In a new interview, Mandy Moore is opening up about a rare blood disorder diagnosis and how it majorly impacts how she’s able to give birth.

Moore, who is pregnant with her second child with husband Taylor Goldsmith, says she has to have an unmedicated birth due to immune thrombocytopenic purpura (ITP). 

“My platelets are too low for an epidural,” Moore told TODAY Parents. She confirmed that she also had an unmedicated birth with her now 17-month-old son, Gus, due to ITP.

Related: Mandy Moore announces she’s expecting baby #2 in the sweetest way

“It was awful. But I can do it one more time. I can climb that mountain again,” Moore said. “I wish medication was an option — just the idea of it being on the table is so nice. But we’ll just push forth like we did last time.”

What is immune thrombocytopenic purpura?

According to the Mayo Clinic, immune thrombocytopenia is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets—the cells that help blood clot. The disorder is also more common in women.

In many cases, immune thrombocytopenia may have no signs and symptoms. If they do occur, this is what to look out for:

  • Easy or excessive bruising
  • Superficial bleeding into the skin that appears as pinpoint-sized reddish-purple spots (petechiae) that look like a rash, usually on the lower legs
  • Bleeding from the gums or nose
  • Blood in urine or stools
  • Unusually heavy menstrual flow

Research published in the National Library of Medicine suggests that women diagnosed with ITP prior to conceiving could be at an increased risk for stillbirth, fetal loss, and premature delivery. Though among 446 pregnancies in women with ITP, 346 resulted in live births.

Someone like Mandy Moore, who has ITP, is unable to get an epidural if their platelet count is very low. Placing an epidural can cause injury around the spinal cord.

Related: Mandy Moore cancels tour—and anyone who’s been pregnant will applaud

Earlier this summer, Moore (understandably) canceled her first tour in almost a decade due to her second pregnancy.

“When we booked these shows, I wasn’t pregnant and although I truly thought I could power through, the way we are traveling (long hours on the bus and not getting proper rest) has caught up, taken its toll, and made it feel too challenging to proceed,” she said in a statement.

Last week, she shared an update on her ITP via Instagram.

“I am fine. I just have to continue to get my blood checked — my platelet levels checked — throughout pregnancy. They’re low, but they’ve always been low,” Moore explained in part. “But I’m all good. Everything’s good.”