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Most pregnancies result in 1 baby, sometimes there are twins. Every now and then there are triplets. My guess would be that 4 at once has happened before too. But 5? How about 6? Surely not 7.

How many could a human woman be pregnant with at once? The requirement would be that she can give birth to them all safely, and survive, and the babies have a fair shot of surviving too.

Note: With modern technology. I forgot to include that part the first time.

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This question asks for hard science. All answers to this question should be backed up by equations, empirical evidence, scientific papers, other citations, etc. Answers that do not satisfy this requirement might be removed. See the tag description for more information.

closed as off-topic by John Dallman, Don Qualm, ltmauve, Liam Morris, user535733 May 19 at 23:37

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If this question can be reworded to fit the rules in the help center, please edit the question.

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    $\begingroup$ I'm voting to close this question as off-topic because it's a question about human biology, not worldbuilding. It's also trivially answered with a Wikipedia link. $\endgroup$ – John Dallman May 19 at 21:24
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    $\begingroup$ None. Childbirth and pregnancy are not safe and it's not even entirely safe now - see Maternal Death for more info. $\endgroup$ – StephenG May 19 at 21:25
  • $\begingroup$ I didn't see the hard-science tag...I hope my citations are hard enough. If not, please someone tell me so I have a chance to beef them up before my answer is closed. Though I've seen answers on hard-science tags with nothing but a single Wikipedia cite stay open... $\endgroup$ – Cyn May 19 at 21:44
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    $\begingroup$ "How many babies can a human women safely be pregnant with at once?" - I'm afraid the answer is none. What are your standards of safety for the world you've created? StephenG had it right, unless you specifically define "safety" and how it applies here, the whole affair becomes opinion-based. $\endgroup$ – Don Qualm May 19 at 21:53
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    $\begingroup$ A number of people have been quoting "record beating" births. Please note that these exceptions do not prove that child birth with these numbers is completely safe. It's always a risk (something we should teach a lot more to young males !). $\endgroup$ – StephenG May 19 at 22:52
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With modern medicine, terrific prenatal care, and a woman in good health, twins and triplets usually turn out well.

Quadruplets are rare but more common with modern fertility treatments. Survival is good.

No quintuplets survived until 1934. Modern care is essential.

It took until 1983 to get surviving sextuplets. Only 4 sets have ever existed in the world.

The record for surviving multiples is octuplets. Several sets were all born alive but only one set survived past infancy (and is still alive, at age 10).

For higher numbers:

There have been a few sets of nonuplets (9) in which a few babies were born alive, though none lived longer than a few days. There have been cases of human pregnancies that started out with ten, eleven, twelve or fifteen fetuses, but no instances of live births. The pregnancies of the 10, 11 and 15 fetuses have all resulted from fertility medications and assisted reproductive technology (ART). However, there has been one documented case when 12 fetuses were conceived naturally.

The most common complication for multiple births, including twins, is prematurity. But there are other health risks as well. And of course stillbirth is not uncommon:

Multiples are also known to have a higher mortality rate. It is more common for multiple births to be stillborn, while for singletons the risk is not as high. A literary review on multiple pregnancies shows a study done on one set each of septuplets and octuplets, two sets of sextuplets, 8 sets of quintuplets, 17 sets of quadruplets, and 228 sets of triplets. By doing this study, Hammond found that the mean gestational age (how many weeks when birthed) at birth was 33.4 weeks for triplets and 31 weeks for quadruplets. This shows that stillbirth happens usually 3–5 weeks before the woman reaches full term and also that for sextuplets or higher it almost always ends in death of the fetuses. Though multiples are at a greater risk of being stillborn, there is inconclusive evidence whether the actual mortality rate is higher in multiples than in singletons.

The risks to the pregnant women go up too. High blood pressure, placental abruption, gestational diabetes, and anemia are all elevated with pregnancies of multiples. Placental abruption can be fatal to the woman, even in a hospital setting and high blood pressure increases the risk of eclampsia, which can lead to seizure or stroke and be fatal. Another risk is postpartum hemorrhage, which is treatable but potentially fatal (quite fatal outside of modern medical care if the mother is not transferred to a hospital promptly).

Also, these days, most twins are delivered by cesarean section. Essentially all triplets and higher are. While surgical delivery is becoming all too commonplace, it's not benign. The maternal death rate for c-section is 0.1 per 1000 operations in the UK and a whopping 5.43 per 1000 operations in a study of 22 countries in Africa. The in-hospital mortality of babies after Caesarean delivery [in Africa] was double that of high-income countries.

In the United States, surgical birth increases the risks of mortality (which are still fairly low) and complications, including long-term ones like hysterectomy and more (way too common) as compared to vaginal birth, even after accounting for serious risks factors requiring c-sections (a small percentage of the total for surgical birth).

If your setting is a time and place without modern medical care, as well as prenatal care to determine things like number of fetuses, position, placental status, etc, then survival rates are going to go way down.

Twins are usually not a problem and, until very recently, delivering twins was part of every OB's training (now they don't even get that training! at least not in the US).

You'd have a fair shot at triplets.

Quadruplets are really pushing it but it's possible. I wouldn't assume things would be okay but, if you want to create a story with quads, you could be on solid ground for that exception.

Quints and higher without modern medical care? Forget it.

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You are looking at Very High Order Multiple Births. The answer to this is, of course, tremendously dependent on technological levels. We can only answer this question historically.

The most famous of these births were those by Nadya Suleman, known as "the Octomom" for giving birth to octuplets and having them all survive. There are two known octuplet births on record. The first was to the Chukwu family, but one of them died. All of the Suleman octuplets survived, so her family would be the one example of 8 births meeting your criteria.

There are no known records of nonuplets (9) surviving long term. There were a few births of 9, but none survived more than a few days. There are also examples of attempted births of 10 to 15 fetuses (due to IVF, of course), but none have resulted in a live birth.

So the best hard science evidence we have today is that 8 is the threshold, but who knows what medical advancements may permit 9 in the future!

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  • $\begingroup$ I’d be intrigued to see the distribution of numbers of births. My intuition is that it’d be a heavily skewed geometric distribution, but I can’t think of any verifiable reason that would be so... $\endgroup$ – Joe Bloggs May 19 at 21:54
  • $\begingroup$ @JoeBloggs I'd expect it to start with a geometric distribution (fixed probability of getting a cell-division wrong at any point and making twins), but then be heavily tempered by miscarriages. It's also really mucked up by IVF, which is the most common cause of higher order pregnancies) $\endgroup$ – Cort Ammon May 19 at 21:56
  • $\begingroup$ Damn you medicine, messing with the natural order of numerical distributions! ;-) $\endgroup$ – Joe Bloggs May 19 at 21:58
  • $\begingroup$ As per the question - did the mother survive? $\endgroup$ – Don Qualm May 19 at 22:00
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    $\begingroup$ @Hoyle'sghost Yes. The mother and all 8 children survived. She is now the mother of 14, through that pregnancy and five other pregnancies. She made a living for a while as a reality TV star, but now tries to live a more inconspicuous life. $\endgroup$ – Cort Ammon May 19 at 22:01
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We can prove 8

And just to cover all the bases...

The greatest officially recorded number of children born to one mother is 69, to the wife of Feodor Vassilyev (b. 1707–c.1782), a peasant from Shuya, Russia. In 27 confinements she gave birth to 16 pairs of twins, seven sets of triplets and four sets of quadruplets.

Numerous contemporaneous sources exist, which suggest that this seemingly improbable and statistically unlikely story is true and she is the woman with most children.

The case was reported to Moscow by the Monastery of Nikolsk on 27 Feb 1782, which had recorded every birth. It is noted that, by this time, only two of the children who were born in the period c. 1725–65 failed to survive their infancy.

However...

Your question is nearly meaningless without a technology reference. Even 100 years ago, Octomom's chances of survival (and that of her children) would have been close to zilch. An hundred years from now, technology may be capable of preserving mother and dozens of fetuses that grow to happy, thriving children. Without the technology (let's say the 1500s) quadruplets may be the most you could get with predictable safety.

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  • $\begingroup$ This shows that 8 is possible, not that it was in any way safe for the woman. It's also possible to survive Russian roulette, but I wouldn't call it exactly safe :-) $\endgroup$ – jamesqf May 20 at 5:08
  • $\begingroup$ @jamesqf happy picture of a happy mother on that website, and the fact that they were all delivered safely appears to be ample proof that it's safe. If you want to argue the matter, I want the OP to exactly define what "safe" means. There's no such thing as a delivery that doesn't carry some risk to both mother and child. $\endgroup$ – JBH May 20 at 6:25
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    $\begingroup$ No, one instance of success does not prove safety, any more than the fact that most women deliver a single infant without problems proves that childbirth is safe. Per Wikipedia, the US maternal death rate was 18 per 100,000 as of 2014: en.wikipedia.org/wiki/… $\endgroup$ – jamesqf May 20 at 17:37
  • $\begingroup$ @jamesqf So we can claim the question to be unanswerable because there's no such thing as "safe," or we can identify a successful maximum provided an obvious contingency for risk must be assumed. Sure would be nice if the OP jumped in and explained himself. Alas, methinks the time for that has passed. $\endgroup$ – JBH May 20 at 18:56
  • $\begingroup$ Or we can say that there is always some risk in pregnancy, but we just don't have a large enough sample size of multiple pregnancies >3 to accurately determine risk statistics. $\endgroup$ – jamesqf May 21 at 20:06

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