“After giving birth, your placenta is supposed to come out. But mine was stuck,” she explained to Elle. “That’s what women usually die from in childbirth — you hemorrhage and bleed to death and they can’t stop it. To get it out — it’s so disgusting — the doctor had to stick his whole arm in me and scrape it off. It was the most painful.”

Kim Kardashian West appears on the cover of the April issue of Elle.Boo George

Wanting to expand their family, and with another pregnancy out of the question, Kardashian West and husband Kanye West searched for a surrogate.

“I refer to her as a surrogate, but it’s completely my and Kanye’s DNA, so technically that’s called a gestational carrier. A surrogate is when they use the husband’s sperm and the surrogate’s egg,” she explained.

“It was a feeling,” she said of finding a woman to carry their baby. “You know when you can trust someone.” The next decision for the couple was whether to have a boy or girl.

“It’s a really tricky thing,” she said. “What 𝑠e𝑥 do you put in? I just said, ‘Which one is the healthiest? Pick the healthiest one,’ and that was a girl.”

Kim Kardashian posted this photo of herself with her children Saint and North West to her Instagram

She announced the birth of their daughter, Chicago, on her official website in January.

“Kanye and I are happy to announce the arrival of our healthy, beautiful baby girl. We are incredibly grateful to our surrogate who made our dreams come true with the greatest gift one could give and to our wonderful doctors and nurses for their special care,” she wrote at the time. “North and Saint are especially thrilled to welcome their baby sister.”

Asked if she would go through the process again, Kardashian West replied, “I dunno,” adding four children would be be the maximum amount of kids she could handle.

“I don’t think I could handle more than that. My time is spread really thin,” she said. “And I think it’s important that in all couples, the mom gives the husband as much attention as the kids.”

As for her relationship with her hip hop producer husband, who has not been in the public eye much since his breakdown and subsequent hospitalization in November 2016, she said that she’s learned a lot from him.

“He’s taught me to have more of an opinion,” she said. “I’ve taught him to be a bit more calm or cautious. We’re a good balance.”