Deep into her second pregnancy and anticipated birth of her first son, Kim Kardashian tells C Magazine’s Amanda de Cadenet why she rarely smiles and gives her fans an education on a female medical condition at the same time. Kardashian is lensed for the 10th anniversary September 2015 issue by Kesler Tran.

During her 2013 pregnancy with daughter North, Kardashian was the subject of incredibly rude weight shaming.

It was the worst! I couldn’t help it, and everyone would say, “She can’t stop eating.” I delivered at 180, and they were like, “She’s 210 pounds. She’s getting dumped because she’s too fat” and all these ridiculous stories. It really took a toll after the fact, when I was losing weight. I gained 50 pounds, and it’s tough to get it off. I was dedicated, but also, it changed the way I viewed wanting my picture taken. Before I was always smiling, and so into being out and about. After I had the baby, I was like,these are the same people that made fun of me, and posted the stories that were so awful, calling me fat for something I couldn’t control. I don’t want to smile for them. I don’t want to be out. Even if I was more confident, I just didn’t feel like being that girl who was going to be smiling for every photo. It changed my mood; it changed who I was; it changed my personality a lot.

In reality, Kim suffered from a medical condition called ‘placenta accreta’. “There were a couple of little operations to fix all that, so that created a little hole in my uterus, which I think made it really tough to get pregnant again. It was a long road. I would go to the doctor in Beverly Hills every day at five in the morning to get tested to see if I was ovulating. I was trying everything: I did acupuncture and got a nutritionist to eat healthier, thinking that was an issue.”

Anticipating that she may have the condition again, Kim’s doctors are discussing the possibility of removing her uterus this time, a possibility that will be discussed after her late year delivery.