‘House of the Dragon’ on HBO: Inside ‘extreme’ childbirth scene

Warning: The following contains spoilers from the series premiere of House of the Dragon.

If viewers have learned anything from eight seasons of Game of Thrones, it’s that no one in Westeros is too important or too loved to suffer a sudden, horrific death.

Fittingly, the long-awaited House of the Dragon spin-off begins with a death – actually two – that are as memorable as they are poignant. In Sunday’s “The Heirs of the Dragon,” Queen Consort Aemma Targaryen (Sian Brooke) bleeds to death after a brutal cesarean performed without her consent or knowledge. The attempt to save her child and to find a male heir to the Iron Throne is ultimately in vain: the baby lives only a few hours.

The brutal sequence, punctuated by a fierce jousting match, highlights the dangers women face in this mythical, quasi-medieval realm, but also has surprising modern relevance in a perilous post-Roe moment.

“Every birth on this show has a theme, just like the battles I’ve filmed in the past have a central concept. The theme of that birth scene was ‘torture,'” co-showrunner Miguel Sapochnik wrote in an email to The Times. He directed the episode as well as many of the most epic episodes of Game of Thrones including Battle of the Bastards and The Long Night.

“The show’s hope and purpose — beyond its primary entertainment — is to shed light on how the experiences of men and women in this world have parallels with our own past and present.”

Created by George RR Martin and Ryan Condal, House of the Dragon opens almost two centuries before the time depicted in Game of Thrones. The seemingly kindhearted king Viserys Targaryen (Paddy Considine) rules Westeros, and his devoted wife Aemma is pregnant with what they hope to be the next Targaryen king. Despite having several stillbirths and miscarriages, Aemma feels it is her duty to conceive an heir.

“Thus we serve the kingdom as royal wives. Birth is our battlefield. We’ve got to learn to face that stiff-eyed,” she says to her spirited, dragon-riding teenage daughter Rhaenyra (Milly Alcock), who clearly has other plans for her future.

That resolve is tested when Aemma goes into labor. The baby is breech and attempts to move him are unsuccessful, leaving few options for a safe birth. The Grand Maester (David Horovitch) explains Viserys’ predicament: “During a difficult birth, the father sometimes has to make an impossible choice: sacrifice one or lose both.”

A young girl sits with her pregnant mother.

Milly Alcock (left) and Sian Brooke in House of the Dragon.

Viserys grants them permission to proceed with the unmedicated C-section (which presumably has a different name in Westeros). Despite knowing it will kill them, Aemma is never told what will happen — let alone that she has any say in the matter.

Confused, then frightened, Aemma is tied to the bed by a team of midwives while the Grand Maester makes an incision in her abdomen and removes the child. She screams in agony as blood spurts onto the sheets. Moments later, Viserys weeps over her lifeless body lying on a blood-soaked bed. His young son also dies within a few hours.

“I know it might sound extreme, but we wanted it to be hard to see. We wanted people to remember that no matter what they thought of Viserys, he did it and could never take it back,” Sapochnik said. “It’s the most tantalizing incident in history and had to be strong and fearless.”

“It’s pretty hard now as a woman to think about putting yourself in it [Aemma’s] Position. It’s so prone to thinking, ‘This is you: a vessel for birth,'” Brooke said in a phone interview. “This struggle shows man’s eternal quest for power and status. And then there is this woman who is at the mercy of a man’s choice.”

“You think you’ve taken this big leap forward, that women are able to make decisions about their own bodies,” she added. “It’s quite shocking that unfortunately there is some resemblance between that and centuries ago.”

Brooke recalled trying to explain the character to her two little boys. “Back then we didn’t have the wonders of modern medicine. It was very dangerous and this lady is dying,” she said. “And my youngest said to me, ‘Oh mom, I’m so glad I’m not a woman.'”

Though the series is set in a fantasy world, Aemma’s fate is a reminder of the suffering endured by countless women throughout history before anesthetics, antibiotics, and other modern medical advances. Her horrific death — and the specific language of the men who decided her fate — also resonates strongly in post-Roe America, where newly restrictive laws are forcing pregnant women to delay or even forgo treatment for dangerous complications.

Sapochnik said the wording of the maester’s statement in the scene – “a father gets to choose” – was specific and intentional, “the idea was that Queen Aemma can’t choose her fate even though she’s right there. King Viserys and the Grand Maester never think to consult her, and so she is powerless to make a decision about her own body.”

A king and his pregnant queen smile.

Paddy Considine and Sian Brooke in House of the Dragon.

Though the scene was written, filmed, and edited well before the Supreme Court overturned Roe vs. Wade in June, “it feels more timely and impactful than ever,” Sapochnik said.

The director had two midwives on set during filming “to explain to us the reality of having a caesarean without anesthesia or modern tools and medicine,” he said. “We also tried to ensure that the effect of the resulting blood loss on the mother is represented so that it is clear what killed her.” (One of the midwives also appears in the scene.)

Brooke said she spent about a day and a half “nailed to the bed with her legs apart” filming the birth — by no means a comfortable situation, but nothing compared to reality. Before filming began, the actors also had a day-long rehearsal to ensure they were comfortable working with the prosthetics and other special effects that make labor so lifelike.

“I had a prosthetic abdomen, and then the special effects and prop makers would fill the abdomen with blood,” Brooke said. A pump ensured that the blood flowed realistically during the incision.

Sapochnik’s goal is “not to shy away from what’s happening, but also not to make it sensational,” he said. This meant a painstaking editing process that began with an “all-in version” of the birth sequence. Then they began to “slowly carve away … what was too much or felt unnecessary or a replay.” After they broke it with the tournament sequence, some moments of the birth became redundant, so they made more cuts. Taken together, “the scene is intended to be a distillation of the experience of men and the experience of women during this time”.

They also changed the point of view of the scene, “shifting from Viserys’ birth experience to Aemmas, until we felt we had found the right balance that neither glorified nor shied away from the point we were trying to make,” he said.

Finally, the showrunners acted out the scene for as many women as possible to get their feedback. “We didn’t want to do anything wrong. And the feedback has been unanimously positive,” he said. “Some felt it wasn’t violent enough.”

https://www.latimes.com/entertainment-arts/tv/story/2022-08-21/house-of-the-dragon-childbirth-scene-aemma-viserys-targaryen ‘House of the Dragon’ on HBO: Inside ‘extreme’ childbirth scene

Sarah Ridley

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