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The birth of nine babies at the same time was such an unusual event that most people who heard the news believed it was a hoax. The world’s first nonuplets were born on the 4th of May 2021, to a Malian couple and achieved the Guinness World Records title for the most children delivered at a single birth to survive.

The nonuplets include five baby girls named Adama, Oumou, Hawa, Kadidia and Fatouma, as well as four boys named Oumar, Elhadji, Bah and Mohammed VI. They were born prematurely through caesarean section.

The pregnancy was high-risk for their mother Halima Cissé and the babies were delivered after just 30 weeks. Some of them spent more than three months in an incubator and there were concerns that they would not all survive. However, in 2022 the nonuplets marked their first birthday in Casablanca, Morocco, where they were born.

According to their father Abdelkader Arby, “They are currently crawling and some are taking their first steps! This is the most difficult time when they need a lot of attention. When they start to move and want to go here and there and you always have to be there as exhausting and draining as it may be.”

Their father further shared that they all have different personalities “Some are quiet, while others make more noise and cry a lot. Some want to be picked up and carried all the time. They all have very different personalities, and it is perfectly okay.”

Ahead of the birth, Cissé was flown to Morocco by the Malian government for specialist care and for the authorities to continue to support the family. She and her offspring were taken care of in a medicalized flat, belonging to the owners of the private clinic where the babies were born, Ain Borja Clinic.

According to Dr Khalid Mseif, who had been monitoring the family since the birth, “The parents have been helped from the outset, nurses came and helped a lot because it is not easy to take care of nine babies at the same time, it is very hard work, a lot of work.”

Multiple births are risky and mothers with more than four foetuses at a time are advised to terminate in some counties where abortion is legal. There is also the risk that babies can develop health problems due to their premature birth such as sepsis and cerebral palsy. Multiple births account for three percent of all births worldwide. Globally, recent decades have seen a major increase in multiple birth rates.

Nearly half of the world’s twins are born in Africa. Spontaneous multiple birth is high in Africa. Studies conducted as early as the 1960s witnessed the high incident rate of multiple births in Western Africa, especially in Nigeria. A study concluded that in 1999, out of 2.8 million twins born worldwide, nearly 1.1 million (41%) were born in Africa as compared to 39% in Asia, 13% in America and six percent in Europe (Pison, 2000).

Another study found very high twinning rates (above 18/1,000 births) in many Central, Western and South-Eastern African countries (Smits & Monden, 2011)

Africa and Asia make up about 80% of all the twin deliveries in the world at present. According to Professor Christiaan Monden, an author from the University of Oxford, “The twinning rate in Africa is so high because of the high number of dizygotic twins, which are twins born from two separate eggs. This is most likely due to genetic differences between the African population and other populations. “

After receiving care for over a year in Morocco, the Guinness World Record-breaking nonuplets are finally home in Mali, where they are eagerly awaited by relatives and the local people.