The happy mother and her husband, 36-year-old Victor, already had a seven-year-old son at that time. nine0003

The birth of six twins is extremely rare, occurring in one in 4.4 million people. Only once before in New York were born six babies at once. It happened in 1997.

In October 2010 in the Italian city of Benevento, near Naples, 30-year-old Carmela Oliva had six children - four girls and two boys. In Italy, this was the first such case in the last 14 years.

To help the babies to be born, doctors were forced to resort to caesarean section. Children were born with low weight - from 600 to 800 grams. According to doctors, this phenomenon is not associated with artificial insemination, but with the treatment that the mother underwent - the fact is that Italian laws prohibit transplanting more than three embryos. nine0003

Setuples

Bobbie McCaughey (USA) gave birth to 7 children on November 19, 1997. They weighed between 1048 and 1474 grams and were born at 31 weeks pregnant within 16 minutes by caesarean section.

7 twins were born 8 weeks prematurely - on January 14, 1998 - to 40-year-old Hasna Mohammed Humair (Saudi Arabia). Among them, 4 boys and 3 girls, the smallest weighed 907 grams.

In August 2008, in the northern Egyptian province of Beheira, the 27-year-old wife of a local farmer, Ghazalu Khamis, gave birth to seven twins at once! As it turned out, the Egyptian dreamed of giving her husband a son and was taking pregnancy-stimulating drugs. The result is four sons and three daughters. nine0003

Ghazala Khamis was placed under observation two months before the birth: the development of twins in the mother's womb did not cause concern - the doctors were only worried about the increasing pressure on the kidneys. After a caesarean section, the woman in labor also underwent a blood transfusion. But all the crumbs were born healthy and quite large - from 1.4 to 2.8 kg, which in itself is a mystery of nature.

Octopuses

On January 26, 2009, 33-year-old Nadia Suleman gave birth to eight twins, all of whom were healthy. nine0003

The mother of the newborn eight was then living with her other children and parents in the suburbs of Los Angeles - in the small town of Whittier. The family already grew up six kids aged two to seven years, among whom there is a pair of twins.

The children's grandmother left her job and devoted herself to her daughter's family. And grandfather, to help Nadia, went to Iraq to work under a contract. Nadia herself claimed that she decided to take this step because of her own childhood, in which she missed her brothers and sisters so much. In addition, the eccentric American said that she was following the example of her idol, the large Angelina Jolie. A few years ago, Suleman even had plastic surgery to look like an actress. nine0003

Eight was conceived through in vitro fertilization (IVF). Doctors in such cases insist on the reduction (removal) of a part of the embryos. After all, such a number of them can adversely affect both the health of the mother and the health of future children.

But the Californian, having enlisted the support of her large family, refused the reduction. A single mother divorced her husband a long time ago precisely because they could not have children together.

Delivery by caesarean section was nine weeks premature. A team of 46 doctors who took birth was expecting the birth of seven babies, which, although not often, does happen. However, there were eight newborns - six boys and two girls - and they are all quite healthy. Baby weight - from 700 g to 1.9kg. Seven of them immediately breathed on their own and were bottle fed. The whole family was discharged from the maternity hospital home in just a week.

From 10 and more

There is information about the birth of ten twins at once. Such cases were recorded in Spain in 1924, in China in 1936 and in Brazil in 1946. But this is not the limit.

Eleven children at once - that's the largest number of twins known. The first birth of 11 twins occurred on 29May 1971 in the USA, in the city of Philadelphia. The second - in 1977 in Bangladesh, in the city of Bagarhat. In both cases, none of the children, unfortunately, survived.

In addition

The largest number of children born to one mother

The largest number of children born to one mother, according to official data, is 69. According to reports made in 1782, between 1725 and 1765. The wife of a Russian peasant Fyodor Vasiliev gave birth 27 times, giving birth to twins 16 times, triplets 7 times and 4 twins 4 times. Of these, only 2 children died in infancy. nine0003

Of our contemporaries, the most prolific mother is considered to be Leontina Albina from San Antonio, Chile, who gave birth to 55 children in 1943-81. As a result of the first 5 pregnancies, triplets were born to her, and exclusively male.

Woman with the most births

The record number of births, 38, is claimed to be Elizabeth Greenhill of Abbots Langley, Hertfordshire, UK. She had 39 children - 32 daughters and 7 sons - and died in 1681. nine0003

The largest father in history

The largest father in history is the Russian peasant of the village of Vvedensky Yakov Kirillov, who in 1755 was presented to the court in connection with this (he was then 60 years old). The first wife of a peasant gave birth to 57 children: 4 times four, 7 times three, 9 times two, and 2 times one. The second wife gave birth to 15 children. Thus, Yakov Kirillov had 72 children from two wives.

Russian woman who gave birth to 69 children: truth or fiction? nine0001

• Adam Hadhazi
• BBC Future

9 November 2015

Sign up for our 'Context' newsletter to help you understand what's going on.

Image copyright Getty

Carrying and raising even one child is a rather laborious task. However, historical documents claim that a certain woman gave birth to as many as 69 children. Is it true? And will modern medicine be able to expand women's reproductive opportunities? The correspondent is looking for answers to these questions BBC Future.

If the British yellow press had existed in the 18th century, the story of the family of the Russian peasant Fyodor Vasiliev would have caused her a crazy stir.

What's the matter? It is believed that Vasiliev's first wife, whose name history has not preserved, holds the world record for the number of children born.

According to a message sent to Moscow by the monks of the Nikolsky Monastery, between 1725 and 1765, Vasilyeva managed to give birth to 16 pairs of twins, give birth to triplets seven times, and quadruples four times. nine0003

She gave birth 27 times, respectively, for a total of 69 children.

(More BBC Future articles in Russian)

One can only wonder how a modern newspaper editor would have reacted to such fertility, especially given the uproar surrounding mother of eights Nadya Suleman (nicknamed "Octomama" and who gave birth to 14 children) and the British Radford family ( their 17 children became the subjects of a TV documentary).

So, is it possible in principle to give birth to more than 60 children? nine0003

"Something from the realm of fantasy. Imagine 69 children? Come on!" says James Segars, director of reproductive and women's health research at Johns Hopkins University.

I decided to take a little closer look at this surprising (and, at first glance, dubious) statement by consulting reproduction experts.

I was hoping to find out what the physical limits were to the number of children a woman could naturally have. nine0003

Along the way, it was discovered that thanks to the achievements of modern science, a woman can theoretically become a mother to more children than we ever thought possible.

Image copyright, Getty

In the UK, only 1.5% of pregnancies are twins, and the chance of triplets is only 0.0003%

Let's start with the mathematical part of the Vasiliev story. Are 27 pregnancies possible in the 40 years in question? nine0003

At first glance, this seems to make no sense, especially considering that triplets and quadruplets are usually born earlier.

Let's make approximate calculations: 16 twins for 37 weeks; seven triplets at 32 weeks; four quarters of 30 weeks. It turns out that in total Vasilyeva was pregnant for 18 years out of 40. She was drawn to salty things - and so on for a couple of decades.

Another question is whether this is possible in reality. nine0003

First of all, you need to understand whether a woman is able to maintain a constant readiness for childbearing over such a long period.

Women usually have their first menstrual period around the age of 15: every 28 days, an egg is released from their ovaries - usually one.

Ovulation recurs until the ovaries are depleted of eggs during menopause, which occurs around the age of 51.

Image copyright Getty

Most women cannot get pregnant after age 45. Is there enough time to give birth 69children?

However, a woman's ability to conceive decreases sharply long before the onset of menopause.

"A 45-year-old woman's chance of getting pregnant is about 1% per month," says Valerie Baker, assistant professor of obstetrics and gynecology at the Stanford University School of Medicine.

The aging of a woman leads to a decrease in the number and quality of eggs. In the process of intrauterine development, a female embryo can have up to seven million immature eggs, and about a million remain at birth. nine0003

An adult woman retains only a few hundred thousand eggs. Of this many cells inside the follicles, approximately 400 reach maturity and participate in ovulation, providing their carrier with approximately 30 years of potential childbearing.

The last eggs that ovulate at the end of a woman's reproductive years are at a much higher risk of mutations, genetic abnormalities and other problems associated with aging.

Often, pregnancies involving these atypical eggs end spontaneously. nine0003

"Most women are not able to get pregnant after they reach 42-44 years old," says James Segars. "But sometimes it happens even closer to 50 years old."

Image copyright, Getty

Women only have about one million eggs at birth, and their number is constantly declining.

And if Vasilyeva breastfed her children - which is logical for a peasant woman who could not afford a nurse - ovulation did not occur in her body. This natural method of contraception would further reduce her chances by 69pregnancies.

It turns out that Fedor and his wife were very lucky (or perhaps unlucky) that even after she reached 50 she had no problems with having new children.

Survive childbirth

And that's not all the difficulties associated with the birth of 69 babies.

Evolution has taken care of slowing down the female "biological clock", because bearing and giving birth to a child is an extremely difficult task, which only becomes more difficult with age. nine0003

"Limits must be set by nature itself," says Valerie Baker. "Pregnancy is the most stressful process a woman's body has ever gone through."

Photo copyright, SPL

The birth of multiple twins or triplets can theoretically lead to a large number of children in the family, but the health risks are high

How burdensome childbirth is for a woman gives the greatest reason to doubt the veracity stories about 69children - especially considering that it was a couple of centuries ago in the Russian outback.

In developed countries, the availability of modern obstetric care (eg medically induced caesarean section) has reduced maternal mortality.

In Britain, there are only eight deaths of women from pregnancy-related causes per 100,000 births during pregnancy or six weeks after it ends. These are the latest World Bank statistics.

Meanwhile, in one of the poorest countries on Earth, Sierra Leone, the rate is 1,100 deaths per 100,000 births. nine0003

In this regard, the assumption that Fyodor Vasiliev's wife survived 27 births is doubtful.

"Before, any pregnancy was a risk to the life of the mother," explains Segars. With multiple births (for example, with the birth of a quadruple), the risk of serious life-threatening complications increases rapidly.

"Every pregnancy at that time was difficult, even if only one child was born," says Jonathan Tilly of Northeastern University (USA), who is researching the use of oocyte stem cells to treat female infertility and other diseases (read more about this below) . nine0003

A bunch of backbiters

Another aspect that looks implausible in the story of the Vasilievs is the possibility of multiple conceptions of two, three and four children at the same time.

There are two types of multiple pregnancies: either several eggs that leave the ovaries as a result of ovulation are successfully fertilized by spermatozoa (so-called fraternal twins), or one fertilized egg is divided into two or more viable embryos, resulting in identical twins with identical genetic code. nine0003

Photo copyright, SPL

Modern fertilization technology makes it theoretically possible to have an infinite number of children

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In general, situations like this are extremely rare. So, in 2012 in Britain, the chance of giving birth to twins was only 1. 5% of all pregnancies, triplets - an insignificant three ten thousandths of a percent, and four or more babies were born three times out of 778,805 times. This is evidenced by the statistics of the Multiple Births Foundation. nine0003

Yes, the tendency to have twins is indeed hereditary, and in Fyodor Vasiliev's wife it could be especially pronounced.

However, in general, the likelihood that Vasilyeva was somehow able to conceive and survive the birth of at least 16 twins looks microscopic.

"There are 16 twins alone? I would be very surprised," Tilly comments.

Another wake-up call in the history of the Vasilievs: it is claimed that 67 out of 69 children born by them survived infancy. nine0003

In the 18th century, infant mortality was high even for children born as a result of a single pregnancy, and reached alarming levels in the case of twins and so on - these children are usually premature and less healthy.

"Even if you had quadruplets today, I'm not sure they would all survive," says James Segars.

Finally, it is impossible to believe in the existence of a woman ready for such a life. "Just imagine how stressful it is!" Valerie Baker says nine0003

Segars echoes her: "You can go crazy! I can't imagine what it was like to live in this house."

If, after all, this story is a true story, and not a legend, then the endless need to take care of children could be the decisive reason for the Vasilyevs' divorce, which followed after several decades of marriage.

Already an elderly man, Fyodor Vasiliev remarried, and his new wife allegedly gave birth to "only" 18 children. This is to the question of topics for the yellow press.

Brave New World

So what's the real limit? The answer to this question is not so simple, since the "natural" restrictions that apply to the offspring of a single woman can now be circumvented.

Firstly, the development of assisted reproductive technologies (ART), which appeared in the late 1970s, led to a surge in the birth rate of twins, triplets, and so on (Nadia Suleman used ART).

Photo copyright, SPL

According to one researcher, there may someday be a way to activate a woman's ability to produce many times more eggs.

Secondly, now surrogate mothers can carry fetuses from other parents, which potentially increases the number of children in the family even more.

What scientists have recently found out is that we probably greatly underestimate women's reproductive capabilities.

According to research in recent years, inside the female ovaries are "oocyte stem cells" that, if properly stimulated, could lead to the creation of an almost infinite number of eggs. nine0003

Jonathan Tilly and his colleagues have collected information about these cells from a variety of creatures - from flies to monkeys.

In 2012, they got to human oocyte stem cells. As it turned out, they do not contribute to the production of eggs, unlike similar animal cells. For female flies, this is a common way to produce new eggs.

Many physicians working in his field express doubts, but Jonathan Tilly is sure that there is a theoretical possibility to activate this mechanism in women. nine0003

He hopes to help women whose egg reserves are depleted, including prematurely - for example, due to cancer treatment.

If this hypothetical procedure really turns out to be possible, the imagination paints the following picture: fertility drugs are used to hyperstimulate the ovaries, with numerous follicles simultaneously maturing and ovulating.

This multitude of eggs can be surgically retrieved and fertilized in a test tube, then surgically placed in the wombs of any number of surrogate mothers whose job it is to carry the fetus. Each of them can potentially give birth to two or more twins. nine0003

The author of the photo, SPL

Men are capable of becoming fathers to hundreds of children. What if science gives women the same opportunity?

Thus, from a reproductive point of view, women could approach men, becoming mothers for hundreds or even thousands of children - leaving far behind the achievements of Fyodor Vasiliev's wife.

However, Tilly makes it clear that his research in no way suggests that women will be able to have thousands of children. He intends to contribute to the elimination of infertility in those who have been diagnosed with such a diagnosis. nine0003

However, the researcher hopes that scientific advances will help equalize the reproductive opportunities of men and women.

After all, males produce millions of sperm throughout their lives, so the only natural limit to their offspring is the presence (or absence) of ovulating partners.

Conqueror (and, some believe, serial rapist) Genghis Khan apparently fathered hundreds of children throughout his vast Asian empire some 800 years ago. According to genetics, about 16 million people living today are his descendants. nine0003

"Theoretically, men can become fathers before very old age, and if you start early, the situation can develop according to the model of Genghis Khan," says Jonathan Tilly.

According to him, "men's fertility is really unlimited", but if we assume that his research will give the desired result, then "women's too".

If such a scenario does materialize, the existence of mothers with countless children would create a sensation, perhaps even more than 69Vasiliev's children.

The question is: how would the public react to multiple fatherhood? If not so violent, is it fair?

"People take unlimited male fertility for granted - everyone knows we can do it," explains Tilly. ".

The researcher believes that the issue must be put into perspective, and the equality for which women have deservedly fought for the past few decades should also apply to reproduction issues.

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