Hailey Bieber Opened Up About Her Uterine Septum. Here’s What the Condition Actually Means for Fertility and Pregnancy

When Hailey Bieber recently shared that she had a uterine septum before becoming pregnant with her son, the revelation sparked curiosity — and concern — among many fans unfamiliar with the condition.

The model and Rhode founder described learning she had the congenital uterine abnormality shortly before she unexpectedly conceived her now 16-month-old son, Jack Blues, with husband Justin Bieber.

“It was a surprise,” Bieber said of her pregnancy during an appearance on the SHE MD podcast, co-hosted by her own OB/GYN Dr. Thaïs Aliabadim. She recalled Aliabadim warning her to monitor the condition because “it could potentially be an issue,” and that surgery might have been needed depending on how it progressed.

“So I had a septum in my uterus, and Dr. A kept saying, Well, we need to look at this and keep an eye on it before you get pregnant because it could potentially be an issue’,” Bieber recalled. “‘I don’t really know. We’ve got to see. I might have to give you a small surgery for it. Not sure.’ And 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.” 

“And then she calls me, and she’s like, I’m pregnant!’ And I’m like, No!’ ” Dr. Aliabadi joked. 

Despite the risks, Bieber’s pregnancy ultimately went well. But her story has brought new attention to a medical condition that many women may have without realizing it. According to experts, uterine septum is actually one of the most common structural differences in the uterus.

“A uterine septum is a band of tissue that divides the uterine cavity partially or completely,” says Dr. Jennifer Lincoln, a board-certified OB-GYN and author of “The Birth Book: An OB-GYN’s Guide to Demystifying Labor and Delivery.”

“It’s the most common uterine anomaly, present in roughly 2–3% of the general population and higher among people with recurrent pregnancy loss,” she says.

Dr. Rhiana Saunders, a reproductive endocrinologist and infertility specialist at Aspire Houston Fertility Institute, says the often asymptomatic congenital abnormality can give the inside of the uterus “a slight heart-shaped appearance.”

There are two primary forms. A complete septum divides the uterus entirely and may extend through the cervix and even into the vagina. The more common type is a partial septum, where the uterine cavity is divided but the tissue band does not extend all the way down to the cervix.

“Uterine septa are generally asymptomatic, meaning many women do not experience noticeable symptoms,” Saunders says. “Often, the first indication is recurrent miscarriage.”

The reason has to do with how the altered uterine shape can affect pregnancy. The septum may limit blood supply in the uterus, which can make embryo implantation more difficult or affect blood delivery to a developing fetus.

“The main concerns are that a uterine septum can increase the risk of miscarriage, preterm birth, and malpresentation,” Lincoln says, referring to cases where a baby is not positioned head-down before delivery, which can increase the likelihood of needing a cesarean section.

Saunders says the condition may also limit how the uterus expands during pregnancy. In some cases, this can increase the risk of premature labor or intrauterine growth restriction, where a baby grows more slowly than expected.

But having a uterine septum does not necessarily mean someone will struggle with fertility or pregnancy.

“A uterine septum does not automatically cause infertility,” Saunders says. “Not all women with a uterine septum experience miscarriage or difficulty conceiving. In fact, many women go on to have healthy, full-term pregnancies and may never realize they have one.”

That variation is partly due to the wide differences in size and structure of the septum itself.

“The size variation can really change its impact on pregnancy outcomes,” Lincoln says. “A small partial septum may have little to no clinical relevance, while a complete septum dividing the cavity fully carries higher risk.”

Because the condition can sometimes be missed, accurate diagnosis is important.

“Diagnosis requires proper imaging, like a 3D ultrasound or MRI,” Lincoln says. “A 2D ultrasound alone can miss it or misclassify it.”

Another frequent misconception is confusing uterine septum with a bicornuate uterus, a different condition where the uterus has two distinct cavities.

“With a uterine septum, the uterus typically has a normal external shape but contains a thin wall of tissue dividing the cavity,” Saunders explains. “A bicornuate uterus, by contrast, has two separate and distinct uterine cavities.”

Treatment also varies depending on a person’s medical history. Some patients never need intervention, while others benefit from a minimally invasive surgery called hysteroscopic septoplasty, which removes the tissue dividing the uterus.

“Studies have shown that after this procedure, live birth rates can increase dramatically in women who have suffered recurrent miscarriages,” Saunders says, noting that outcomes can improve from approximately 3% to as high as 80%.

If someone learns they have a uterine septum, asking the right questions can help guide next steps. Patients should first ask whether 3D imaging was used to confirm the diagnosis, then ask the size and extent of the septum, and whether treatment is recommended based on their personal reproductive history.

Bieber’s story illustrates an important point: even when risks exist, outcomes can still be positive.

Her pregnancy was ultimately full-term, though not without challenges. She described undergoing an 18-hour induced labor before delivering her son, followed by a postpartum hemorrhage that doctors were eventually able to control.

Looking back, Bieber said she remained hopeful even after learning about the potential complications.

As her doctor recalled on the podcast, when the risks were first explained, Bieber simply replied: “You know what? I believe that everything’s gonna work out fine.”