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House of The Dragon opens with a scene of contested succession. In the year 101 AC, 182 years before the birth of Daenerys Targaryen, King Jaehaerys I calls the lords of Westeros to King’s Landing to witness him officially announce his successor. Both his son and his brother have died, leaving the dynasty without an all-important male heir. And rather than appoint the obvious next in line — his granddaughter Rhaenys Targaryen (Eve Best), only child of the king’s oldest child — as queen, Jaehaerys chooses the son of his second son, Viserys (Paddy Considine), to rule. It’s a decision that sets the tone for not only the premiere episode of HBO’s Game of Thrones prequel, but for the fate of the entire Targaryen dynasty.

Dubbed “The Queen who Never Was,” Rhaenys accepts her fate gracefully enough. Fast-forward nine years, and we meet three more women whose existences are defined in relation to men, whether they be fathers, husbands, or sons. Rhaenyra Targaryen (Milly Alcock, in this first episode) is the king’s oldest — and, for the moment, only — child, who’s always felt as if she disappointed her father simply by being born female. She does not particularly enjoy the courtly lifestyle, and dreams of riding to glory in battle on the back of her dragon. That doesn’t matter, however, because power is very gendered in Westeros.

As Rhaenyra’s mother, Lady Aemma Arryn (Sian Brooke) tells Rhaenyra early on in the episode, “the childbed is our battlefield.” Aemma’s — and therefore her daughter’s — power lies in her capacity to get pregnant and bear a male heir. Nothing else matters. But, as Aemma tells her husband shortly before she goes to labor, “this will be the last one.” She’s suffered through multiple stillbirths and miscarriages, and her body can’t take any more pregnancies. And so she ceases to be of value to the realm, as is illustrated in the bloodiest scene in an episode full of them.

While Aemma attempts to deliver a baby who’s breeched (i.e., is turned with the feet downward instead of the head, a common and dangerous complication), the maester pulls the king aside and tells him it’s time to “make an impossible choice.” Who will live, and who will die? What’s more important: The potential of a baby boy, or the real, adult woman screaming in pain mere feet away? Significantly, no one asks Aemma her opinion on the matter.

In fact, she’s surprised and terrified when her husband kneels down beside her, strokes her hair and tells her not to be afraid, and nods to the maester to begin cutting. Aemma will die as the maester performs a medieval Cesarean section on her, slicing directly into her stomach with only as much anesthesia as he could administer “without hurting the child.” (One assumes that Aemma was not consulted on this point, either.) Viserys’ face falls with relief when the maester tells him the child is a boy. The sacrifice was worth it — at least, until the boy dies as well.

Director Miguel Sapochnik begins with a closeup of blood dripping from the maester’s hands, ramping up the gore as he cuts back and forth between the violence of Aemma’s murder-by-surgery and the bloodshed of the tournament happening outside the castle walls — a tourney put on, ironically enough, in the baby boy’s honor. Once the nightmarish act is complete, Sapochnik pulls back for an overhead shot of Aemma’s mutilated body splayed on sheets dark with blood, like a tableau from a horror movie. The gendered juxtaposition of jousting, with its phallic lances and roaring machismo, with the blood and pain of childbirth is very much intentional: Last month, Sapochnik told The Hollywood Reporter, “In medieval times, giving birth was violence. It’s as dangerous as it gets […] We have a number of births in the show and basically decided to give them different themes and explore them from different perspectives the same way I did for a bunch of battles on Thrones.”

In the House of The Dragon premiere, women are the unwilling foot soldiers being sent out on the front lines of men’s battles. Later in the episode, Viserys’ decision to make Rhaenyra his heir is motivated more by his anger towards his brother Daemon Targaryen (Matt Smith) than his faith in Rhaenyra’s abilities. And Otto Hightower (Rhys Ifans) has obvious ulterior motives for sending his daughter Alicent (Olivia Cooke) to the grieving king’s bedside to “comfort” him. (A marriage between Alicent and Viserys would be quite advantageous indeed — for her father.) Both men are putting their reputations and feelings above their daughters’ happiness and safety, because they both see these girls as property that they can do with what they will.

Although it takes place in a fantasy context, this view of women as the property of the men in their lives, who can decide if these women live or die without them having any say in the matter, is very much present in our world. And it’s not a relic of the medieval era, either: It’s a question that’s become terrifyingly tangible in the U.S. in recent months, where the repeal of Roe v. Wade has already led to pregnant people being denied life-saving medical care, risking infection, hemorrhaging, and death because a group of legislators decided to prioritize the possibility that their fetus might outlive them. And it’s long been a reality in countries around the world where abortion has never been accessible.

Like those real-life examples, House of the Dragon shows us what happens when women are treated as vessels and incubators. This is the norm in Westeros, a kingdom whose mores and attitudes are based on the similarly misogynist world of medieval Europe. The creatives behind Game of Thrones have long been criticized for insisting on historical accuracy in this area, but not in, say, the existence of dragons; in that same Hollywood Reporter interview, Sapochnik kicked up his share of online dust by saying that House of the Dragon doesn’t “shy away” from depicting violence against women.

According to its creative team, House of the Dragon — which, as Roxane Gay already pointed out on Twitter, has two male showrunners, and is based on books written by a man — differs from Game of Thrones because it’s coming from a “female perspective.” It seems, in this first episode, that means we’re being set up for a series about soft power, about the behind-the-scenes influence of mothers, daughters, and mistresses on the men who actually get to sit on the Iron Throne. With that in mind, House of the Dragon may be following a similar arc to Game of Thrones, where it breaks down its female characters in order to build them back up later on. And the way that disempowerment — and, presumably, eventual re-empowerment — plays out will say a lot about what the men behind this show think that women’s relationships, ambitions, and inner lives are all about.