A 25-year-old Malian woman has given birth to nine babies – two more than doctors had detected during scans.

Halima Cisse gave birth to the nonuplets in Morocco. Mali’s government flew her there for specialist care.

“I’m very happy,” her husband told the BBC. “My wife and the babies [five girls and four boys] are doing well.”

A woman who had eight babies in the US in 2009 holds the Guinness World Record for the most children delivered at a single birth to survive.

Two sets of nonuplets have previously been recorded – one born to a woman in Australia in 1971 and another to a woman in Malaysia in 1999 – but none of the babies survived more than a few days.

World record holder Nadya Suleman’s octuplets have grown up and are now 12 years old. She conceived them through in vitro fertilization.
Fanta Siby, Mali’s health minister, congratulated the medical teams in Mali and Morocco for the “happy outcome”.

Prof Youssef Alaoui, medical director of the Ain Borja clinic in Casablanca where Ms Cisse gave birth, told the AFP news agency that the case was “extremely rare, it’s exceptional” – and a team of 10 doctors and 25 paramedics had assisted at the delivery of the premature babies.

They weighed between 500g and 1kg (1.1lb and 2.2lb) and would be kept in incubators “for two to three months”, he said.
Ms Cisse’s pregnancy became a subject of fascination in Mali – even when it was thought she was only carrying septuplets, Reuters news agency reports.

Doctors in the West African nation had been concerned for her welfare and the chances of the babies’ survival – so the government intervened.

After a two-week stay in a hospital in Mali’s capital, Bamako, the decision was made to move Ms Cisse to Morocco on 30 March, Dr Siby said.

After five weeks at the Moroccan clinic, she gave birth by Caesarean section on Tuesday, the minister said.

According to Prof Alaoui, Ms Cisse was 25 weeks pregnant when admitted and his team had managed to extend her term to 30 weeks.
Her husband, Adjudant Kader Arby, is still in Mali with the couple’s older daughter, but he says he has been in constant touch with his wife in Morocco and is not worried about the family’s future.

“God gave us these children. He is the one to decide what will happen to them. I’m not worried about that. When the almighty does something, he knows why,” he told BBC Afrique.

He says the family have been overwhelmed by the support they have received.

“Everybody called me! Everybody called! The Malian authorities called expressing their joy. I thank them… Even the president called me.”

What causes a multiple pregnancy?
It is very unusual for such pregnancies to occur naturally – often it is the result of fertility treatment – though we do not know if this happened in Ms Cisse’s case.

But gynaecologist Bill Kalumi, from Kenya’s Kenyatta National Hospital, says they really only occur when this has been the case.

There are a range of reasons why fertility treatment is sought.

But most commonly in Africa fertility drugs are prescribed when a woman comes off a hormonal form of contraceptive as she can find that it takes a while to ovulate again, Dr Kalumi says.

This can then result in the release of several eggs, instead of one, during a woman’s monthly cycle.

Multiple births are risky for both mother and babies – and a woman who is found to be carrying more than four foetuses tends to be advised to reduce that number in countries where abortion is legal.

Most pregnancies involving large numbers of babies end prematurely, as in Ms Cisse’s case.

And premature babies – those born before 37 weeks – are at risk of developing problems as they have immature lungs and are prone to infections such as sepsis because of their weak immune system.

Longer term, children born in multiples are also more likely to develop cerebral palsy – which affects movement.