This is the scary condition that led Kim Kardashian to hire a surrogate

This article originally appeared in Coveteur.

When news broke that Kim Kardashian and Kanye West had hired a surrogate for their third child, we, of course, had a ton of questions. The first and foremost being about Kim’s condition, which inspired the couple to begin the process in the first place. What exactly is placenta accreta, anyway?

“My doctor had to stick his entire arm in me and detach the placenta with his hand, scraping it away from my uterus with his fingernails,” Kim once wrote about the condition, detailing what she went through after a “fairly easy” delivery with North. “How disgusting and painful!!!”

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According to the American Pregnancy Association, while women typically shed their placenta after giving birth, placenta accreta occurs when “placenta attaches itself too deeply into the wall of the uterus.” And while one in 2,500 pregnancies result in placenta accreta, there are also different levels of severity: increta (when the placenta penetrates the uterine muscle) and percreta (where placenta penetrates through the uterine wall and attaches to another organ).

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Doctors warned Kim—who also went through an unsuccessful operation to repair her uterus—that there would be health risks if she decided to have another baby. In some cases, placenta accreta can lead to hemorrhaging, which can then lead to death.

“I’ve come to the conclusion in my mind that I can’t carry another one,” Kim told her mother, Kris Jenner, on Keeping Up With the Kardashians. “So now I want to explore surrogacy.”

But according to Jane Groenendaal, Surrogacy Director for New Beginnings Surrogacy Service, it might not all be smooth sailing. “It isn’t uncommon for a surrogate to want to work with a couple that doesn’t already have kids…There is nothing public about Kim’s ability to carry a child on her own at this point. She may be being prudent because of previous complications during birth, but we don’t really know. This may be an issue for her surrogate. She’s also high profile, so a surrogate carrying her child might also become high profile, and if she has her own family to take care of, the media attention could be an issue.” If nothing else, this is a nice reminder that not everyone is out for attention.

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TMZ is reporting that Kim and Kanye have agreed to pay $45,000 in 10 monthly installments to the agency facilitating the surrogacy, and have already put down a $68,850 deposit—a small price once you a) consider their income and b) consider all the risks. Should all go as planned (fingers crossed—we’re wishing them tons of luck!), these two will be in good company: celebrities like Nicole Kidman, Tyra Banks, and Sarah Jessica Parker have all had children via surrogacy.