Hailey Bieber has really opened up — and luckily, so did her uterus.
On an episode of the podcast “She MD” this week, the beauty entrepreneur sat down with co-hosts Mary Alice Haney and Dr. Thaïs Aliabadi, who also happens to be Bieber’s OBGYN, to go deep on her medical history — including her recent pregnancy.
The pregnancy had been a surprise for the celebrity, who had just been warned by Aliabadi about a rare complication in her uterus that might require a “small surgery” to sort out.
“I told her, ‘Don’t get pregnant,’” Aliabadi said on the podcast, remembering those early conversations with Bieber before her pregnancy.
It turned out that Bieber, now 29, had a septum in her uterus, also known as a septate uterus, which could potentially cause problems for her and the baby if she were to get pregnant.
“I was like, ‘OK. Well, I’m not thinking about getting pregnant right now, so we’ll just cross that bridge when we get there.’ And then I magically got pregnant,” Bieber said. “It was a surprise.”
The Rhode founder, who gave birth to her first child, Jack Blues, in August 2024, was cool-headed as she recalled her experience now, saying that ultimately “it all worked out and clearly my septum did what it needed to do.”
But the pregnancy — and the birth — weren’t exactly peachy.
What is a septate uterus?
Aliabadi explained that a septate uterus is a genetic condition in which a thin wall divides the uterine cavity into two parts. A typical uterus, according to the Cleveland Clinic, is “one hollow or open space.”
If the septum is less than one centimeter, it’s classified as mild. Anything between one to two centimeters is moderate. And anything above that would be considered severe.
The Cleveland Clinic estimates that around 1.5% of women have a septate uterus, though Aliabadi said it could be closer to 3%, especially because it’s sometimes missed in conventional ultrasounds.
How is a septate uterus diagnosed?
In fact, Aliabadi said this condition is missed by doctors “all the time.”
In a regular ultrasound, if you don’t know what to look for, you’re going to miss it, she explained. That’s why she does a 3D image of every single cavity, “so I can see that wall dipping.”
“If you have recurrent unexplained infertility, besides PCOS and endometriosis, you want to make sure your doctor has a 3D image of your uterine cavity, because it’s so important that they don’t miss it,” she added.
What are the risks associated with a septate uterus?
Aliabadi’s scans showed that Bieber’s septum fell in the moderate range, which comes with a higher risk of miscarriage and preterm delivery. Of all women who miscarry, Aliabadi said 15% have a septum in their uterus.
She estimated at the time that Bieber’s miscarriage risk was about 25-40%.
Meanwhile, her risk of preterm delivery, classified as a birth any time before 37 weeks, was 10-20%. That number, Bieber said, “was our bigger scare.”
In general, a moderate septum isn’t an automatic reason to terminate a pregnancy, Aliabadi said, but if there had been a previous miscarriage, it might be reason to operate.
To get a better sense of Bieber’s preterm delivery risk, Aliabadi ran a blood test called PreTRM, which gives doctors an estimate of how likely a patient is to go into preterm labor. (The tests can run patients around $750.) This allowed her to check on the status of the placenta and assess how well nutrients were being delivered to the fetus, as well as check for inflammation.
Another potential challenge of a septate uterus is that the septum can interfere with an intrauterine device (IUD), because the arms of the IUD can’t expand in the uterus. That’s why sometimes IUDs are misplaced by doctors, or they get pushed out, Aliabadi explained.
Did Hailey Bieber have any other pregnancy complications?
At the beginning of the episode, Bieber also briefly discussed how, at 25, she suffered a TIA, or a mini stroke. This was the result of a small hole in her heart, which doctors were able to close after she was admitted with stroke symptoms.
Her doctors at that point told her it was good they discovered the hole, also known as patent foramen ovale or a PFO, and closed it before she got pregnant, which would have increased her risk for a more severe stroke.
“It was the most near-death experience feeling that I ever had because obviously it’s very serious,” Bieber said. “But I was grateful that it led to finding what was wrong. […] I’m glad I found it when I did and I took care of it because now I have a lot more peace of mind for the rest of my life.”
By the time she actually did get pregnant a couple years later, her pregnancy was “so good,” she said. (Well, at least after 13 weeks of “crazy” nausea.)
“I was super personally militant with my pregnancy,” she said. “I was like, I’m gonna exercise the whole time. I want to put my body in the best possible shape for delivery.” She described her approach as being like she was “about to run a marathon.”
She said she was working out until the day before she went in for her delivery, doing Pilates, weight training and strength training, plus some prenatal yoga and a lot of stretching.
How did the septate uterus affect Hailey’s birth?
At just around 40 weeks, Bieber had an induced labor that lasted 18 hours, which Aliabadi praised as being exceptionally fast. After 44 minutes of pushing, Bieber’s son was born.
But the drama didn’t stop there. Bieber explained that she “couldn’t stop bleeding” after the birth. And when she wasn’t responding to clotting medication, Aliabadi herself went up into her uterus to make sure all the placenta had been expelled and there wasn’t anything causing an obstruction.
The three of them got into the gory details throughout the episode, discussing how common hemorrhages can be for women immediately postpartum, which can climb to 10% for women who underwent C-sections.
Luckily for Bieber, her doctors were eventually able to get the bleeding under control and dispatch her, along with her healthy newborn son.
Reflecting on the first conversations they had about her septate uterus, Aliabadi said, “I never forget, as I was telling her, ‘Well, these are the risks,’ she looked at me. She’s like, ‘You know what? I believe that everything’s gonna work out fine.’ And I looked at her, and I’m like, ‘I think so too.”
