‘Dead Ringers’ takes an unflinching look at childbirth and loss

Birth in the United States is devilish. Or at least, according to Beverly Mantle, it’s one of two identical twin gynecologists played by Rachel Weisz in the Prime Video miniseries Dead Ringers.

A gender-biased remake of David Cronenberg’s 1988 thriller, the drama is a disturbing exploration of the co-dependent relationship between Beverly and her twin sister Elliot, Manhattan doctors who practice medicine — and do just about everything else — but who Gaining insight their approach to life and work can be incompatible.

Beverly — the reserved, compassionate woman who wears her hair back — wants to “change the way women give birth forever” by opening a revolutionary birthing center. Elliot is an impulsive, hair-raising guy more interested in pushing scientific and ethical boundaries with a state-of-the-art embryology lab than providing compassionate care.

Created by acclaimed playwright and showrunner Alice Birch, the series is anchored by a captivating double performance by Weisz. It retains the surreal, eerie tone of the original film, which starred a deliciously sinister Jeremy Irons.

But expanded to six hours and told from a decidedly feminine perspective, Dead Ringers also offers an unusually lucid look at reproductive health care in the United States – from the agony of infertility and pregnancy loss to the everyday perils of childbirth, particularly for women of color.

And it wastes no time on it: Minutes into the pilot episode, Beverly, who has been trying unsuccessfully to have a baby, is scooping bloody tissue out of the toilet after experiencing another miscarriage. Soon after, in a visceral montage, she and Elliot are doing their thing — using forceps, scalpels, suction devices, and all sorts of verbal coaxing to deliver babies vaginally and by cesarean while blood spatters their shoes. Elsewhere, the show tackles such thorny issues as the regulation of embryos grown outside the womb, the racist origins of modern gynecology, surrogacy, and the influence of wealthy benefactors on medical research.

“We knew we wanted it to start in a really grounded place,” Birch said in a joint phone conversation with Weisz, who played a hands-on role as executive producer on the series. “The twins are so ambitious and have such clear ideas about how to make things better that I felt I had to make the case for imagining something else. We wanted the births to feel real and for these patients to feel like real women walking in and out of clinics today.”

Rigorous realism and preachy didactics aren’t the goals of this overly stylized remake (in keeping with the original, the doctors and nurses wear crimson scrubs), but to make the story work – and to make both Beverly’s and Elliot’s competing visions resonate as strongly as they do – medicine had to be grounded in truth. Dead Ringers is one of a growing number of TV shows, including This Is Going to Hurt and I Hate Suzie Too, that defy the squeamishness that so often hampers the representation of women’s bodies in order to promote reproductive health in a radical form of openness.

“Women’s bodies have always been politicized,” Birch said. “So I think the show would have felt timely whenever it came out.”

But at a moment when maternal death rates are rising and people’s ability to control when and if they become parents is being eroded, after Roe vs terrorizes, humiliates, and ruins women and their bodies,” many viewers might see as the least exaggerated aspect of the entire series appear.

Weisz had been a fan of the Cronenberg film since she first saw it as a teenager, and was fascinated by the “twisted, bizarre, co-dependent relationship” at its center, she said — one that easily switched and fell into place for her Two wealthy characters describe: “There seemed no reason why you couldn’t have two identical twins.”

The actor brought the idea for a remake to Annapurna Pictures and suggested Birch, whose TV credits include ‘Succession’ and ‘Normal People’, to helm the adaptation.

Birch was thrilled to open the story by delving further into the twins’ work in midwifery. In an early conversation with Weisz, Birch recalled a doctor speaking about choosing when life begins when they performed cesareans and describing themselves in godly ways. “It seemed like our twins would say that,” she said.

The writers’ room, made up of seven women (including Weisz), became a place to share stories of childbirth, visits to the gynecologist, and other personal experiences that are now “part of the archaeological layers in the DNA of the entire project.” are, said Weisz.

The authors used the competing personalities of Beverly and Elliot to explore different approaches to women’s health. Beverly believes pregnancy should be treated as a normal physical condition, not an illness — a philosophical descendant of Ina May Gaskin, the pioneering American midwife (although her birthplace is far fancier than Gaskin’s famed Tennessee farm). Elliot, meanwhile, just wants a lab where she can play the role of a loner and break accepted norms with impunity, which is something she’s already prone to do.

To pursue both of their dreams, the Mantles turn to a wealthy benefactor named Rebecca (played by Jennifer Ehle), who has made a fortune selling opioids. (Resemblances to the Sackler family are certainly no coincidence.)

“Finding these people who would literally be the worst people for her to take the money from allowed us to keep asking these really complicated questions,” Birch said.

To better understand the medical and ethical implications of Elliot’s embryological experiments, the authors consulted scientists at the Francis Crick Institute in London. The production also enlisted a number of reproductive medicine experts, including Barbara Sellars, a renowned New York City midwife, and Susan Grant, a recently retired midwife who practiced at Lenox Hill Hospital in Manhattan, who provided feedback on scripts and were present on Set when they filmed deliveries and other procedures.

Grant was called to work “constantly,” she said. “It really takes someone who does that day in and day out to come in and say, ‘No, hold your hands like this.’ “Fetal heart rate would not be that number.” I was really integrally involved. They wanted to do it right.”

She was struck by “the true female dominance, essence and warmth” she encountered on location. (The series’ directors included Sean Durkin, Karyn Kusama, Karena Evans, and Lauren Wolkstein.) For her part, Weisz was thrilled to be surrounded by experts who entertained her with their tales from the birth ditches: “To sit and chat between takes anybody , who spent his life giving birth to babies? I don’t feel any better.”

Weisz also attended several births as part of her preparation for the series. “We know it’s going to happen any second. It’s kind of the most common thing that happens,” she said. “But to witness it feels utterly extraordinary and wonderful and amazing.”

Grant said one of the more challenging, if less gory, scenes involved attempting to rotate a breech baby by applying manual pressure to a pregnant belly. Sewing was also difficult. But she was impressed by the research Birch and the authors had already done. In one instance, she questioned the plausibility of a particularly painful plot twist, only to have Birch cite an article on an almost identical case.

The series is graphic – get ready for close-ups of crowned babies – but it captures the power of being there when a new life is born, Grant said. “That’s the most amazing thing: seeing this huge head coming out of a small vagina.”