Note: This article contains graphic language that may offend some readers.

Bringing a life into this world is no small feat. There is an infinite number of things that can go wrong during a pregnancy — that is, if a woman is able to even conceive in the first place.

According to the Centers for Disease Control and Prevention, around 7.5 million American women ages 15-44 have difficulty getting pregnant or staying pregnant.

Flickr CC/Trevor Davies

Thanks to modern medicine, however, having difficulty with getting or staying pregnant doesn’t necessarily mean one can’t have a biological child. A woman can be artificially inseminated with either her partner’s or donor’s sperm, undergo in vitro fertilization (IVF), or even use another woman to carry her biological child through surrogacy.

For example, Kim Kardashian West and Kanye West have two children together. Unfortunately, doctors have ruled out a third pregnancy for Kim because it’s too risky.

According to Kim’s website, she suffered both pre-eclampsia, a serious condition involving high blood pressure and severe swelling, as well as placenta accreta — another serious condition where the placenta does not naturally dispel from the body. She detailed the horrifying experience:

“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.”

Kim is just one of many women in Hollywood who aren’t medically able to carry a child. And on Wednesday, reports broke that she would be joining the ranks of Sarah Jessica Parker, Nicole Kidman, and Tyra Banks and hiring a surrogate to carry her third child.

To be a surrogate, to offer one’s body to grow another family’s child, is, at the very least, an unmeasurable commitment. So what’s the price tag?

According to TMZ, the surrogacy agency Kim and Kanye are using lists its services at $45,000—to be paid over 10 $4,500 installments. However, there’s more to factor in than just money — there’s privacy, rights, and a slew of other elements … and they aren’t glamorous.

Jane Groenendaal, surrogacy director for New Beginnings Surrogacy Services, told Page Six that even things as simple as communication are completely different when it comes to VIP clients. The key ingredient is privacy.

Groenendaal said that some celebrities, especially in the early stages of the “match,” won’t give the surrogate more than a first name and an emergency contact number.

Groenendaal told Page Six that both the surrogate and the intended parents have attorneys who have access to all contact information in the case of an emergency, but sometimes, that’s all the information the surrogate will get:

“All the communication is done through the agency with the surrogate. Is it rare, an anonymous contract? Yes.”

She continued, saying:

“When we talk VIP, for most of them they’re worried that their private information is going to get out, so they keep their information limited in the early stages of the process because they’ve been through so much heartache trying to get pregnant on their own.”

Groenendaal also added that some celebrities won’t even attend their surrogate’s appointments until the last few in order to avoid becoming attached, but “every match is different”:

“They can’t imagine that surrogacy is going to work for them, so they don’t want to get close and attached to their surrogate if she’s not going to get pregnant. Communication definitely starts off slow in the beginning until there’s a confirmed pregnancy.”

However, whether celebrity or not, Groenendaal told Page Six that “surrogacy is beautiful” and that no matter who the client, “these are real struggles that people go through.”

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My baby boo @thekidssupply

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The Reality of Being a Surrogate to the Rich and Famous Is Revealed — And in Some Cases It’s Harsh

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