The “House of the Dragon” Premiere Includes a Breech Birth – but What Is It?

Trigger warning: Birth trauma

HBO’s “Game of Thrones” prequel, “House of the Dragon,” invites us back into the dragon-tinged, political saga a full three years after the original series ended in 2019. Just like its predecessor, “House of the Dragon” seems to be obsessed with the question of womanhood and its relationship to power. In the past, these questions have not always carefully – or responsibly – been wrought by showmakers, and the women in the series tend to suffer because of it. “Game of Thrones” quickly became known for its gratuitous sex scenes; objectification of women; and unnecessary depictions of rape, abuse, and sexual violence against women all in the name of “historical accuracy” or for character development (particularly in the case of Sansa Stark, who attributed her personal growth and strength to the extreme patriarchal violence her character experienced).

“House of the Dragon” is following a similar path already in the short, tragic story of Queen Aemma. If you need a full-blown refresher of the show’s plot, based on the book “Fire and Blood” by author George R.R. Martin, check out POPSUGAR’s in-depth explainer. The short version: Queen Aemma Targaryen is the wife of the current King Viserys Targaryen. The kingdom is in existential crisis over the matter of succession as the king and queen, after years of trying, have not produced a male heir to inherit the famous Iron Throne. Their only surviving child is a young girl named Rhaenyra, who does not automatically qualify for rule due to her gender.

Related: “House of the Dragon” Already Featured 2 Heartbreaking Deaths

Queen Aemma is very pregnant in the series’s opening episode, and King Viserys is convinced the pregnancy will result in the boy heir he needs. However, things quickly go awry when Queen Aemma goes into labour, and the baby is breeched. The king is given a choice – save the baby or the mother – and without consulting his wife, Viserys quickly chooses his heir. What viewers witness is a painful and forced C-section without anaesthesia, resulting in gut-wrenching screams from Aemma followed by her death.

The scene has drawn criticism for its graphic nature. In an interview with POPSUGAR, showrunner Miguel Sapochnik acknowledged the scene “hits a real trigger for women, which is this idea of choice and that she doesn’t get to choose. . . . She’s effectively murdered by her husband.” But for many who have not experienced childbirth or are unfamiliar with the complications that can happen during labour, it’s still unclear exactly what went wrong.

What Is a Breech Birth?

If you’ve never heard of a breech baby or breech birth before, the term refers to the baby’s positioning in the womb. Ideally, a baby is born head first (called a “vertex presentation”) from the vagina, but in breech birth, the baby’s feet or buttocks come out first, according to the Cleveland Clinic.

There are a few different breech positions the baby could be in, per the Cleveland Clinic.

• Frank breech: the baby’s bottom is facing the vaginal canal, and the legs are pressed straight up against the body, with the feet near the head.
• Complete breech: the baby’s bottom points down, and the positioning resembles a cross-legged position, with the hips and knees flexed.
• Footling breech: the baby’s feet point down, meaning the baby would come out feet first.
• Transverse lie: the baby is positioned horizontally across the uterus, meaning the shoulder would come out first.

Why Is a Breech Birth Concerning?

“Most babies will flip to a head-down position before they reach full term (37 weeks),” per the Cleveland Clinic. Delivering a breech baby vaginally can be risky and cause injury to the baby’s legs or arms (e.g., dislocated or broken bones) or umbilical-cord problems that result in nerve or brain damage due to a lack of oxygen. The question then becomes, what is the safest way to deliver the baby?

There are several ways to address the breech, including turning the baby to the correct position while still inside the uterus (which comes with its own set of risks), a planned C-section (which is most common), or even a vaginal delivery, depending on the situation. It’s important to note that breech babies are rare, accounting for only three to four per cent of full-term pregnancies, and most are born healthy.

But that doesn’t make the “House of Dragon” scene any less difficult to watch – and there are reportedly more birth scenes planned for season one. So if you are pregnant, want to become pregnant, or experienced traumatic or difficult childbirth, you may consider beforehand what kind of imagery you want to be exposed to. There’s no shame in skipping a scene, muting the TV and walking away, or deciding this just may not be the series for you.

Related: Serena Williams Recalls Near-Death Experience While Giving Birth to Daughter, Olympia