A MUM who holds the world record for the most children was warned by doctors she could suffer severe health problems if she stopped giving birth.
Mariem Nabatanzi had given birth to 44 kids by the age of 40 and was told that no family planning methods would work for her.
The woman from Uganda, East Africa, has given birth to four sets of twins, five sets of triplets, and five sets of quadruplets.
Only once did she give birth to a single child.
Six of her children died, and her husband abandoned her and ran off with all the family's money, leaving Mariem with 38 children - 20 boys and 18 girls - to raise single-handedly.
Mariem was married off when she was only 12 years old after her parents sold her and soon after she fell pregnant, giving birth to her first child at the age of just 13.
READ MORE WORLD NEWS
Fertility rates are far higher in Uganda, where the average is 5.6 children per woman, according to the World Bank.
That's more than double the world average of 2.4 children.
But Mariem - dubbed 'Mama Uganda' in her home country - soon realised that she was unlike other women.
When she kept having twins, triplets, and quadruplets, she went to a health clinic.
Most read in News
Doctors told her that she had abnormally large ovaries which led to a condition called hyperovulation.
She was told that birth control wouldn't work, and would likely cause severe health problems.
Treatments do exist for hyperovulation, but they are hard to come by in rural Uganda.
As Dr Charles Kiggundu, a gynecologist at Mulago Hospital in Uganda's capital Kampala told The Daily Monitor, the most likely cause of Mariem's extreme fertility was hereditary.
"Her case is a genetic predisposition to hyper-ovulate - releasing multiple eggs in one cycle - which significantly increases the chances of having multiple births," he said.
Today at 43, she says she was told to stop having children three years ago following her last birth.
She said the doctor told her he had "cut my uterus from inside".
Speaking through a translator to filmmaker Joe Hattab, Mariem said: "It was god's grace to want to give me [so] many children."
However, her story is tinged with sadness.
I have grown up in tears, my man has passed me through a lot of suffering
Mariem Nabatanzi
She said she was forced into marriage at age 12 against her will after her parents sold her for the dowry.
Mariem added that doctors told her she was too fertile and that she needed to keep giving birth in order to reduce fertility levels in her ovaries.
She was told that no family planning method would work for her and that giving birth was the only way to "ease" her body would be to produce children.
According to , a US private health company with offices around the world: "Severe ovarian hyperstimulation syndrome is uncommon, but can be life-threatening."
Other complications can include fluid buildup in the abdomen or chest, blood clots, kidney failure, twisting of the ovary, or breathing problems.
All of her children are from her often-absent husband who finally left her in 2016, the same year that she gave birth to her youngest child.
Speaking through a translator, one of her sons told Joe Hattab that his mother is his "hero".
WHAT IS HYPEROVULATION?
Hyperovulation refers to the production and release of more than one egg during a menstrual cycle.
Hyperovulation can occur naturally or be stimulated via hormone treatments for the purposes of egg donation in third-party reproduction.
Under normal conditions, when more than one egg is released, the chances of conceiving fraternal twins or triplets is increased.
Stimulated hyperovulation involves several drugs and the careful monitoring of hormone levels and ovarian status using an ultrasound.
Once mature, follicles are punctured during the egg retrieval procedure and evaluated for quality before being used for in vitro fertilization.
Source:
Today, Mariem and her brood live in four cramped houses made of cement blocks with corrugated iron roofs in a village surrounded by coffee fields 31 miles north of Kampala.
She told Joe Hattab that a "kind woman" had donated some bunk beds for her children after her husband left her, but it can still get pretty cramped, with 12 in one room sleeping two to a mattress.
Talking about her deadbeat ex-husband, Mariem uses an expletive, before welling up as she adds: "I have grown up in tears, my man has passed me through a lot of suffering.
"All my time has been spent looking after my children and working to earn some money."
Mariem has done everything to provide for her children, turning her hand to hairdressing, scrap metal collecting, brewing homemade gin, and selling herbal medicine.
All the money she makes is immediately swallowed up by food, clothing, medical care, and school fees.
But on a grimy wall in her home in pride of place are hanging portraits of some of her children graduating from school.
Her eldest child Ivan Kibuka, who is in his mid-20s, was forced to drop out of secondary school when his mother could no longer afford it.
"Mum is overwhelmed," he said, "the work is crushing her.
"We help where we can, like in cooking and washing, but she still carries the whole burden for the family. I feel for her."
The most fertile woman in history is alleged to be an 18th-century Russian peasant called Valentina Vassilyev.
Between 1725 and 1765, she is recorded as giving birth to a total of 69 children - 67 of whom survived infancy.
This included 16 pairs of twins, seven sets of triplets, and four sets of quadruplets.
Her husband, Feodor, is alleged to have had six sets of twins and two sets of triplets with his second wife - a further 18 children.
READ MORE SUN STORIES
Read More on The Sun
This would mean he fathered a total of 87 children.
However, unsurprisingly, record-keeping in 18th-century rural Russia was patchy at best, and these figures are disputed by historians.