House of the Dragon episode 1 spoilers follow.

If there was one thing that Game of Thrones knew how to do with perfection, it was to take shock and awe to bloodcurdling new heights.

Ned Stark's death goes down in history as one of the most stunning scenes in Game of Thrones history. In the true sense of the word. We were stunned.

However, showrunners David Benioff and DB Weiss just kept adding and adding more layers to the uncomfortable, squeamish (and, let's face it, exciting) acts.

The Red Wedding massacre was a bloodfest. Ramsay Bolton's sadistic torture of Theon Greyjoy (Alfie Allen) is shiver inducing and Oberyn Martell's eyes being crushed under the thumbs of Gregor Clegane… *screams silently in despair* We can still hear the squelching and the crunch.

game of thrones red wedding
HBO

It's hard to imagine anything topping any of those… cue House of the Dragon with the most intense scene ever.

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It's possible that the Game of Thrones hiatus has made us all lily-livered and soft-bellied. It's even more plausible that the brutal, breech birth-turned-caesarean scene took things to a limit we've never quite reached in the franchise.

When King Viserys' wife experiences complications during birth, he is told he must make a difficult choice: sacrifice the life of his wife during a risky caesarean procedure or leave the birth up to the gods and risk losing them both.

It's not a decision he takes lightly and the intimate scenes of tender love and devotion that precede this agonising moment only heighten the level of palpable anxiety felt by the viewers.

Ultimately Viserys (Paddy Considine) agrees to the procedure. The level of unease is dialled up in increments, making it almost impossible to watch, but watch we must.

paddy considine as king viserys i targaryen, house of the dragon
HBO

Queen Aemma (Sian Brooke) is dragged to the centre of the bed with very little regard, harking back to Rhaenyra's earlier words: "Here you are surrounded by attendants all focused on the babe. Someone must attend you."

However, there is no one to fight her corner now as the frightened and vulnerable queen pleads for them to stop, begging Viserys as she shrieks at the sight of the knife.

No milk of the poppy can save her from what is to come, nor can the Viserys words: "I love you."

Aemma is sliced open and gutted. The scene is most visceral as her open wounds expand under the blade of the knife. Rivers and rivers of blood pool out of her as Viserys holds her hand but looks away, unable to confront his choice.

The excruciating scene is made more extreme by the interception of the bloody tournament taking place in the name of male heir not yet promised.

matt smith, house of the dragon
HBO

Men are stabbed, faces split in two and dead bodies are dragged through the ground leaving trails of blood, all the while Queen Aemma is experiencing her own battle.

It seems a metaphor for her earlier words to her daughter about the childbed being a woman's battlefield. For she too is fighting a harder fight than any of them could possibly imagine.

As the baby is fished out of her the boy – yes a male heir gives a newborn howl just as Prince Daemon (Matt Smith) elsewhere cries out in celebration, thinking he has won the tournament. Perhaps symbolising the twisted win for both Targaryen brothers.

Alas it is not true for either. Daemon loses to Ser Criston Cole (Fabien Frankel) just as Viserys' son does not survive the traumatic birth.

fabien frankel as ser criston cole, house of the dragon
HBO

It is the intimate bond and the closeness that King and Queen have shared earlier that makes this all the more harrowing a scene. It is the fact that her pain, her fear and ultimately her barbaric death was at the hands of someone she loved dearly who loved her back.

Given the turn of events, it may have always been both mother and child's destiny to die, but the way that death unfolded could and should have been handled much more lovingly. Instead Viserys puts the kingdom and his legacy ahead of his wife.

"That's the one thing that he can never quite come back from," said Considine in an exclusive interview with Digital Spy. "Making a choice like that to choose the realm over the potential of his wife's survival."

This feels quite unique in style to House of the Dragon. With Game of Thrones, the acts of violence, torture and terror were always delivered by an enemy. Someone more removed from the pain that they were inflicting upon their victim.

The Red Wedding, one of the most memorable Game of Thrones moments made so because of its violence, was hard to watch.

red wedding game of thrones
Warner Bros.

Lord Walder Frey's gruesome, shock betrayal felt even more impactful because of the contrast between its brutality and merriment of the wedding feast that had been happening not long before.

Robb's Stark's pregnant wife, Talisa (Oona Chaplin), being stabbed numerous times in the stomach was just the unfolding of the horror to come. A horror that ended with Catelyn (Michelle Fairley) having her throat slashed and Robb (Richard Madden) decapitated, his head replaced with that of his dire wolf Greywind.

It was a chilling moment in Game of Thrones history that was heightened by watching the young Ayra Stark's hope of a reunion vanish.

It is however tempered by the show's tendency towards 'an-eye-for-an-eye'. Vengeance was always imminent for the Freys and it came in the form of an older Arya using the skills she learnt from her time with the Faceless Men to make Walder Frey suffer.

walder frey in 'game of thrones'
HBO

It was also less troubling because, unlike with House of the Dragon's birth scene, this betrayal wasn't tainted by personal relationships or love. It was a simple transaction of 'the slighted' seeking revenge (however incredulous) and therefore the detachment made it easier to reconcile.

However, Viserys loved his wife and so his intertwined pain and bitter remorse combined with the gruesome special effects add a special level of poetic horror that sticks, making it a memorable episode.

Let's see what else showrunners Ryan J Condal and Miguel Sapochnik have in store for the rest of the season.

House of the Dragon airs every Sunday in the US on HBO, and on Mondays in the UK on Sky Atlantic and NOW. Game of Thrones seasons 1-8 are available on DVD and Blu-ray.

Headshot of Janet A Leigh

TV writer, Digital Spy Janet completed her Masters degree in Magazine Journalism in 2013 and has continued to grow professionally within the industry ever since.  For six years she honed her analytical reviewing skills at the Good Housekeeping institute eventually becoming Acting Head of Food testing.  She also freelanced in the field of film and TV journalism from 2013-2020, when she interviewed A-List stars such as Samuel L Jackson, Colin Firth and Scarlett Johansson. In 2021 she joined Digital Spy as TV writer where she gets to delve into more of what she loves, watching copious amounts of telly all in the name of work. Since taking on the role she has conducted red carpet interviews with the cast of Bridgerton, covered the BAFTAs and been interviewed by BBC Radio and London Live. In her spare time she also moonlights as a published author, the book Gothic Angel.