THIS is the dramatic picture of Nadya Suleman just eight days before she gave birth to octuplets last month.
Given her size, it is a surprise that doctors did not know how many babies the 33-year-old was about to have until they were born.
The photograph was published as more concerns about the cost of looking after the babies – along with Ms Suleman's six other children – emerged.
Even before the single, unemployed mother gave birth to the octuplets, she had been caring for her six other children with the help of $490 (£345) a month in food stamps, plus Social Security disability payments for three of the youngsters. That amount is set to rise with her growing brood – all born using fertility treatment.
On top of this bill, the hospital where the octuplets are expected to spend seven to 12 weeks has requested undisclosed reimbursement from Medi-Cal – California's Medicaid programme, for care of the premature babies, according to reports.
News of the growing costs has increased criticism over Ms Suleman's decision to have so many children. "It appears that, in the case of the Suleman family, raising 14 children takes not simply a village but the combined resources of the county, state and federal governments," wrote Tim Rutten, a Los Angeles Times columnist.
On the internet, bloggers heaped insults on the mother-of-14, calling her an "idiot" and criticising her decision to have more children when she could not afford the ones she already had.
Ms Suleman's spokesman, Mike Furtney, asked for understanding.
He said: "I would just ask people to consider her situation and she has been under a tremendous amount of pressure that no-one could be prepared for"
Mr Furtney added that he, Ms Suleman and her family had received death threats and had received messages that were "disgusting things that would never be proper to put in any story".
Ms Suleman said she did not consider the public assistance she received to be welfare and did not intend to remain on it for long.
A Nadya Suleman family website has also been set up to help collect donations for the children.
It features pictures of the mother and each octuplet and has instructions for making donations by cheque or credit card.
Ms Suleman, whose six older children range in age from two to seven, said three of them received disability payments.
She said one was autistic, another had attention deficit hyperactivity disorder, known as ADHD, and a third experienced a mild speech delay with "tiny characteristics of autism". She refused to say how much they received in payments.
In California, a low-income family can receive Social Security payments of up to $793 a month for each disabled child.
The Suleman octuplets' medical costs have not been disclosed, but in 2006, the average cost for a premature baby's hospital stay in California was $164,273.
Arnold Schwarzenegger, the Californian governor who is struggling to close a $42 billion budget gap by cutting services, declined to comment on the octuplets.
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