It's a topic Beyoncé speaks candidly about in her Netflix documentary, "Homecoming."
The doc (and a surprise live album of the same name) was released Tuesday night and offers intimate details about what the superstar calls an "an extremely difficult pregnancy" and a harrowing birth.
"My body went through more than I knew it could," she confessed in a series of voice-overs that run throughout the feature. "I was 218 pounds the day I gave birth ... I had high blood pressure. I developed toxemia, preeclampsia."
It made for a crisis that risked both her well-being and that of her babies.
When she first spoke out about the subject, in an essay she penned for Vogue last year, Beyoncé said the conditions meant that she had to be "on bed rest for over a month." But in "Homecoming," she explained the frightening ordeal in more detail.
"In the womb, one of my babies' hearts paused a few times, so I had to get an emergency C-section," she said.
After weeks in the neonatal intensive care unit, Sir and Rumi went home happy and healthy, but Beyoncé's own struggles — to get back to the stage and to find a new balance in her life — continued.
"It’s my first time back home on the stage after giving birth," she said of the performance at the heart of the documentary, her Coachella showstopper in 2018. "I’m creating my own homecoming, and it’s hard ... There were days that I thought I’d never be the same. I’d never be the same physically; my strength and endurance would never be the same."
It made for a physical and mental battle.
"That’s hard when you don’t feel like yourself,” Beyoncé said. "I had to rebuild my body from cut muscles."
As hard as she worked to make her Coachella dream a reality — after having to cancel her planned set the year before due to her pregnancy — Beyoncé was divided during the grueling rehearsals that led up to the big event.
"My mind was not there," she put it bluntly. "My mind wanted to be with my children. What people don't see is the sacrifice."
She would breastfeed the twins during breaks in her trailer and squeeze in quality time with her other child, 7-year-old Blue Ivy.
But eventually, the 37-year-old finally found a way to juggle it all and create a new normal — as a performer, a mother, a wife and more.
"I just feel like I'm just a new woman in a new chapter of my life and I'm not even trying to be who I was," she said. "It's so beautiful that children do that to you."
"Homecoming" is currently available to stream on Netflix.