Mother of 44

1882 Nov 4, Quad-City Times, P4, Davenport, Iowa

Mrs. Mary Austin, who lately died at Washington, had forty-four male children, eleven of whom survive.  She was a doctor of medicine and surgeon, and served through the war with the rank of major.  Mrs. Austin had triplets six times.
 

I found this news clip when searching for my 3d great grandmother.  What I want to know is when did she have time to be a doctor and surgeon?  And triplets six times only accounts for 18 children.  I'm left to assume she was simply an over-achiever!