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A Ugandan woman whom locals have dubbed “the world’s most fertile woman” has been banned from having more babies, Australia’s 7 News reported.

Mariam Nabatanzi, 39, has given birth to 44 kids — including four sets of twins, five sets of triplets and five quadruplets. She was sold into marriage at the age of 12 and had her first set of twins at the age of 13. The family lives in deep poverty. She lives in four cramped houses with her children, in a village surrounded by coffee fields.

Doctors have now banned Nabatanzi from having any more babies. The single mother, who earlier this year was the subject of an Al Jazeera mini-documentary, works a handful of jobs to take care of her 38 living children.

Nabatanzi works as a tailor, hairdresser and herbalist to support her family, and has said that, above all, she wants her children to receive an education.

“Generally, I have tried to educate them. My dream is that my children go to school. They can lack anything (else), but they must go to school,” Nabatazni said in the Al Jazeera documentary.

Dr. Chales Kiggundu, a gynecologist from Uganda interviewed in the documentary, said Nabatanzi’s incredible number of pregnancies were the result of hyperovulation, which is when the body releases more than one egg during the menstrual cycle. The phenomenon increases a woman’s chances of having twins, triplets or quadruplets.

“You find that some of the women have the potential of having between 10 to 12 eggs that come at the beginning of the month,” Kiggundu said. “Some of the have the potential to have more than one fertilization take place.”

The woman’s fertility is likely to be hereditary, the gynaecologist said.

“Her case is genetic predisposition to hyper-ovulate — releasing multiple eggs in one cycle — which significantly increases the chance of having multiple births,” he said, quoted by The Sun.

“It is always genetic.”

Nabatanzi has made attempts to stop having children in the past, including using an IUD after her 18th baby was born, a 2018 BET article reported. However, the device made her so sick that she went into a coma.

According to the BET article, doctors have told Nabatanzi that, given her condition, certain contraception measures could be incredibly dangerous to her health. The mother-of-44 said a doctor told her he had “cut my uterus from inside”.

Despite these challenges, Nabatanzi said she’s grateful for every single one of her kids.

“Feeling sorry for myself is something I dropped because I know these children are a gift from God that I have to treasure, so I try my best to fend for them,” she told BET.

Nabatanzi has lost six children, Nzherald reported. Her last child died during childbirth and was part of her sixth set of twins, three years ago.

Shortly after, she was abandoned by her husband.

“I have grown up in tears, my man has passed me through a lot of suffering,” she said in an interview.

“All my time has been spent looking after my children and working to earn some money.”

She does whatever job she can do to earn money for her children, including hairdressing, event decorating, selling scrap metal, brewing local gin and selling herbal medicine.

Her eldest child, Ivan Kibuka, is now 23 and dropped out of high school because his mum could not afford it.

“Mom is overwhelmed, 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,” he said.

Twelve of the children sleep on metal bunk beds in just one room. The other children sleep on shared mattresses and some on the dirt floor.

Everyone helps around at home and a roster nailed to the wall divides the duties.

According to the woman, the family can go through 25kg of maize flour in one day.

The mom says she just wants her children to grow up and live happy lives.

“I started taking on adult responsibilities at an early stage,” the mum said. “I have not had joy, I think, since I was born.”