In the opening chapter of the HBO series, the queen, Aemma Targaryen (Sian Brooke), is in the midst of a difficult labor. Her husband, King Viserys Targaryen (Paddy Considine), is desperate for a son in order to secure a male heir to the throne, in accordance with tradition.
Told that the baby is a breach birth, the medical advisers say that the king faces a terrible choice, one that will require either losing the baby, or sacrificing the life of the mother in order to try saving it.
After agonizing for a time, the king chooses the latter, with the blood loss from the grisly procedure killing the queen.
The fact that the baby later dies doesn’t erase Viserys’ actions, although it does eventually prompt him to designate his daughter, Princess Rhaenyra (Milly Alcock), as his heir, despite the break with tradition that entails, and the expectation that a future son, born to a new queen, will prompt him to supplant her.
Addressing those themes, executive producer Miguel Sapochnik has said a fundamental tension within the series is “the patriarchy’s perception of women,” noting that exploring such material — including the decision to anchor the story around its female characters — “made this show feel more contemporary.”
So in terms of writing the series off as sheer fantasy, as the premiere suggests and future episodes will reinforce, don’t let the dragons fool you.