But that wasn’t the end of her struggles. After delivering healthy baby North, Kardashian West discovered she also suffered from placenta accreta, in which the placenta grows into the muscle of the uterus rather than detaching readily. In short, placenta accreta is no joke. “It’s very, very dangerous,” says Dr. Jacques Moritz, who specializes in obstetrics and gynecology at Weill Cornell Medicine in New York. Should the doctor not recognize what’s happening quickly enough, the uncontrolled bleeding, in the worst-case scenarios, can lead to hysterectomies or even death. (Kardashian West’s 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. How disgusting and painful!!!” she wrote on her blog.)
A scarred uterus can sometimes cause placenta accreta; for other women, there is no known cause. “The recommendation after one placenta accreta occurrence is usually no more pregnancies,” says Moritz. Happily, Kim did not have a hysterectomy, and after a few surgeries to remove pieces of the remaining placenta and scar tissue, she was able to conceive again. But placenta accreta followed once more with Saint and doctors advised that a third pregnancy was considered too risky. This season on KUWTK, viewers watched the reality star grapple with the decision to hire a surrogate, meet with a mother who had used a surrogate, and ultimately decided it was right for her. “I’ve come to the conclusion in my mind that I can’t carry another one. So now I want to explore surrogacy,” Kardashian West said on the show.
Surrogacy -- in which a test-tube fertilized egg is implanted in another uterus -- was first successfully achieved in the ‘80s and is “mostly a legal issue now,” according to Moritz. “The science is relatively straightforward and low risk, especially if both the mother donating the eggs and woman carrying the child are young and healthy. There should be no problems there at all,” he says. He also notes that California, where the West family lives, is particularly friendly to the laws surrounding surrogacy. New York, for instance, does not allow surrogacy. Moritz explains it used to be that many surrogates wanted to be very close to the child, but that has since become less common. “Nowadays, it’s a pretty simple business transaction,” he says. TMZ has a full list of the stipulations of the family’s surrogacy agreement, including a $45,000 pay-out.