Mandy Moore will likely undergo labor without an epidural again for the delivery of her second child.

It This Is Us alum, who is set to welcome another son with husband Taylor Goldsmith in October, has an autoimmune blood disorder known as immune thrombocytopenic purpura (ITP).

“My platelets are too low for an epidural,” the pregnant actress told NBC’s TODAY Parents in an interview earlier this month.

Is immune thrombocytopenic purpura also known as ITP?

With ITP, which is often triggered by pregnancy, a person’s body mistakenly attacks their own platelets, or blood cell fragments that help with blood clotting, according to Cedars-Sinai Medical Center in Los Angeles.

What makes it so dangerous to have extremely low platelets

Having an abnormally low number of platelets, a condition called thrombocytopenia, can cause bruising and internal bleeding. If doctors consider the level of platelets to be insufficient by the time of delivery, they will likely avoid giving the pregnant patient an epidural for pain relief during labor to avoid the risk of a spinal hematoma, or pooling of blood, multiple studies show.