The Many Violations of the Violent Birth Scene

Does the gory surprise C-section in “House of the Dragon” represent a grim historical reality, an urgent political statement or a worn cultural cliché?

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By Amanda Hess

“Are you sure you want to watch this?” my husband asked as we cued up the “House of the Dragon” premiere last week.

We had both seen the online warnings that the “Game of Thrones” prequel kicked off with a “grisly,” “brutal” and “gory medieval C-section.” I had undergone a cesarean section a couple of years ago, during the birth of my son, and now I was again pregnant and preparing for the possibility of a second surgery. But yes, I was sure I wanted to watch it.

I was, I guess, curious about what the most horrific interpretation of the procedure might look like. I’m still thinking about the scene — not because it is so violent, but because its violence is framed as so profound. Like so many depictions of pregnancy, its visceral and emotional possibilities are largely obscured by a tangle of clichés posturing as insight.

King’s Landing, after all, is not a subtle place. At the top of the episode, an uncomfortably pregnant Queen Aemma foreshadows her fate: “The childbed is our battlefield,” she tells her daughter, Princess Rhaenyra. “We must learn to face it with a stiff lip.” Meanwhile, her husband, King Viserys, is ominously confident that this pregnancy, after a run of miscarriages and stillbirths, will finally produce a male heir.

Instead, the queen’s labor reaches a dangerous impasse. The grand maester informs the king that the baby is in a breech position, and that “it sometimes becomes necessary for the father to make an impossible choice” — to “sacrifice one or to lose them both.” Viserys approves the surgical removal of the baby without Aemma’s knowledge or consent. As birth attendants restrain their desperate, confused queen, the grand maester slices into her belly. The queen dies, and her baby dies soon after.

What is the meaning of this gruesome spectacle? George R.R. Martin’s “Fire & Blood,” the book on which “House of the Dragon” is based, has the queen die in childbirth in an unspecified manner; only in the show does it become a murder by way of a rogue belly slicing. In a series of interviews, Miguel Sapochnik, one of the showrunners and the episode’s director, exhaustively explained the resonance of the choice. The scene — intercut with a bloody jousting tournament mounted by the king in premature celebration — was designed to be “a distillation of the experience of men and the experience of women” in Westeros, Sapochnik said. But it was also meant to reveal “parallels to our own past and present,” he added. It represents the grimness of childbirth in the medieval era, from which Martin’s fantasy world draws, when “giving birth was violence”; but it also represents the grimness of childbirth in post-Roe America, when the scene reads as “more timely and impactful than ever.”

“Anxious not to get it wrong,” eager “not to shy away” but also “not to sensationalize,” the creative team — the episode was written, directed and edited by men — enlisted two midwives to advise on set and innumerable women to screen the sequence before it aired. The scene, Sapochnik promised, was just the beginning of a whole season of portentous births, each seeded with additional gender commentary. The theme of this birth, he explained, was “torture.”

The sheer violence of the scene didn’t shock me. (Earlier in the episode, a character slices off a man’s penis and tosses it atop a pushcart piled with various severed appendages — violent spectacle is a major element of the show.) But the implied profundity of the violence struck me as faintly ridiculous. The loading of meaning onto the queen’s death felt like an attempt to sidestep the criticism that dogged “Game of Thrones” — that it indulged in senseless violence against women. But the imposition of sense on such violence can also feel unsatisfying, as the female character’s interiority is subsumed into the creators’ effort to make a statement.

The scene creaks under the weight of so many signifiers. The queen is shot from seemingly every angle; no perspective on her pregnant body goes unseen. We see her moaning in the background, tangled in bedclothes. We zoom close on her delirious face in gauzy light, evoking the softness of a maternity shoot. Often we see her from above, as if we are peering down on her in a surgical theater. Or we spy her from beyond her rounded stomach, as if we are attendants assisting in the delivery. We look down upon her as she is cut open, drained of blood and stuffed with reaching hands.

As the scene wears on, the camera itself seems moved by cowardice. It retreats further and further from the queen’s perspective, assuming a remote and clinical gaze. Often it looks away entirely, focusing instead on the cartoonish gore of the jousting,which comes to stand in for the violence of the birth. The queen’s screams are silenced, overlaid with the sounds of a roaring tournament crowd and the outlandish squishing of skulls and brains. In its desperation for meaning, the scene does become senseless.

Being pregnant can feel like passing from the physical world into the world of signs. Pregnancy is weighted with so much metaphorical significance that it is even a metaphor for significance — pregnant with meaning. But I’m not pregnant with meaning; I’m just pregnant. And so I watch depictions of pregnancy and birth from my own removed position, curious what my experience signifies to other people, and what it is supposed to say about our culture and politics.

The “House of the Dragon” C-section is neither historically accurate (the mother’s life was valued over that of the fetus in much medieval teaching, as Rebecca Onion detailed in Slate) nor particularly of the moment (post-Roe, many women are begging doctors for surgical interventions in their pregnancies). But it does access a persistent cliché: The C-section is a birth choice loaded with stigma, as Leslie Jamison noted in an essay on the procedure last year. It is coded as “both miraculous and suspect, simultaneously a deus ex machina and a tyrannical intervention” — the antithesis of a “natural birth.”

This construction voids the mother’s role in childbirth, ceding it to a patriarchal medical establishment. The riddle from “Macbeth” — which posits that because Macduff was “untimely ripped” from his mother’s womb, he is not “of woman born” — persists. On-screen pregnancies still rarely end in C-sections. When they do, they are the stuff of horror. As the film critic Violet LeVoit has argued, the vaginal birth is framed as the climactic final struggle of the hero’s pregnancy journey. A C-section, then, renders our hero a victim — and a failure.

None of this coincides with my own experience. I didn’t feel bad for having a C-section, or feel that I didn’t truly “give birth” to my son; I felt that my doctors and I did what was medically necessary to deliver him safely. And yet I feel nagged by this imposed narrative, and I am reminded of it whenever I see a birth scene shot from above, as the “House of the Dragon” one often is.

Birth was, for me, an overwhelmingly sensory experience, not a visual one. During labor, I couldn’t see past my own abdomen. My strongest memory of the surgery, which the hospital shielded from my view with a raised blue tarp, is of the uncanny release of pressure in my anesthetized body when the baby was removed. As it was happening, a doctor asked if I wanted her to photograph the moment, and I impulsively agreed, thinking that I could always delete the image if I couldn’t stomach it. When I look at the photo now, I recognize my son’s features emerging from the bloodied edges of my body, but I don’t recognize the point of view. It is as if I am reliving another person’s memory, not my own.

So no, the depiction of violence in birth does not bother me. But the bird's-eye view of it does. The camera’s insistence on its lofty perspective, on looking down on the birthing woman’s full body from a spectator’s remove — that strikes me as the real violation. In those jarring shots, the depiction of male violence becomes indistinguishable from the male gaze.

Maybe future “House of the Dragon” births will resonate with my own feelings about childbirth. And I’m sure other parents, bringing their own experiences to the episode, left it with different interpretations. But that is the trouble with trying to distill the entire “experience of women” into a scene — the idea is absurd, even in a fantasy world.

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