What a time for a dramedy about gynecology. With the US Supreme Court preparing to overturn Roe v. Wade and anti-abortion advocates suggesting that forcing people to carry unwanted pregnancies is no big deal, the AMC+ series This is Going to Hurt hits a raw nerve.

Not that This is Going to Hurt is a feminist show. Adapted by Adam Kay from his 2017 memoir about working in the U.K.’s National Health Service, the show stars Ben Whishaw as Adam, an exhausted ob/gyn struggling to do the best he can for his patients in an underfunded London public hospital. The focus is very much on the doctors holding the speculums, rather than the women with legs in stirrups. 

But Kay understands as well as anyone who’s given birth or had gynecological maladies how precarious the medical system is. He’s seen up close the toll that pregnancy can take on the body. Few of us gossip publicly about the aftereffects of childbirth, which can include scars, vaginal tearing, hemorrhoids, infections, and pelvic pain. With my second kid, unnoticed scraps of placenta stuck in my uterus triggered weeks of hemorrhaging.

In the bad old days, which may be coming back, reproductive health got bracketed under the belittling term “female trouble.” Generations of women kept mum about periods, endometriosis, and menopause. So there’s something amazing and liberating about seeing a streaming series that lets the amniotic fluid flow free. Kay has worked as a comedy writer on shows like That Mitchell and Webb Look, but here the humor is so black that it leaves bruises. Whishaw delivers the most mordant punchlines Fleabag-style, directly to the viewer through fourth-wall.

We are Adam’s only confidantes as he stumbles through the gory and gooey pandemonium of his life. He hides his work-related PTSD from his charmingly chill boyfriend Harry (Rory Fleck Byrne) while simultaneously keeping his love life secret from both his hospital colleagues and his mother. The latter is played by the great Harriet Walter, who sharpened her caustic mothering skills on Succession. When Adam finally comes out, she snipes, “I’ve watched you pull your pants down at far too many children’s birthday parties to be fazed by one of your outbursts.”

A scene in the first episode perfectly encapsulates the quirky tone of the series. Having fallen asleep in his car, Adam encounters a pregnant woman outside the hospital. Still dressed in his civilian clothes, he peeks under her dress and finds that she is so ready to give birth that the baby’s hand is sticking out of her vagina. Adam leads her on a panicky, madcap journey through the back halls of the hospital. “Are you a real doctor?” she whimpers. “Fair question, but strangely one you’ve asked me after you let me look at your vagina,” he says witheringly to the camera.

Adam spends his 90-hour work weeks elbow-deep in innards. He’s constantly having to slice open abdomens and pull out infants. Sometimes he’ll get to push a prolapsed uterus back in. So he’s bone-tired and short-tempered when he’s called in for a shift during his best friend’s bachelor party and, as a result, makes a terrible error that will haunt him for the remainder of the season.

This is Going to Hurt sometimes feels like a howl of despair beneath its quippy veneer. Luckily, the howler is played by Whishaw, who has practically has a PhD in playing fragile characters. In this case, it’s a shut-down misanthrope whose righteousness sometimes pushes him over ethical lines. (At one point he punishes a racist patient by sewing up her stomach in a way that deliberately ruins her body tattoo.) Adam survives his toxic workplace with a combo of sarcasm and hostility, passing on the treatment that is heaped on him from above.

The recipient of much of his callousness is Shruti (the fantastic Ambika Mod), a young student doctor he is supposed to be mentoring on the obstetrics and gynecology rotation—the “brats and twats” ward, as he calls it. Trudging through grueling hours of appointments and surgeries while also studying to pass her upcoming exam, Shruti struggles to retain her empathy. She doesn’t always succeed, and she hates herself for it. In some ways, Shruti is the heart of the series, and Adam can’t help but be changed by his relationship with her.

Taking its cue from Kay’s memoir, This is Going to Hurt is set in 2006, which allows it to avoid modern conveniences like iPhones—as well as contemporary horrors like Brexit and Covid, which is overstretching the UK’s health system even further. But the fog of grief, anxiety and sheer weariness through which Adam and Shruti wade feels totally 2022. This remarkable gyne-comedy takes us inside a broken system and offers a chilling glimpse of the real stakes in the reproductive rights conversation. 

This is Going to Hurt makes me wonder why there aren't more series set in the obstetrics ward. Then again,  Amazon has an upcoming remake of Dead Ringers—with Rachel Weisz reinventing the role of twin gynecologists originally played by Jeremy Irons in the David Cronenberg movie. Maybe we are seeing the messy birth of a whole new genre.