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Since she first stepped into the limelight on her hit reality series, Keeping Up with the Kardashians, Kim Kardashian has always stated that she wanted a big family. After a couple of failed relationships, the KKW Beauty mogul found happiness with her rapper hubby, Kanye West, and the duo went on to have four gorgeous children together.

Unfortunately, Kardashian’s pregnancies with her older children, North and Saint were extremely difficult and high risk. As a result, she as unable to carry her youngest children, Chicago and Psalm. Instead, the Skims founder and West chose surrogacy as a way to have more children.

Kardashian has been open about her challenging pregnancies and her surrogacy experiences. Now, she’s even revealed that she also had a surrogate therapist to help guide her through the process.

This is why Kim Kardashian’s pregnancies were so difficult

Though many women often talk about loving pregnancy — Kardashian got candid about how uncomfortable she felt when she was pregnant with North and Saint. Some major health concerns contributed to the beauty mogul’s high-risk pregnancies.

Kardashian had both placenta accreta –when the placenta attaches too deeply to the uterine wall, and pre-eclampsia which made her extremely swollen and uncomfortable. On her now-defunct app — Kardashian wrote,

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. How disgusting and painful!!! My mom was crying; she had never seen anything like this before. My delivery was fairly easy, but then going through that—it was the most painful experience of my life! They gave me a second epidural but we were racing against time, so I just had to deal. They say that this is what some women died from as a result of childbirth back in the day, without proper care. I’m so thankful that my doctor was able to catch this and address the issue immediately.

Kim Kardashian really enjoyed the surrogacy process

Though she was very nervous about surrogacy — even keeping her identity a secret from her chosen surrogate at first– Kardashian has said that she is so grateful that she chose that route. After all, carrying another child would have been life-threatening for her.

 “I really, really enjoyed the surrogacy process,” she explained to People. “I will say, when it came to the breastfeeding time, I was like, ‘Okay, this is the best decision I ever made.’ It’s a game changer, having to not go through [nursing] every few hours. I can spend so much more time with the older kids and getting them used to the baby.”

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This is why Kim Kardashian had a surrogate therapist

When she decided to have her daughter, Chicago through a surrogate — Kardashian didn’t actually know what to expect. “You get your surrogate attorney, you get your surrogate broker and then the broker recommended that we use a therapist that would communicate with me first and then communicate with her and kind of be our liaison,” she told attorney Laura Wasser, for her new podcast, All’s Fair.

Thankfully, the KKW Beauty founder bonded so much with her surrogate that she didn’t really need the surrogate therapist in the end.

“Towards the end we got close enough where we could communicate really without that,” she recalled. “[The therapist] would suggest, ‘Hey, I think you guys should communicate once a week through text, maybe on Mother’s Day. She’s a mother as well. Maybe get her a massage or something that’s appropriate for her to pamper. Things like going through the birthing plan, so if anything was uncomfortable she would be that buffer to say, ‘This is who I want in the room. What are you comfortable with? How does this work?”