In a time before ultrasounds or car seat laws, Vivian Volk delivered four sets of twins and one single birth — all while living in the simplistic era of the 1960’s. Volk, who recently turned 90, says each set of twins was a complete surprise to her and her late husband, Joe.

Tasked with caring for nine small children, Volk says her to-do list was long, and she went to bed every night exhausted. Still, the New Jersey mother, grandmother and great-grandmother says she was blessed, and holds that she wouldn’t change a thing about her days washing cloth diapers or packing nine school lunches.

Here, Volk shares her thoughts on modern parenting, family values and stay-at-home motherhood with TODAY.com

A photo of the nine Volk children, taken in 1963 when the youngest set of twins, Jim and Sandra, were three. Courtesy Lauren Volk

On how times have changed since she was a new mom:

There was no such thing as a sonogram — so I was unaware that I was even having twins. Each time was a wonderful surprise. I’ve heard now that when a mother is expecting twins, complete bed rest is recommended for the last trimester, but bed rest was never an option for me.

I actually went through a move from Pennsylvania — where the first three children were born — to New York when I was seven months pregnant with the second set of twins. All of my twins went full term and were born healthy.

All of my babies were diapered using cloth. These diapers were washed and sterilized and hung on the line, when the weather allowed. And, none of my children ever had a diaper rash.

Baby bottles were glass then. There were some plastic bottles available, but I didn’t think plastic was good for my young babies, so I stayed away from them. I believed glass bottles were the best.

We didn’t use baby monitors, as there was no such thing back then. I believed that a nursery or bedroom was for sleeping, and my advice to young mothers today is to keep the nursery quiet and simple, without all the bells and whistles that are found in nurseries today. Babies sleep best in a quiet, simple, sweet environment.

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There were no car seats when I had babies. Although car seats are a necessity nowadays — I cannot imagine the type of vehicle we would have needed for nine children, all of which would have fallen within the car seat laws of today.

Vivian Volk with her nine children. Volk's first son, Tyler, was a single birth, followed by four sets of twins: Lauren and Tom, Ken and Kristen, Nancy and Janice, and Jim and Sandra. Courtesy Lauren Volk

Thankfully, my children grew up in a time when they could ride their bikes everywhere and could safely play outside until dark. We also lived in walking distance to the library, the parks, and schools.

The biggest change has been technology. Phone use was limited when I had small children, as we used a party line. Conversations took place at the dinner table with the kids, or by sharing coffee with neighbors. TV was limited to Sunday nights — Lassie or Walt Disney — and they were not in front of a computer all day.

Instead, the kids all played musical instruments, were involved with Girl Scouts and Boy Scouts and intramural sports. And they played — arts and crafts, building models, board games, building forts, baseball games with the neighbors, hide-and-go-seek, or just being kids.

On what today’s parents can learn from her:

Fortunately, I was a registered nurse, so I had a great deal of knowledge about health and the medical needs of my children. I did not believe in rushing to the doctor at every sign of an illness.

Sometimes, a fever just needs to run its course. And, immunizations are important. Also, I believe that limiting the use of antibiotics enabled my children to develop their own resistance to illnesses.

Raising children is never easy — but I would think getting too much advice from the Internet must be confusing to young moms nowadays.

Vivian Volk with her five daughters. (From left: Nancy, Lauren, Sandy, Kristen and Janice.) Courtesy Lauren Volk

My husband and I had similar values — we talked a lot about what was best for our children and the decisions we made, we made together. It was never about what we read, what the new research showed, or what other parents were doing. It was about our own children and what we thought was best.

Vacations were important to us. Camping was always a fun adventure — and their father would take them in groups: the five older kids would go on one trip, and then the four younger kids on another trip. For many summers, we vacationed in Atlantic City, which was a great time for the kids — but not so much for me. I was always counting heads, and I still sometimes joke that this was not so make sure I had my nine, but to make sure I didn’t go home with ten.

On how she survived parenting nine kids:

With four sets of twins, and nine kids in total, I ask myself that all the time. I was able to be a stay-at-home mother until all my children were in school. Once they all started school, I was able to continue my nursing career, but to me — it was important to be home with my children for that time.

My days were very structured in order to get everything done. In terms of a week, my chores were staggering. I fixed 189 meals, did 35 loads of laundry, sterilized 84 baby bottles — not to mention the number of dishes I washed, diapers I changed or cuts and scratches I treated.

To me, the most important meal of the day was breakfast, so I made a hot breakfast for my kids every morning. If it wasn’t eggs or pancakes — it was warm cereal. Then, I’d pack nine school lunches for the kids — which was quite the assembly line. Dinner was always as a family at the dinner table and this was where all the fun took place.

Vivian Volk recently celebrated her 90th birthday surrounded by many of her children, grandchildren, and great-grandchildren. Courtesy Lauren Volk

Although I went to bed each night exhausted, I counted my blessings — all nine of them. It was a wonderful gift I was given — raising nine beautiful, successful children.

So, how did I do it? Really, I was the lucky one. I felt badly for my husband, who had to work two jobs and wasn’t able to spend the time with the kids that I was. He was an amazing father and husband and I miss him dearly.

If I had to do it over again — I wouldn’t change a thing. I am so blessed.

This story was told with the help of TODAY.com's Terri Peters